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

Board of Directors – Part I14 th June 2013There are sections in the guidance on record keeping and the opportunity forcommissioners to obtain support from Commissioning Support Units or from othersources such as the private or voluntary sectors.Conflicts of InterestThere is a significant section on conflicts of interest, in particular where individuals areinvolved in commissioning and potentially the provision of a service. The documentrecognises that this can be direct or indirect and financial or non-financial. It alsorecognises that can affect all stages of a procurement process from specificationdevelopment to contract award.Other than excluding conflicted individuals from the procurement process there are otherways suggested, including use of out of area GPs or independent lay persons. It alsosuggests that decisions taken could be subject to an independent review by a third partyand that the processes of how these are being managed should be full recorded.Anti-Competitive BehaviourThere is a short section on anti-competitive behaviour by commissioners. The process forMonitor assessing whether a commissioner has acted anti-competitively envisagesweighing the costs and the benefits of the commissioner’s procurement process andassessing the net effects of these on users of health care services. Monitor may considerwhether a commissioner has:• “…limited the extent to which providers are able to compete by limiting the totalnumber of patients a provider can treat or income a provider can earn…”• “…restricted the ability of providers to differentiate themselves to attract patients,such as, for example, by imposing minimum waiting times that providers must adhereto or restricted opening hours, without objective justification…”The final section of the Compliance document relates to the commissioner responsibility tooffer patient choice. The part of this that affects us relates to maximum waiting times inelective care. This supports existing requirements such that where a patient that hasbeen referred for elective care will not have commenced treatment within 18 weeks of areferral being received the commissioners are required to take all reasonable steps toensure that a patient is offered an appointment with a clinical appropriate alternativeprovider.3. Enforcement of the RegulationsThe other guidance published in addition to the above is the enforcement guidanceassociated with the same Procurement, Patient Choice and Competition Regulations.This covers the steps that Monitor would take on being informed of a potential breach ofthe guidance by a commissioner. These steps include;Monitor Guidance on Procurement Patient Choice and Competition Regulations Page 3 of 4For Information