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Procurement, choice and competition in the NHS: documents and guidance

Guidance and information about NHS procurement, choice and competition for healthcare providers and commissioners.

The rules that govern procurement, choice and competition in the NHS are set out in:

Monitor’s role is to make sure that procurement, choice and competition operate in the best interests of patients and to step in if anti-competitive behaviour by NHS commissioners or providers goes against patients’ interests.

For more information about Monitor’s role read the updated publication ‘About Monitor: an introduction to our role.’

Contact Monitor

Find out how to contact Monitor for informal advice or to make a formal complaint.

  1. NHS procurement, choice and competition: ask a question or make a complaint

    • Detailed guide
  2. Integrated care: ask a question or make a complaint

    • Detailed guide

Guidance

The following documents include rules and guidance relating to procurement, choice and competition and Monitor’s approach to enforcing them.

  1. Procurement, patient choice and competition regulations: guidance

    • Statutory guidance
  2. NHS healthcare providers: working with choice and competition

    • Guidance
  3. Choice and competition: hypothetical scenarios for NHS healthcare providers

    • Guidance
  4. Integrated care licence condition: guidance for providers of NHS-funded services

    • Statutory guidance

Formal investigations

This is a list of current and closed investigations undertaken by Monitor under the procurement, choice and competition regulations.

For formal investigations undertaken by the Co-operation and Competition Panel (from 2009 to 2013) please visit the National Archives’ website.

  1. Case: Investigation into the commissioning of elective services in North East London

    • Notice
  2. Case: Investigation into the commissioning of complex adult community services in East Devon

    • Notice
  3. Case: Investigation into the commissioning of elective services in Blackpool, Fylde and Wyre

    • Notice
  4. Case: Investigation into the commissioning of radiosurgery services in Yorkshire and Humber

    • Decision
  5. Case: Investigation into the commissioning of cancer services in Manchester

    • Decision

Projects

Information on projects carried out by Monitor.

  1. Improving GP services: commissioners and patient choice

    • Research and analysis
  2. Exploring how choice is working in NHS adult hearing services

    • Consultation outcome
  3. NHS walk-in centre services in England: review

    • Research and analysis
  4. General practice services: research project

    • Consultation outcome

Mergers

Advice and guidance on mergers.

For merger cases conducted by the Co-operation and Competition Panel (from 2009 to 2013) please visit the National Archives’ website.

  1. Supporting NHS providers considering transactions and mergers

    • Guidance
  2. Supporting NHS foundation trusts considering a merger: proposed approach

    • Consultation outcome
  3. Assessing public hospital mergers

    • Guidance
  4. Merger rules: how they affect pathology service reconfigurations

    • Guidance
  5. Merger benefits for NHS foundation trusts: Monitor's draft guidance

    • Consultation outcome
  6. Reviewing mergers involving NHS trusts and NHS foundation trusts

    • Guidance
  7. Advice to the Competition and Markets Authority (CMA) on the relevant customer benefits of an anticipated pathology joint venture in south east England

    • Guidance
  8. Merger of pathology services of Southport and Ormskirk Hospital and St Helens and Knowsley Teaching Hospitals

    • Notice
  9. Heatherwood and Wexham Park Hospitals NHS Foundation Trust: advice on proposed merger

    • Guidance
  10. Case: Proposed merger of University Hospitals Bristol and North Bristol NHS Trust

    • Decision
  11. Case: Proposed merger of Royal Free and Barnet and Chase Farm Hospitals

    • Decision
  12. Neurosurgery at the Royal Free and UCLH: advice on transfer of services

    • Guidance
  13. Brighton and Sussex and Surrey and Sussex pathology services: advice on proposed merger

    • Guidance