Securing best value for patients: Requirements for commissioners to adhere to good procurement practice and protect patient choice covers procurement, patient choice, anti-competitive conduct, conflicts of interest and Monitor.
The 41-page document, published on Wednesday, invites responses until the 26 October closure date.
It says: ‘Commissioners’ most important task will therefore be to secure best value from limited resources. Commissioners will need to find ways to do more with their budgets. Simply doing the same things in the same way will not be affordable in the future.
‘They will need to harness new ways of delivering care and secure the best value services from the most efficient providers. Failure to meet these challenges would inevitably mean reduced access to services, poorer quality and growing dissatisfaction with the system.’
It says: ‘Commissioners may establish qualification criteria that providers would have to meet in order to be ‘qualified’ to list services on a menu of choices to be made available to patients.
‘Like the current rules, we propose to enshrine as an overarching principle that commissioners should use the providers who are best capable of meeting patients’ needs and delivering value for money, whether they are from the public, private or voluntary sectors.
‘This does not mean that commissioners should pursue competition as an end in itself or seek to increase the market shares if particular providers, but rather that commissioners should be able to demonstrate that they have considered alternative options in determining which providers offer best value.
‘We wish to ensure that commissioners do not discriminate unfairly between providers, for example, by preventing voluntary and independent providers bidding for contracts’
‘Monitor would be able to consider complaints that a commissioner has taken action which is inconsistent with a patient’s right to choose.’
Preventing anti-competitive conduct
‘We therefore need to avoid restricting competition where this would erode best value by allowing poorer providers to maintain lower standards of care.
‘We recognise that there are circumstances where commissioners might legitimately seek to restrict competition, for example, where this is indispensable to ensure that individual providers achieve minimum volumes of surgical procedures to ensure patient safety.
‘They will need to be able to demonstrate that they have duly considered the available alternatives, based on objective criteria.
‘If commissioners decide to make arrangements which materially restrict competition, they will need to be able to demonstrate that these are in patients’ interests.
‘Commissioners will need to be able to demonstrate that the restrictions to competition are indispensable for delivering the intended benefits.’
Managing conflicts of interest
‘Interested parties will be able to appeal to Monitor where they believe that commissioners have failed to act transparently in the procurement of services or that private interests have affected their decisions.’
‘Monitor will be able to investigate complaints from any interested parties including providers, associations of providers, patient groups or individual patients.’