Last month Monitor published its guidance on the NHS Procurement, Patient Choice and Competition Regulations 2013, which implement Section 75 of the Health and Social Care Act 2012. This statutory guidance is required by law and is intended to support commissioners of NHS services in understanding and operating in accordance with the rules around purchasing high quality services for patients. The guidance is available here: Commissioners can now start to use Monitor's guidance to assess their obligations under these contentious regulations.

Following this, David Bennett, chief executive of Monitor has announced that Monitor will be focussing on the decisions CCGs are making about transforming community services contracts. Community services contracts were let by primary care trusts in 2010-11, typically to their former provider arms and usually on terms of between three and five years. Consequently a number of them are up for renewal. Monitor is concerned that very few CCGs have begun tendering the contracts and anecdotal evidence suggests many are looking to roll on the contracts or avoid tendering them all together.

Under the Regulations not every contract has to be but out to tender but there needs to be a proper process to decide whether or not to tender a contract. For example, the guidance states commissioners do not have to tender a contract if it is in the best interest of patients not to do so. CCGs must satisfy themselves the services currently being provided could not be improved and that there are not alternative providers that could deliver them. It may also be possible for CCGs to argue that an integrated system is better for patients and it would be difficult to create that through an open tender. However, CCGs will need to be able to demonstrate that these criteria have been met. Monitor is unlikely "to take a CCG's word for it".