Independent panel backs ICB plan to replace GP OOH provider with private company

An ICB will go ahead with its plans to replace a ‘trusted’ not-for-profit company led by GPs with a private out-of-hours (OOH) provider, after an independent panel backed this decision.

Shropdoc, which is a cooperative of over 200 GP members in Shropshire and Powys, has run OOH services in the area since 1996.

But earlier this year, Shropshire, Telford and Wrekin (STW) ICB revealed its intention to award the new five-year OOH GP contract, worth over £32.5m, to the Wiltshire-based company Medvivo.

Shropdoc challenged this decision in February, leading to an extension of the usual procurement ‘standstill period’ and the challenge was accepted for review by NHS England’s independent patient choice and procurement panel.

Now the panel has completed its review of the process and recommended the ICB should proceed with awarding the contract to Medvivo.

In its representation to the panel, Shropdoc argued that there were ‘fundamental breaches’ of regulation, including Provider Selection Regime (PSR), the NHS Act 2006 and the principles of transparency, proportionality, and fairness underpinning public procurement law.

It said: ‘The ICB failed to meet its obligations under Regulation 4 of the PSR and Section 242 of the NHS Act 2006 by not properly consulting with GPs during the pre-procurement stage.

‘GPs were not treated as stakeholders with critical insights into how services are delivered or how proposed changes might affect clinical practice, service safety, and workforce planning.

‘The use of public engagement surveys from a patient perspective does not amount to meaningful consultation of GPs.

‘Despite the conclusions made in its panel report, the ICB itself acknowledged the service was unchanged in scope or delivery model so the contract value increase was 23%, below the 25% required.’

But the panel found that the ICB ‘did not breach its obligations’ nor the PSR regulations.

The panel report said: ‘Given the panel’s findings that STW ICB acted in accordance with the PSR Regulations, the panel advises STW ICB to proceed with the proposed contract award as originally intended.’

Campaigning group Shropshire Defend Our NHS, who had raised concerns about the plans and gathered thousands of signatures as part of a petition against the decision, said: ‘There is devastating news today. Shropdoc’s appeal against the decision of our health bosses to award the GP out-of-hours contract to Medvivo has been unsuccessful.

‘This outcome, delivered by the NHS Independent Patient Choice and Procurement Panel, is nothing short of disgraceful.’

Shropdoc told Pulse that they are still within a legal standstill period until midnight on 11 July and they are unable to provide any detailed response at this time.

A spokesperson said: ‘We note the recent publication of the GP Out of Hours service procurement outcome and the NHS Independent Patient Choice and Procurement Panel’s report.

‘As we are currently within a legal standstill period until midnight on July 11th, we are unable to provide any comment or formal statement.’

The ICB said that the findings (see box) confirm it acted ‘in full accordance’ with regulations, conducting a ‘transparent, fair and proportionate procurement process’ in ‘full compliance’ with statutory and legal requirements.

The ICB previously denied that its decision was a ‘cost-cutting exercise’, despite its financial reports suggesting otherwise.

A Pulse analysis of the ICB’s publicly available financial information has revealed that in 2024/25 Shropdoc was set to be paid almost £1m more than the proposed annual value of Medvivo’s contract award.

The ICB’s director of commissioning Gemma Smith said: ‘We welcome this report and remain committed to delivering a high-quality, value-for-money out-of-hours service that meets the needs of local communities.

‘This outcome reflects the dedication and hard work of everyone involved throughout this complex process. We thank the panel for their thorough review and will now carefully consider the full report.’

Pulse has contacted Medvivo for comment.

The panel’s findings

In summary, the Panel’s findings on the provider selection process carried out by STW ICB for the GP OOH service in Shropshire, Telford and Wrekin are as follows:

First, the Panel finds that STW ICB, in conducting pre-procurement consultations, did not breach its obligations under Regulation 4, and in particular its obligation to secure the needs of people who use the services, improve the quality of services and improve efficiency in the provision of services, and its obligation to act transparently, fairly and proportionately.
Second, the Panel finds that STW ICB, in not including the CCCSPA service in the Prior Information Notice, did not breach the PSR regulations, and in particular its obligation under Regulation 4 to act fairly.
Third, the Panel finds that STW ICB, in relation to pre-procurement consultation on the CCCSPA, did not breach the PSR regulations, and in particular its obligations under Regulation 4 to secure the needs of people who use the services, improve the quality of services and improve efficiency in the provision of services, and to act transparently, fairly and proportionately.
Fourth, the Panel finds that STW ICB provided limited information in the tender documentation on the specific KPIs that would be implemented, but did not breach the PSR regulations, and in particular its obligation under Regulation 4 to act transparently, fairly and proportionately.
Fifth, the Panel finds that STW ICB, in evaluating the financial aspects of Medvivo’s proposal, did not breach the PSR regulations, and in particular its obligation under Regulation 4 to act with a view to securing the needs of the people who use the services.
Finally, the Panel finds that STW ICB, in deciding to use the competitive process, did not breach the PSR regulations, and in particular its obligations under Regulation 6, which sets out the conditions governing commissioners’ choice of provider selection process. The Panel also finds that STW ICB, by providing information to Shropdoc in response to its request for information about the choice of provider selection process, did not breach its obligations under the PSR regulations, and in particular its obligations under Regulation 12(4).

Source: Independent patient choice and procurement panel review