NHS foundation trust regulator Monitor today launched a consultation on the licences that will be needed to provide health services in future.
The move follows the government’s changes in the Health and Social Care Act 2012, which include opening up services to ‘any qualified provider’. Monitor’s role is being extended to protect and promote the interests of patients and to ensure that services provided are economical, efficient and effective.
The licences will allow the regulator to collect the information needed to set prices for treatment, safeguard patient choice and introduce a requirement on co-operation, the consultation states.
The new NHS provider licence: consultation document sets out seven ‘continuity of services’ conditions, including a restriction on asset disposal and a co-operation duty in the event of providers going bust.
However, the proposal for providers to have to obtain a credit rating has been dropped. Instead, Monitor will calculate its own risk rating for each provider.
The consultation on the provisions comes after an administrator was appointed to run an NHS trust for the first time earlier this month. South London Healthcare NHS Trust, which operates three hospitals, is now being run by special administrator Matthew Kershaw, the Department of Health’s director of provider delivery.
A ‘risk pool levy’ is also proposed, which would require licensees to contribute towards an insurance scheme to cover special administration costs. Other conditions proposed cover the publication of information, payment of fees, and a fit and proper person test for senior staff.
The consultation, which runs until October 23, asks whether this should include requirements for directors and governors to adhere to standards around personal behaviour, technical competence and business practices.
All licence holders would also have to register with the Care Quality Commission.
Other details in the consultation include proposed pricing conditions. Monitor will be taking over responsibility for setting prices for NHS services, in partnership with the national NHS Commissioning Board. There are five proposed pricing conditions, including a duty to comply with the nationally set prices, and a requirement for ‘constructive engagement’ with commissioners around any local modifications to tariffs.
Conditions relating to competition are also proposed, which Monitor intends will ‘protect and promote patients’ interests’ by supporting choice and preventing anti-competitive behaviour.
There are also options for an integrated care condition, intended to join up services between providers. The three options range from a positive obligation that all steps ‘reasonably regarded as necessary’ for integration should be taken, to a list of proscribed actions. Monitor prefers a third option of a broadly defined prohibition of anything that could reasonably be regarded as detrimental to integrating care.
Monitor intends to issue licences to NHS foundation trusts when the relevant part of the Act comes into force, which is likely to be in April 2013. It is then expected that other providers will need to apply for licences from April 2014, although this has still to be confirmed by the Department of Health.
Dr David Bennett, Monitor’s chair and interim chief executive, said: ‘Today we have launched an important consultation explaining our proposals for how NHS providers will be regulated and services protected for patients in the future.
‘Patients, NHS staff and organisations interested in how NHS-funded services are provided and commissioned can now influence how an important part of the government’s NHS reforms will be implemented. I urge everyone to get involved with this consultation so we can ensure that NHS services are provided in a way which delivers the best possible results for patients.’
