1. Help inform our response to Monitor’s consultations on procurement, patient choice and competition Guidance on “Section 75” regulations of the Health and Social Care Act 2012

2. Introduction  Monitor is consulting on guidance for commissioners and providers on patient choice, procurement and competition, to help them avoid breaching the rules and regulations  These regulations are referred to as the Section 75 regulations, and relate to the Health and Social Care Act 2012  Competition in the NHS needs to be carefully handled to make sure it is used to benefit service users and does not distract from the quality of care  This guidance will have an important role to play in the new NHS system

3. Section 75 regulations  The regulations have been controversial  RCN members debated them at Congress 2013 and called for Council to increase its lobbying on the issue of competition in the NHS  The RCN wants to hear from as many members as possible to make sure your views are reflected in our response to these consultations

4. Key themes of guidance  Adherence to existing legislation (e.g. compliance with patient rights to choose as set out in the NHS Constitution) – Monitor cannot change the underlying legislation  Commissioner-led approach to competition – commissioners decide when or when not to use competition, but they must be transparent about their reasons and process  Monitor will take a cost/benefit approach when considering whether the rules and regulations have been broken and if so, which action they will take. This is not just about money, but also a qualitative assessment, and looks at whether patients are affected or not (for good, or bad)

5. Key questions  Do you have concerns about the guidance and any related impact on patients?  Do you have concerns about the guidance and any related impact on any specific areas of nursing policy and/or practice?  Do you think the guidance provides sufficient reassurance that decisions about the use of competition will be made in the best interests of patients?  Do you think that there are sufficient safeguards to ensure that patients are the focus of all our efforts, including regulatory action on competition?

6. How to respond  You can read a more detailed briefing on the consultations, and the full Monitor documents, at www.rcn.org.uk/consultations  Email your views to leela.barham@rcn.org.uk  Closing date: 21 June