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Review: Fair Playing Field – for the benefit of patients

Health Sector Regulator, Monitor, yesterday launched 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.  Monitor is requesting initial submissions to provide early evidence to the review.

The purpose of the review is to examine whether there are matters that mean not all NHS-funded healthcare providers operate on an equal footing – and if so, whether something can be done that would address problems and result in significant benefits for patients. So the review aims to identify barriers to a fair playing field, and possible solutions which would protect and promote the interests of patients.  The review will start with a very broad scope, will cover all types and different sizes of providers and be open to looking at any problem raised.

The review is being conducted at the request of the Secretary of State for Health.  It will help the Secretary of State meet the requirement under the Health and Social Care Act to report to Parliament in March 2013.  We expect that the final report may include recommendations to Government and other regulators as to how any differences in the treatment of providers of NHS funded care could be addressed.  Given the breadth of the review, and the time and resources available, the final review is also likely to recommend areas for further work. 

Monitor's Chairman David Bennett said:

"Monitor welcomes the opportunity to undertake this important work which has the aim of improving services to patients at its heart.

"We will be looking to gather a range of views from providers, commissioners, patients and experts to inform our investigations into the factors which enable providers to operate on an equal footing, and to advance our thinking about how a system which best promotes and protects the interests of patients can be achieved."

Notes to editors

  1. Monitor has today called for initial submissions to consider the range of areas in scope for the review, the key issues and the scale of patient detriment.  Submissions or stakeholder queries should be sent to
  2. Media queries should be directed to Isabella Sharp 020 7340 2442
  3. Matters that have already been raised as areas which might prevent some providers from operating on an equal footing with others include:

    - Corporation and value added tax
    - NHS staff contracts and pensions
    - Payment systems
    - Barriers to exit
    - Teaching and training for clinical staff
    - Incumbency advantages
    - Costs of capital
    - Access to capital
    - Information and IT
    - Insurance
    - Tendering and commissioning behaviours

  4. The review has the following timetable:

    - Call for initial submissions: 14 June 2012
    - Deadline for initial submissions: 6 July
    - Call for evidence: July
    - Stakeholder workshop events: July, August, September

    The rest of the timetable will be confirmed after we have reviewed initial submissions and spoken to interested parties. The review will report to the Secretary of State for Health in early 2013 and be published shortly afterwards.  The Secretary of State will then publish a report to Parliament.

  5. The review will be advised by a steering group, chaired by the Department of Health and including representatives from other Government Departments and the NHS Commissioning Board.
  6. David Bennett’s letter to the Secretary of State and the call for submissions can be found here

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