Choice and Competition framework

The Health and Social Care Act 2012 requires commissioners to ensure good practice and promote and protect patient choice.

Choice and competition are amongst many tools that a commissioner may decide to use to improve services for patients. It will be for commissioners to decide if, when and how to use competition. Commissioners will need to act transparently and be able to demonstrate the rationale for their decisions in terms of patient interests.

The Act also sets the parameters on choice and competition within which Monitor and NHS England (previously known as the NHS Commissioning Board) will work.

  • Monitor must exercise its functions with a view to preventing anti-competitive behaviour in the provision of health care services for the purposes of the NHS that is against the interests of people who use such services.
  • NHS England must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

What are Monitor and NHS England doing about these issues?

In its June 2011 report, Choice and competition – delivering real choice, the NHS Future Forum highlighted the role of competition in the NHS as a tool for commissioning clinical services where it serves the interests of citizens and the choices they wish to make. Monitor and NHS England are working in partnership to develop a Choice & Competition website and have published a note setting out how the website will help commissioners and providers understand where competition may deliver improved outcomes for patients.

Co-developed with commissioners and providers, the Choice & Competition website will bring together for the first time in one place all of the key material that has a bearing on choice and competition in the NHS in England. Consistent with the principle that it is for commissioners to decide if and when to introduce choice or use a competitive procurement process, the website will evolve as experience and evidence grow over time, sustaining an absolute focus on improving patient outcomes above all else.

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