1. www.gov.uk/monitor The future of commissioning 23 June 2015

2. Presentation today Monitor’s role in regulating commissioning The current regulations: a framework for change –What lessons can be learned from Monitor’s approach to the regulations? How do the regulations fit together and do they impose new obligations? Achieving the vision of the Forward View – new challenges and responses 2

3. Monitor is the healthcare regulator for England 3 Provider Appraisal Make sure public providers are well-led Make sure essential services are maintained Make sure NHS payment system promotes quality and efficiency Make sure choice and competition operate in the best interests of patients 123 4 Pricing Co-operation and competition Provider Regulation Our job is to protect and promote the interests of patients by ensuring that the whole sector works for their benefit

4. Procurement, Patient Choice and Competition Regulations (section 75) 4 Commissioners must secure the needs of patients who use services and improve the quality and efficiency of those services The objective that commissioners must pursue:

5. Choice, competition and integration 5 How do you go about improving services? What can you do to ensure services are provided in an integrated way? Do or should patients have a choice of provider for any of these services? Can you achieve a better outcome by enabling providers to compete?

6. 6 Commissioners & patients selecting provider(s) that best meet their need Payment system links provider revenue with performance Well-run providers - responding to the needs of commissioners & patients The rules are a framework to drive change Commissioners have a key role to play in achieving the vision of the Forward View The regulatory framework provides a framework for change and we want to help commissioners overcome the barriers they face

7. How do the regulations fit together? There are currently three different regimes that commissioners need to take into consideration when procuring health care services for the purposes of the NHS: the new European Procurement Directive (2014/24/EU) will apply to NHS health services from April 2016 7 The regulations do not impose any one way to procure services and commissioners need to consider a range of options NHS (Procurement, Patient Choice and Competition) Regulations 2013 Public Contract Regulations 2006 Treaty on the Functioning of the European Union (where there is a cross-border interest)

8. Innovation is presenting new challenges for us all to address 8 How do we value and safeguard patient choices in more integrated models of care? How do we get the right balance between stability in longer contracts and building improvement into the system? How do we achieve effective joint commissioning? ? We are working with commissioners to resolve issues like these and will make our advice available to all

9. Contact us for advice Visit our website: https://www.gov.uk/monitorhttps://www.gov.uk/monitor Write to:Cooperation and Competition Directorate Monitor 3rd Floor Wellington House 133-155 Waterloo Road London SE1 8UG Email: cooperationandcompetition@monitor.gov.ukcooperationandcompetition@monitor.gov.uk Telephone: Luke Dealtry on 020 3747 0228 Our publications: https://www.gov.uk/government/collections/procurement-choice-and-competition-in-the- nhs-documents-and-guidance

10. Questions and discussion