Feature Commissioning

A healthy market? Lack of transparency raises doubts about NHS commissioning

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7115 (Published 04 December 2013) Cite this as: BMJ 2013;347:f7115
  1. Jane Deith, freelance journalist
  1. 1Oxfordshire, UK
  1. janedeith{at}yahoo.co.uk

At least £6bn worth of work is out to tender in England’s NHS. But in the “arms race” between commercial providers vying for NHS contracts, there is much secrecy around how these contracts are awarded and how they’re really performing, reports Jane Deith

In Cambridgeshire the biggest ever NHS contract is up for grabs: an £800m (€960m; $1.3bn) five year deal to provide services for older people, including palliative care. Nine bidders—from NHS foundation trusts to outsourcing giants Serco, Virgin, and Circle—are through to the final round of the competition.

Patient groups in Cambridgeshire know that the clinical commissioning group is under pretty strict instructions to select the provider who is “best value for money.” They want to scrutinise the tender from start to finish, by which time the process will have cost £800 000. What exactly are the commissioners including in the tender? What are their criteria for success?

But ask to see the tender specification and you’ll be disappointed. “Because we are in a procurement process it makes it difficult to release information. Previously a specification would have been produced and put out. What we are doing is testing the ideas from all these bidders to bring into a spec which will be a tangible document. That will come out through the procurement process,” says Neil Modha, a general practitioner and member of the Cambridgeshire and Peterborough Clinical Commissioning Group.

So nothing’s written down on paper. For now it seems we just have to trust the commissioners to get this contract right.

Freedom of information?

NHS history tells us that with a commercial contract comes commercial confidentiality. When the contract to run community health in Suffolk was put out to tender, it went to Serco. But NHS Suffolk, which awarded the three year contract, refused to reveal how low Serco had bid, …

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