NHS Providers response to NHS Improvement's consultation on oversight of NHS-controlled providers
This consultation covers proposed changes for how NHS Improvement oversight would operate in the future. We have a number of comments about the proposals and we would highlight that the repeated references to ‘organisations controlled by NHS Providers’ throughout the consultation has the potential to cause confusion about the scope of the proposals by implying that NHS trusts are captured by the new proposals.
Key messages include:
- We recognise that the proposals put forward are intended to ensure that emerging new care models are appropriately captured by the regulatory system, with the aim of mitigating the risk of provider organisations falling through the gaps of regulation and the potential risk to the system and the provision of high quality care that this could create. We also recognise that there may be consideration for this additional level of scrutiny if control is shared across two or more foundations.
- However, it is important to recognise that the proposals amount to a significant shift in the current system architecture, in effect amounting to the recognition by NHS Improvement of another type of entity in the NHS system beyond NHS trusts and foundation trusts.
- We also believe that in a number of instances there are likely to be strong ties between subsidiaries and joint ventures and their parent organisations which call into question the extent to which it is feasible or practical to treat the latter as free agents in the system for oversight and accountability purposes.
- Consideration must be given to the level of additional regulatory burden that these proposals would bring and the impact on frontline care and resources available for investment into services.
- The proposals potentially affect the equal standing of NHS foundation trusts that have set up such joint ventures or subsidiaries and private providers, as the latter would benefit from the greater flexibility in terms of the oversight they are subject to. We do not believe that the need to maintain a level playing field between ventures entered into by foundation trusts, such as the establishment of joint ventures or subsidiaries, and private providers has been satisfactorily taken into account in considerations of the proposals.
- Should NHS-controlled providers be recognised and overseen in the same way as foundation trusts (FTs) and trusts through the Single Oversight Framework (SOF), there is a need for NHS Improvement to provide further clarity as to which parts of the SOF will apply to these providers.
- Finally we would be concerned if the proposed extension of oversight to NHS-controlled providers would create an unfair competitive advantage to private providers to deliver these services.