On 21 May 2012, the Secretary of State wrote to Monitor asking us to undertake "an independent review of matters that may be affecting the ability of different providers of NHS services to participate fully in improving patient care."
The purpose of the Fair Playing Field review was to examine whether there are matters that mean not all NHS-funded health care providers operate on an equal footing and if so, whether something can be done that would address these issues and result in significant benefits for patients.
The review deliberately started with a very broad scope, and was open to looking at any problem raised. It covered all types and different sizes of providers, including NHS Trusts, Foundation Trusts, social enterprises, voluntary and community sector providers and for profit providers.
In terms of services, the scope of the review extended to the provision of clinical services funded by the NHS in England. This included primary care, secondary and elective care, mental health services and community based care. There were instances where we looked at fair playing field issues that arose in relation to non-clinical services that had a significant impact on clinical services, for example, clinical education and training.
The final report includes recommendations to the Secretary of State for Health as to how government, commissioners and regulators might address differences in the treatment of providers of NHS funded care. The review identified the key issues, makes recommendations for their improvement, and identifies areas of further work.
The terms of reference of the Fair Playing Field review can be found here.
The Board of Monitor is accountable for the contents of the review. Monitor's Executive team directed the review drawing upon external resources in its production. The review reported at appropriate points to a Department of Health chaired steering group. The steering group included representatives of the NHS Commissioning Board, HM Treasury and other Government departments.
The terms of reference of the steering group were broadly to:
The full terms of reference of the steering group can be found here.
Gathering a broad range of views from across the health sector was fundamental to the project in order to identify and define the issues, collate the evidence base and help shape our final recommendations. There were six main channels of engagement:
The final report we submitted to the Secretary of State for Health in March 2013 can be found here.
Research shows commissioning and tendering is a major concern for providers
Initial findings published in Monitor's Fair Playing Field review show the commissioning of patient services has been the most common complaint made so far by respondents.
Monitor asked by Secretary of State to conduct Fair Playing Field review
Monitor launches an independent review of matters that may be affecting the ability of current and future providers of NHS services to participate fully in improving patient care.