The new provider landscape
The reforms will affect providers, including NHS and non-NHS providers of care. Some of this will happen indirectly through the changes to the commissioning system, as the new commissioning bodies may want to work in new ways. The reforms also emphasise patient choice which will also likely increase the amount of competition in the NHS, and a focus on outcomes rather than processes.
The main changes relating directly to providers are:
- All NHS trusts will be expected to become foundation trusts, with a new Trust Development Agency set up to help them achieve this safely.
- All providers of NHS-funded services (with the possible exception of very small providers) will need to get a co-licence from Monitor (who consider the financial sustainability of providers) and CQC (who looks at quality).
- The intention is that NHS providers will be allowed to fail if they cannot remain financially viable or provide safe care, though the provision of essential services they provide will be maintained so that patients being treated are unaffected.
- FTs can now earn up to 49% of their income from private sources.
RCN resources
Many of the resources on this page are available in PDF format [see how to access PDF files]. Please note: NHS England was known as the NHS Commissioning Board until 1 April 2013, so some resources may use the organisation's original name.
Foundation trusts:
Other types of provider organisations:
- Download the RCN briefing The independent sector in health and social care in England in 2009 and prospects for the future (PDF 301KB).
- Download the RCN briefing on social enterprise and mutual organisations in the delivery of NHS-funded health care (PDF 164KB).
- Download Nurse entrepreneurs – turning initiative into independence (PDF 679KB).
Choice and competition:
- Information on the section 75 regulations on procurement, patient choice and competition.
- Download the RCN briefing on competition in the NHS in England (PDF 72KB).
- Download the RCN briefing on price and competition in health care in England (PDF 218KB).
System regulation:
- Download the RCN briefing on the NHS failure regime (PDF 422KB).
- Download the RCN briefing on the new role of Monitor (PDF 177KB).