A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

Board of Directors – Part I14 th June 2013There are a number of factors that commissioners are expected to take account ofincluding;• Evaluate and identify the health needs of the population• Take a holistic view of the needs of the health care users• Consider the needs of all users (vulnerable, socially excluded, settings, sustainabilityincluding the impact of a procurement decision on a provider’s capacity to continueother services)• Monitor the quality and efficiency of existing service provision• How health needs might be best secured (including safety, volume of work forclinicians)The above may include consultation processes with local clinicians, out of area expertsand utilise relevant clinical guidelines and best practice, but it does not mention consultinglocal or existing providers. This would therefore be an area to pursue by way ofresponding to their questions.Procurements are expected to be undertaken in a transparent, proportional and nondiscriminatoryway and commissioners should “consider appropriate ways of improvingservices including through services being provided in a more integrated way, enablingproviders to compete to provide services and allowing patients a choice of provider”The section on transparency, as it relates to procurement, indicates that in judgingcommissioner compliance, Monitor would consider the extent to which commissionershave:• Published information on their future procurement strategies and intentions• Taken steps to ensure that providers are aware of their intention to procure particularservicesThese would be of particular interest to us since it has been difficult to get advanceinformation from Commissioners.There is a section which provides guidance as to the interaction between competition,choice and integrated care. –“…commissioners to consider whether introducingcompetition and choice and delivering care in a more integrated way could be used toimprove quality and efficiency.” Enacting the guidance seems to be firmly with thecommissioners and it will be left to them to make judgments based on statements such asthat above. Much of the guidance will inevitably end up being tested by lawyers. A keyissue that arises throughout the guidance on integration and cooperation is that of sharingclinical records.The need to publish contract opportunities for NHS services is examined and inparticular circumstances are described where it may be appropriate to award a contractwithout publishing a contract notice – “single capable provider”.Qualification of providers (e.g. Any Qualified Provider) is covered in a separate sectionand this applies to services other than in the context of a competitive tender. It providedguidance on transparency, non-discrimination and proportionality.Monitor Guidance on Procurement Patient Choice and Competition Regulations Page 2 of 4For Information