On Monday, the Department of Health confirmed that commissioners of NHS funded services must not impose minimum waiting times for treatments, or restrict patient choice for routine elective care. The announcement was in response to recommendations made by the Co-operation and Competition Panel, which had considered these issues in two cases. The first was its report into the operation of choice in routine elective care nationally which was published in July. The second was a case involving a conduct complaint against NHS Wiltshire which found that the commissioners for Wiltshire Bath and North East Somerset were in breach of the Principles and Rules for Co-operation and Competition by imposing restrictions of this kind. The arrangements were found to have a fairly obvious adverse impact on patients.
The outcome of the report and the NHS Wiltshire case makes it clear that imposing minimum waiting times and/or restricting choice of provider are not acceptable ways in which to address the challenge of controlling commissioning budgets. Commissioners are reminded that they must comply with the Principles and Rules for Co-operation and Competition when commissioning services. It is also worth remembering that patient choice is a right set out in the NHS Constitution.
Any commissioners currently engaging in such practices have been told to stop and to improve their commissioning practices and transparency. Going forward aspiring CCGs will need to bear this decision in mind as they seek to become more involved in commissioning decisions.