Contracting, tendering and procurement

Under the PSR providers may apply for Direct Award B accreditations to provide consultant-led patient choice services where patients are free to choose between multiple qualified providers.  The Surrey Heartlands ICB Direct Award B Accreditation Process supports the implementation of patient choice as outlined in the PSR. 

Patient Choice and Accreditation 

Part 8 of the NHS Standing Rules places obligations on commissioners in relation to patient choice, including enabling the legal rights to choice of provider and team. The rights apply when:

• the patient has an elective referral for a first outpatient appointment (new episode of care).
• the patient is referred by a GP, optometrist or dentist into secondary care (non-urgent elective).
• the referral is clinically appropriate as determined by the referrer.
• the service and team are led by a consultant or a mental healthcare professional.
• the provider has a commissioning contract with any ICB or NHS England for the required service.

You can download the Surrey Heartlands Direct Award B Accreditation Process to understand the steps providers must follow to be considered for accreditation with us. Our Mandatory and Discretionary Exclusion Grounds Questionnaire and Basic Selection Criteria Questionnaire can also be accessed from this website to support providers in deciding whether to apply. 

Application Process 

The Surrey Heartlands Direct Award B process comprises two elements – completion and successful passing of a Mandatory, Discretionary and Basic Selection Criteria Questionnaire and completion and successful passing of a bespoke Local Requirements Questionnaire dependent upon the patient choice service under offer.    

Questionnaires are evaluated by qualified assessors and providers will be advised of the outcome per the evaluation cycle detailed below. 

To ensure a consistent and transparent approach to evaluation and accreditation, Surrey Heartlands ICB operates a structured cycle with moderation and decision-making panels convened every six weeks. Each cycle will be anchored by a defined “Day One,” which marks the deadline for submissions to be considered in that cycle’s panel. Day One will be set exactly six weeks in advance of the scheduled panel meeting. Provider submissions received on or before Day One will be included in the upcoming panel cycle.

The six-week period between Day One and the panel allows sufficient time for the end-to-end evaluation process: submission collation, distribution to evaluators, initial assessment, and clarification (where required), collation of scores, and review by moderators. This culminates in a formal moderation and decision panel. Submissions received after Day One will be deferred to the following six-week cycle, ensuring fairness and adequate time for thorough assessment.

This rolling model provides a predictable, fair, and well-governed framework for provider evaluation and accreditation.

1. Day One (Week 1, Monday)
   • Provider Submission Deadline — Final day for providers to submit documentation for inclusion in this cycle. Submissions received after this date roll to the next cycle.
2. Week 1 (Rest of week)
   • Completion and Compliance Review; Dispatch to Evaluators — Submissions undergo an initial check for completeness and compliance. Valid submissions are dispatched to evaluators by end of Week 1.
3. Week 2
   • Evaluator Assessment Part 1 — Evaluators begin detailed assessment of provider submissions. Clarification questions may be issued.
4. Week 3
   • Evaluator Assessment Part 2 — Evaluations continue. Clarifications (if issued) are addressed. Evaluator scores and comments are submitted by end of Week 3.
5. Week 4
   • Collation and Dispatch to Moderators — Scores and comments from evaluators are reviewed, collated, and packaged for moderation. Materials are sent to moderators by end of week.
6. Week 5
   • Moderator Review — Moderators review evaluator outputs, resolve scoring discrepancies, and prepare recommendations for panel.
7. Week 6
   • Panel Meeting and Decision Making — Moderation and decision-making panel convenes. Accreditation decisions are finalised. Outcome letters are issued by end of Week 6.

Direct Award B cycle timetable

• Day one: 9th December 2025
• Panel date: 20th January 2026
• Conclusion of week six: 23rd January 2026

 

Buying NHS healthcare services is now governed by the Health Care Services (Provider Selection Regime) Regulations 2023 (PSR). These regulations came into force on 1 January 2024, replacing the previous NHS (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013.

The PSR provides a flexible and transparent framework for NHS England, Integrated Care Boards (ICBs), NHS trusts/foundation trusts, and local authorities to arrange healthcare services in the best interests of patients. It focuses on:

• Securing patient needs and improving quality and efficiency.
• Acting fairly, transparently, and proportionately.
• Maintaining robust records of decisions. 

Key Principles Under PSR

Commissioners must:

• Act transparently and treat providers fairly and equally.
• Consider integration and innovation to improve services.
• Ensure decisions are proportionate and based on patient needs.
• Publish notices and maintain audit trails for all awards. 

Historic Regulations

The NHS (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 previously governed procurement and patient choice. They required commissioners to act transparently, treat providers equally, and avoid anti-competitive behaviour unless in patients’ interests. These regulations were revoked on 1 January 2024 and replaced by PSR.

Our Commitment to Openness

NHS Surrey Heartlands is committed to transparency in procurement decisions. We publish:

• transparency notices for awarded contracts under PSR
• contract award notices under the Procurement Act 2023
• our Contracts Registers 
• annual summaries of PSR application.

We follow robust internal governance, including conflict of interest policies, financial controls, and audit trails.

Our commissioning and procurement processes are designed to ensure that services are selected and contracted in a way that delivers high-quality care, value for money, and meets the needs of our population. Whether governed by the Provider Selection Regime (PSR) or the Procurement Act 2023, the following stages represent a typical pathway for tendering and contracting:

1. Service Planning and Needs Assessment
   • Identification of population health needs and service gaps
   • Review of current service provision, performance, and outcomes
   • Alignment with national policy, Integrated Care Strategy, and local commissioning priorities
     
     
2. Pre-Market Engagement and Stakeholder Involvement
   • Early engagement with potential providers to test market interest and capacity
   • Publication of Preliminary Market Engagement Notices where appropriate
   • Involvement of clinicians, patients, VCSE partners, and system stakeholders to inform service design and commissioning approach
     
     
3. Procurement Route Determination
   • Selection of the appropriate procurement route based on service characteristics, market conditions, and statutory guidance
   • Documentation of rationale and governance approvals
     
     
4. Specification and Documentation Development
   • Development of robust service specifications, outcome measures, and evaluation criteria
   • Integration of clinical standards, patient experience, and equality impact considerations
   • Preparation of procurement documentation including instructions, terms, and scoring methodology
     
     
5. Tender Publication and Supplier Invitation
   • Formal publication of tender opportunities via Find a Tender
   • Clear communication of timelines, requirements, and submission protocols
     
     
6. Evaluation and Decision-Making
   • Assessment of bids against published criteria including quality, price, and social value
   • Use of multidisciplinary evaluation panels and subject matter experts
   • Application of robust governance, moderation, and conflict of interest management
     
     
7. Contract Award and Mobilisation
   • Publishing Transparency Notices (PSR) or Contract Award Notices (Procurement Act)
   • Finalisation of contractual terms using the NHS Standard Contract
   • Mobilisation planning and readiness assurance with the successful provider
   • Mobilisation planning with the successful provider
     
     
8. Contract Management and Review
   • Ongoing monitoring of service delivery, performance, and compliance
   • Regular review meetings, reporting, and escalation protocols
   • Use of feedback, data, and stakeholder input to inform future commissioning cycles

 

Ref	Contract process followed	Number
(a i)	the number of contracts awarded where Direct Award Process A was followed	5
(a ii)	the number of contracts awarded where Direct Award Process B was followed	0
(a iii)	the number of contracts awarded where Direct Award Process C was followed	3
(b)	the number of contracts awarded where the Most Suitable Provider Process was followed	0
(c)	the number of contracts awarded where the Competitive Process was followed	1
(d)	the number of framework agreements concluded	0
(e)	the number of contracts awarded based on a framework agreement	0
(f)	the number of contracts awarded, and modifications made in reliance on regulation 14 (urgent award or modification)	2
(g)	the number of new providers to whom a contract was awarded	3
(h)	the number of providers who held a contract in the previous year but no longer hold any contracts	5
(I i)	the number of written representations made in accordance with regulation 12(3) and received during standstill periods	0
(I ii)	a summary of the nature and impact of those representations.	N/A
	Total number of providers the relevant authority is currently contracted with	670
	Details of any reviews by the Independent Patient Choice and Procurement Panel - number of requests for consideration received by the Independent Patient Choice and Procurement Panel - number of requests accepted and rejected by the Independent Patient Choice and Procurement Panel for consideration - number of times where the Independent Patient Choice and Procurement Panel advised the relevant authority to re-run or go back to an earlier step in a provider selection process under the PSR - the number of times the advice was followed.	0

The registers show provider details, their services provided and the contract value. Please email any questions to the Contracts team.

NHS Surrey Heartlands Primary Care Contract Register August 2025 [xlsx] 80KB

NHS Surrey Heartlands Contracts Register August 2025 [xlsx] 20KB