No, non-NHS providers, for example independent, voluntary, community, or social enterprise sector providers are not considered relevant authorities under the PSR, so do not need to apply the PSR.

Social care services are not in scope of the PSR and must be procured using the Public Contracts Regulations 2015 (or after 24 February 2025 the Procurement Act), unless they also contain a component of health care services.

Where there is a mix of health care and social care services, then these may be procured under the PSR if they meet the requirements for a mixed procurement under Regulation 3 of the Health Care Services (Provider Selection Regime) Regulations 2023.

The PSR applies only when relevant authorities arrange health care services in England. From 24 February 2025, the Procurement Act will replace the PCR. The Procurement Act does not apply to contracting for health care services by these relevant authorities.

For example, the Procurement Act applies to the procurement of goods (e.g. medicines or medical equipment) and services delivered by relevant authorities that are out of scope for the PSR (e.g. cleaning, catering, consultancy, estates) – unless these services are part of a mixed procurement that is covered by the PSR. The Procurement Act also applies to the procurement of health care services when procured by public bodies and organisations that are not relevant authorities under the PSR.

SEND health care services are in scope of the PSR. But education and social care services are not in scope of the PSR, so if these are arranged alone the PSR must not be used.

If the services being arranged involve health care services and other goods or services, it may be considered a ‘mixed procurement’ if it meets the requirements for mixed procurement.

Patient transport services delivering a regulated activity (for example, those that require Care Quality Commission (CQC) registration) are in scope of the PSR. Patient transport services delivering an activity that does not require CQC registration are out of scope of the PSR. Where both regulated and unregulated activity is commissioned, the relevant authority must consider whether the mixed procurement provisions apply.

Relevant authorities under the PSR will need to ensure they are prescribed under the NHS Bodies and Local Authorities Partnership Arrangements Regulations 2000 before making arrangements under those powers.

An agreement made under section 75 of the National Health Services Act 2006 for partnership arrangements between NHS bodies and local authorities can include arrangements for pooling resources and making arrangements for the exercise of certain NHS and local authority health-related functions (including certain commissioning functions) by the other partner(s). These arrangements are often used to integrate health and social care services. Where services are commissioned under these partnership arrangements, they must be arranged under the PSR if the services arranged are health care services, or if they meet the PSR requirements for mixed procurements.

NHS England and integrated care boards (ICBs) may choose to use part of their general allocation to make grants. A grant does not require the grantee to deliver any services or goods and therefore does not constitute a contract for health care services. Awarding of such grants does not fall within the scope of the PSR.

If the ICB does require the delivery of a service as part of that grant, then it is not a grant, it is a contract and the PSR must be applied.

The PSR does not set out any expectations about whether relevant authorities should lot their contracts or framework agreements, but there is nothing that prevents services being lotted. If services are lotted, there will be a need to consider the relevant decision-making process for each lot.

Relevant authorities are advised to consider whether lotting is a suitable way of approaching the procurement.

Existing Procurement Policy Notices (PPNs), issued before 1 January 2024, do not apply to PSR procurements.

Future PPNs will clearly set out whether, and the extent to which, they apply to PSR procurements.

Up-to-date information can be found on the NHS Provider Selection Regime website.

Relevant authorities can read and familiarise themselves with the regulations and the guidance. The guidance provides detailed information about how to comply with the new regime.

Relevant authorities can also access the PSR toolkit implementation products, which provide further support about the application of the PSR.

In addition, relevant authorities are advised to consider whether:

• current contract expiry dates are fully understood, so that planning for contract renewals can be carried out well in advance;
• conflicts of interests are effectively identified and managed in advance of the PSR coming into force;
• plans for record keeping requirements are in place;
• the new requirements for the publication of transparency notices on the FTS website are understood – the FTS guide can help with this;
• the key criteria are understood, including the types of evidence that may be used; and
• their market knowledge of the provider landscape is up to date and how they will continue to maintain this

Each procurement process must be run, and award decisions must be made, under the law as applicable at the point at which that process began. The Public Contracts Regulations 2015 (PCR) and the Procurement, Patient Choice and Competition Regulations 2013 (PPCCR) continued to apply until 1 January 2024.

Therefore, if a procurement exercise was commenced under the PCR/ the PPCCR, then it must be completed under those rules. This applies even if the process is ongoing and completed after the PSR took effect.

Relevant authorities that have commenced a procurement process under the PCR but wish to re-start that procurement process using the PSR should first formally abandon the procurement process in accordance with the PCR/the PPCCR. The relevant authority must then re-start the procurement process from the beginning under the PSR rules. We recommend that any relevant authorities considering this should take legal advice before doing so – so that they may consider the risks of such an action, and whether they can lawfully abandon their original process under the PCR.

Contracts called off from a framework agreement established before the PSR came into force must be called off using the process described in the framework agreement (which would have been based on the PCR and/or PPCCR).

The Provider Selection Regime (PSR) must be used by the relevant authorities to which it applies – these are: integrated care boards (ICBs), NHS England, local authorities, combined authorities, NHS trusts and foundation trusts. The PSR applies to the contracting of health care and public health services by relevant authorities irrespective of who the provider is (i.e., whether the service is provided by NHS providers, other public sector bodies, local authorities, or providers within the voluntary, community, social enterprise (VCSE) and independent sectors). This means that an NHS trust will have to follow the PSR when procuring healthcare services, even once the Procurement Act comes into force. Healthcare services in scope of the PSR will be out of scope of the Procurement Act, except for where relevant authorities are applying the exclusions under Schedule 6 of the Act (from 24 February 2025).

Relevant authorities will however have to apply the Procurement Act for the procurement of all other (non-health care) services and goods. For example, the Procurement Act will apply to the procurement of goods (e.g., medicines or medical equipment) and services delivered by relevant authorities that are out of scope for the PSR (for example – cleaning, catering, consultancy, estates etc.) – unless these services are part of a mixed procurement that is covered by the PSR. The PSR must be used by the relevant authorities to which it applies – these are: ICBs, NHS England, local authorities, combined authorities, NHS trusts and foundation trusts. The PSR applies to the procurement of health care and public health services (as defined in the Health Care Services (Provider Selection Regime Regulations 2023) by relevant authorities irrespective of who the provider is (i.e., whether the service is provided by NHS providers, other public sector bodies, local authorities, or providers within the voluntary, community, social enterprise (VCSE) and independent sectors). This means that (subject to the rules on mixed procurements) an NHS trust will have to follow the PSR when procuring health care services, even once the Procurement Act comes into force. Health care services in scope of the PSR will be out of scope of the Procurement Act.

Relevant authorities may consider organising market engagement events, roundtables or meet the buyer days as part of their pre-market engagement exercises. However, this is not a requirement of using the most suitable provider process, and relevant authorities may also choose to undertake more strategic commissioning activities that help to build an understanding of the potential providers in their area and how the local services interact.

Relevant authorities must also publish a notice setting out their intention to follow the most suitable provider process. Following the publication of this notice, the relevant authority must wait 14 calendar days before beginning its assessment of providers. If providers contact the relevant authority in this period to ask to be considered for the contract award, then the relevant authority must fairly consider whether these providers might be potential providers.

Relevant authorities may design and run the competitive process any way they choose, so long as the process complies with the procurement principles of the Provider Selection Regime (PSR) and with the steps outlined in the competitive process. This means that relevant authorities may run the competitive process in stages (e.g., assessing the different award criteria at different points in the process).

We expect timescales applied to be reasonable.

Relevant authorities may have their decisions challenged under the PSR. This includes the record keeping, publication and transparency requirements set out in the Regulations and the PSR statutory guidance. They must be able to produce these records if challenged either during the standstill period (including through the Independent patient choice and procurement panel) or outside the regime (for example, through a judicial review).

There may be occasions under the regime where decisions could be subject to a judicial review.

It is the responsibility of the relevant authority to satisfy itself that the requirements to follow direct award process A apply. There may be occasions where decisions taken under the PSR – including the decision to follow direct award process A – could be subject to a claim for judicial review: relevant authorities must ensure their decisions are reasonable and documented.

Relevant authorities may consider other factors, relevant to their local area, as part of their decision-making when selecting a provider. However, relevant authorities are expected to integrate all considerations under the five key criteria.

No. Once a decision has been taken about the weighting of the key criteria, relevant authorities must record these and where required publish these. All assessments of providers must be made against the stated weighting of the key criteria. If relevant authorities wish to change the weighting of the key criteria, they must abandon the provider selection process (in accordance with the regulations and the guidance) and must start a new provider selection process.

However, where relevant authorities are following the competitive process and decide to run the process in multiple stages, they may decide to weigh the key criteria differently in the different stages of the process (i.e., change the relative importance throughout the process), provided that the relevant authority makes this clear upfront and continues with what it has published at the outset of the process. For example, relevant authorities may decide that in the first round of selection they wish for some of the key criteria to be pass/fail (such as value) then in the next round for all key criteria to be weighted equally.

No. The key criteria can be balanced differently depending on the services, objectives, and priorities under consideration.

The Provider Selection Regime (PSR) sets out the basic selection criteria that providers should meet. This includes financial stability.

The PSR also includes a list of exclusion criteria, which align to those in the Procurement Act 2023; this means that providers can be excluded from selection processes based on their financial standing, such as bankruptcy or because they are undergoing insolvency proceedings. In very exceptional circumstances, a relevant authority may award a contract to an excluded provider where there are overriding reasons relating to the public interest.

The Provider Selection Regime (PSR) requires relevant authorities to consider five key criteria when making decisions; one of these is value. This does not just refer to the cheapest service, instead relevant authorities are advised to consider the wider meaning of value for money – for example, how the service might add value across an integrated health care system, how the service quality might improve outcomes beyond the immediate service and thus reduce overall spending.

We advise that for provider selection processes with higher contract values, greater focus is given to value for money and the quality and efficiency of the services to be provided, unless this means the service does not best meet the needs of the population it is serving.

The PSR does not prescribe how the assessment of the key criteria must be undertaken. Detailed information on the key criteria is set out in Annex D of the statutory guidance.

NHS England published its Net Zero Roadmap, which includes a commitment to reach net zero by 2045 for emissions from goods and services procured by the NHS. NHS organisations should place a minimum 10% weighting on net zero and social value in NHS procurement. Furthermore, since 1 April 2023 there is a requirement for suppliers to provide a carbon reduction plan, which applies to the purchasing of good and services – including health care services – by NHS organisations and organisations acting on their behalf.

Therefore, when NHS organisations are using the PSR (and following direct award process C, the most suitable provider process, or the competitive process) to arrange health care services they must ensure that the social value key criterion is weighted to be a minimum of 10%. When local authorities are contracting for health care services jointly with NHS organisations or on behalf of NHS organisations then they must also comply with this requirement.

Contract modifications are changes made to a contract during the term of that contract.

Provider selection, using one of the provider selection processes, is intended to be applied when a:

• contract is coming to an end and a new contract needs to be awarded
• new service needs to be established (and so a new contract needs to be awarded for the delivery of those services)
• modification to a contract is desirable mid-term but would lead to a modification that’s not permitted, resulting in a new contract needing to be awarded via one of the provider selection processes (the relevant authority would have to carefully check contract terms).

Where the contract was awarded using the PSR mixed procurement provisions (see Regulation 3), then that contract is in scope of the PSR, and any contract modifications would need to be made under the PSR.

If the proposed contract modification would lead to the contract no longer being in scope of the PSR – that is, because the contract modification would result in the services out of scope of the PSR becoming the higher value of the contract – then that modification would not be permitted under the PSR and a new contract would need to be awarded. The new contract would need to be awarded using the PCR or Procurement Act as it would no longer meet the requirements of the PSR mixed procurement provisions.

Where the contract was awarded using the PCR prior to 1 January 2024 but the main subject matter of the contract is healthcare services in scope of the PSR, then the PSR would need to be applied for any contract modifications following 1 January 2024. If the proposed contract modification would lead to the contract no longer being in scope of the PSR – that is, because the contract modification would result in the services out of scope of the PSR becoming the higher value of the contract – then that would not be a permitted modification under the PSR and a new contract would need to be awarded. The new contract would need to be awarded using the PCR or Procurement Act as it would no longer meet the requirements of the PSR mixed procurement provisions.

All transparency notices under the PSR are published on the Cabinet Office’s FTS portal. Information about where each notice must go is provided in the additional FTS guide.

Currently, there are no PSR bespoke FTS templates. Relevant authorities should continue to use the PCR notices at this time. Guidance on how to enter data into the notices is included in the FTS supplementary guide.

No. The intended approach notice must be published on the Find a Tender Service (FTS) website.

Relevant authorities must publish a summary of their application of the Provider Selection Regime (PSR) annually online (e.g., via the relevant authority’s annual reports or annual governance statement). We expect the first annual summary to relate to contracts awarded using the PSR between 1 January 2024 – 31 March 2025, and we expect this to be published no later than six months following the end of 2024/2025 financial year.

Following the first annual summary, all other annual summaries must be published no later than six months following the end of the financial year they relate to.

Where, following a particular provider selection process, multiple providers are awarded a contract for the same service, then a single transparency notice – which lists all successful providers – would suffice.

However, if multiple provider selection processes were followed and these resulted in multiple providers being awarded different contracts, then each contract awarded (following a particular provider selection process) would require the publication of a transparency notice.

Every arrangement between a relevant authority and a provider for the delivery of health care services in return for payment is a contractual arrangement and must be documented appropriately.

Where the commissioner is an integrated care board (ICB) and the health care services required are not primary care services, the terms and conditions of the NHS Standard Contract (full length or shorter from, as appropriate) must, by law, apply to that arrangement.

From 1 January 2024, the award of any contract for health care services, regardless of value or duration, is governed by the PSR. To avoid having to carry out a new provider selection process for each individual placement, relevant authorities could put in place arrangements in advance to facilitate placements, for example:

• by using the most suitable provider process or the competitive process to award contracts to selected providers;
• by using the competitive process to establish a framework agreement; or
• where relevant authorities are offering a choice of providers to patients and the number of providers is not restricted by the relevant authority, then they must award a contract to all eligible providers using direct award process B.

Each specific circumstance would need to be considered and relevant authorities should consider seeking legal advice.

Depending on the provider selection process adopted, the relevant authority would need to follow the transparency requirements for that process and publish the required notices for that process.

Relevant authorities are required to be transparent about their decision making under the PSR. This is to ensure that the system is fully informed about the decisions that are being taken.

Providers may make representations during the standstill period if they believe that the PSR has not been correctly applied. If the provider remains unsatisfied with the response of the relevant authority to its representation and remains of the view that the PSR has not been applied correctly, the provider may submit a representation to the PSR Review Panel (see the guidance for further information).

Any decision made by a relevant authority under the PSR may potentially be challenged via an application for judicial review.

The PSR sets a minimum length for the standstill period, during which providers may make representations to the relevant authority. If any representations (that meet the required conditions) are received during this period, then the standstill period will remain open until the relevant authority provides any requested information, considers the representations, and makes a further decision.

Until the standstill period is brought to an end (as per the Health Care Services (Provider Selection Regime) Regulations 2023), the relevant authority cannot proceed to award the contract.

It is the responsibility of the relevant authority to review representations and to make a further decision about its application of the PSR and about the award of the contract to the selected provider.

However, the relevant authority may ask individuals independent from it to support its review of representations. The relevant authority is advised to consider any conflicts of interest that may arise as a result of doing this.

Once the relevant authority has considered the advice of the panel, it may make a further decision, to be its final decision and replacing the previous one, to:

• enter into a contract or conclude the framework agreement as intended;
• go back to the start of the selection process or to the step where a flaw was identified, and repeat that step and subsequent steps; or
• abandon the procurement

This final decision on contract awards is for the relevant authority, as the panel only provides advice. Any final decision of a relevant authority on contract award could be subject to a claim for judicial review.

No. There is currently no fee associated with asking the panel to review the decision of a relevant authority.

Yes. For example, where an ICB arranges for the exercise of its commissioning functions by a local authority or places this function into a joint committee using section 75 powers, the ICB would remain liable for the decisions of the local authority exercising those functions – this is set out in s.75(5) of the 2006 Act.

Relevant authorities therefore are advised to set out, in advance of entering into section 75 arrangements, how decisions made by the body exercising the functions would be overseen.

This may for example include situations where a provider brings a representation against the local authority that is exercising the commissioning functions of an ICB, and where this representation goes to the PSR review panel for advice. The ICB arranging for the exercise of its functions by the local authority would be advised to consider how they might ensure the local authority considers the advice of the PSR review panel.

The length of a framework agreement must not exceed four years, other than in exceptional circumstances where the relevant authority is satisfied that the subject-matter of the framework agreement justifies the longer term.

Therefore, once the framework agreement has reached the end of its term, relevant authorities must establish a new framework agreement using the competitive process, if they wish to keep using a framework agreement. Relevant authorities may decide to set out the same requirements, the same terms and conditions, and apply the key criteria in the same way. However, different providers may apply to be party to the new framework agreement.

If the framework agreement includes the specific health care service, and the framework agreement was awarded, or the process commenced to award the framework agreement prior to 1 January 2024, the relevant authority can call off the specific health care services from that framework agreement, utilising the call off methodologies prescribed by the PSR.

The NHS Standard Contract must continue to be used by NHS England and ICBs when awarding contracts for relevant health care services other than primary care services.

No. The Provider Selection Regime (PSR) does not set limitations on contract lengths, nor (where it is the form of contract being used) does the NHS Standard Contract.

However, relevant authorities are advised to consider carefully the risks and benefits of offering a longer contract, in the context of their own standing rules and, for example where applicable, NHS England’s Contract Technical Guidance and Standing Financial Instructions.

The Provider Selection Regime (PSR) does not specify how many times a contract can be extended using contract modifications. However, relevant authorities must ensure that they comply with the provisions for contract modifications in the PSR, as well as the terms of the specific contract.

We have introduced some minor changes to the NHS Standard Contract 2024/25 reflecting the PSR. These deal with permitted variations, termination and extension of contract terms, as well as providing space within the Particulars for recording the route through which the individual contract was awarded – whether under the new PSR or the preceding regime. These are effective as of 1 April 2024.