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Government reveals plans to increase competition under ‘any qualified provider’

GPs will have to offer patients a choice of providers when they refer them to mental health or community services, under Government plans to ramp up competition in the NHS published today.

Under the guidance to extend Any Qualified Provider, PCT clusters and commissioning groups will have to choose three community or mental health services from a list provided by the Department of Health to implement AQP.

The list includes adult psychological therapies, diagnostics in the community, musculoskeletal services and podiatry services. Alternative services can be chosen if there is thought to be a higher priority in the community.

When patients are referred by GPs, they will be offered a choice from the list of qualified providers, which the Government hopes will drive up competition in the health service.

AQP is one of the most controversial aspects of the Government's health reforms, with opponents saying it will open up the NHS to private providers. However, ministers were given the green light for the policy by the NHS Future Forum who said many independent providers were ‘currently providing excellent services that people choose to use.'

PCT clusters and GP consortia have to choose the three community or mental health services they intend to use by this September, and implement AQP in April to September 2012.

A further extension of AQP will occur in 2013/14, with suggested areas including maternity services, speech and language therapy, self management of long term conditions and chemotherapy.

In an open letter to PCTs and commissioning leaders the Government's commissioning tsar Dame Barbara Hakin said: ‘We are confident that in taking this work forward, together, we can use patient choice of provider as a lever to improve access to services, and offer the best quality services to meet individual patient needs.'

BMA chair Dr Hamish Meldrum said patient choice under these proposals would be 'limited' by budgetary constraints.

'We would question is the assumption that increasing competition necessarily means improved choice. When competition results in market failure in the NHS, the ultimate consequence is the closure of services, and the restriction of choice for the patients who would have wished to use them,' he said.


List of suggested areas for AQP

• Musculo-skeletal services for back and neck pain

• Adult hearing services in the community

• Continence services (adults and children)

• Diagnostic tests closer to home such as some types of imaging, cardiac and respiratory investigations to support primary assessment of presenting symptoms

• Wheelchair services (children)

• Podiatry services

• Venous leg ulcer and wound healing

• Primary Care Psychological Therapies (adults)


Source: Department of Health