The proposed licence conditions cover the means by which Monitor will set prices for NHS services, ensure patient choice and provider competition, support integrated care and help commissioners maintain service continuity.
It also translates Monitor’s current oversight of the governance of NHS foundation trusts (FTs) into the new framework.
The statutory consultation, which ends on 23 October 2012, invites stakeholders to comment on the draft conditions and vote for options in some cases.
Monitor expects to issue licences to FTs in April 2013 and to other NHS providers from April 2014.
The general licence conditions include requirements that providers should display “effectiveness, efficiency and economy” and set out appropriate patient eligibility and selection criteria.
The pricing licence conditions include compliance with the National Tariff and “constructive engagement” with commissioners regarding local tariff modification.
The choice and competition conditions are designed to ensure that patients can choose between providers, and to stop providers “preventing, restricting or distorting competition”. Monitor consults on the option of requiring providers to ensure that patients are offered impartial advice about their choices.
To support integrated care, Monitor proposes “a broadly defined prohibition”: that the licensee will not do anything “detrimental to enabling integrated care”. This, it says, will allow providers and commissioners to “take the lead”.
To support continuity of services – described explicitly in terms of a licensee becoming “financially distressed or insolvent” – Monitor proposes measures including co-operation between providers and restrictions on disposal of assets. It will set out a Risk Assessment Framework later this year.
The proposed licence conditions for FTs include provision of information to a new advisory panel and Monitor’s continued oversight of FT governance.