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NHS Market Access


The NHS is the largest single healthcare delivery organisation in the world and as a consequence it has a complex structure with both national and local drivers. For this reason companies have traditionally found access into the NHS difficult both in terms of selling products and services and in respect to partnering with the NHS for the development and adoption of new ideas and technologies.

Following the introduction of the government's Innovation Health and Wealth strategy, increased emphasis is being placed on partnering with the business community in order to transform healthcare delivery. Therefore in addition to guidance on how to sell finished products into the NHS this section will also review new opportunities for innovation partnership and technology adoption. To put this in context we begin by outlining the new NHS infrastructure for commissioning services for post April 2013.

The new NHS Infrastructure POST April 2013

NHS Infrastructure map
For further information on the role of organisations in this schematic visit NHS England Website -

For a full schematic of the new health and care system visit -

Clinical Commissioning Groups

Due to the importance of the CCG's in the new commissioning process information is provided below.

With responsibility to NHS England (formally the NHS Commissioning Board) the clinical commissioning groups will take primary control for commissioning services.

Previous control of local spending (Est - 80% of total NHS budget) for services such as medicines, dentists, hospital operations and tests was held with 152 individual Primary Care Trusts (PCT's). Some services were provided by independent private health charities or companies.

In April 2013 the PCT's were replaced by a new organisation led by General Practitioners (GP's) called Clinical Commissioning Groups (CCG's). Every GP practice is required to be registered with a local CCG, although it is expected that only a small number of GP's will play a role in determining local service provision. The CCG's have a reduced budget estimated to be approximately 60% of the total NHS budget. This reduced budget is in line with the belief that CCG's will offer more cost effective, stream lined delivery of care and service.

A key element of the CCG's role will be to offer advice and support on buying and planning health services. As PCT's had done previously, the new CCG's will decide what hospital care is available to patients locally. Healthcare in England is predominantly provided by the NHS, although the NHS does pay for some routine operations to be carried out by private companies.

Commissioning Support Units

Commissioning support units are set to take on important functions in the new NHS structure. They will support clinical commissioning groups by providing business intelligence, health and clinical procurement services, as well as back-office administrative functions, including contract management.

Selling into the NHS

Businesses can sell products through National, Regional and Local procurement routes. These are outlined below.

  • NHS Supply Chain
  • National Framework Contracts
  • Regional - Collaborative Procurement Hubs/Confederations
  • Local contracts managed by individual trusts

NHS Supply Chain (National)

NHS Supply Chain constitutes end-to-end supply chain services incorporating procurement, logistics, e-commerce and customer and supplier support. This is a single organisation created for the benefit of NHS trusts, hospitals and other healthcare organisations. The organisation combines the former NHS Logistics Authority, significant parts of the NHS Purchasing and Supply Agency, expertise in healthcare logistics from DHL and procurement experience from Novation.

For more information visit -

National Framework Contracts Tenders (National)

The National Framework tender and contract process is designed to meet the NHS Supply Chain management needs of the NHS. It is competitive, standardised, accommodates public procurement requirements and customer input. The frameworks are based on finding the most appropriate suppliers and evaluating their propositions based on: Financial criteria, clinical acceptability and Ease of use.

Contracts are awarded to suppliers who meet the broadest range of criteria, including innovation, quality and value for money. Contracts for products and services valued at over £113,057 (17 July 2013)) must be advertised in the Supplement to the daily Official Journal of the European Union (OJEU).

Procurement levels change, but you can confirm the current levels and service distinctions by visiting: (See diagram below)

Collaborative Procurement Hubs/Confederations (Regional)

Most NHS trusts are now partners in 'collaborative procurement organisations' where, on a regional basis, they can share information and resources to achieve economies of scale. Examples of such are North of England Commercial Procurement collaborative, NHS Commercial Solutions and NHS Shared Business Solutions.

An example of a collaborative procurement organisation can be found by visiting -

Local Trust Contracts (Local)

Local Trust contracts are often managed by a trust's supplies department. Its approach to suppliers will vary according to the value, size and complexity of its requirements. The Department of Health has set down procurement guidelines indicating that for contracts valued below £3,000 a trust should ask for telephone quotes; for contracts valued between £3,000 and £10,000, it should request a minimum of three written quotes; for contracts valued above £10,000, minimum of three formal written tenders should be sought. Actual interpretations of these guidelines vary from trust to trust. (See diagram below)

KTN Roadmap Diagram

Estates & Capital Equipment - The Dept Health uses two major Public and Private Partnerships (PPPs) to deliver its NHS Plan: the Private Finance Initiative (PFI) and NHS Local Improvement Finance Trust (LIFT). The NHS ProCure 21 Framework brings the NHS and the construction industry together for new-build projects.

You can find information on PPPs and associated procurement policies at: Department of Health - PPP

Products for GP Prescription - Suppliers wishing to list their products under the Drug Tariff for prescription by GPs or nurses must seek approval from the NHS Business Service Authority (NHSBSA). These will usually be products for self-administration, possibly with a carer's help, and will normally fall into the following categories: dressings, bandage and associated appliances, incontinence appliances, stoma appliances, and chemical reagents. If the NHSBSA grant approval, the cost, either comparatively with other similar products, or, if it is a new treatment regime, by comparison with alternatives, will be reimbursed.

You can access the application form at:

Requirements of NHS Tendering

Pre qualification questionnaire (PQQ)
Invitation to tender (ITT)

Pre qualification questionnaire (PQQ) guide

A PQQ is part of the restricted tender procedure and is used to identify a short-list of capable companies to invite to tender in the restricted tender procedure.
The questionnaire seeks to identify the relevant capacity (financial and resources), experience and expertise of the company. It is not used to evaluate possible solutions that the company may offer and any criteria used at the pre-qualification stage will not be used again or be revisited when evaluating the invitation to tender.
Many elements are pass / fail during the PQQ stage and may require input from specialist officers such as finance to undertake a financial assessment of bidders to be short listed. If references are required the NHS Trust will obtain these at the PQQ stage. The Trust cannot obtain references after this point in the process.
Further information and guidance can be found at the Department of Health website

Invitation to tender (ITT) guide

An ITT is issued to the successful suppliers who passed through the PQQ stage. A tender is essentially a written presentation, tailored towards the needs of the purchasing organisation, of a company's ability to deliver the requirements of a contract, which is evaluated against set criteria to establish their suitability for undertaking the work to the standard required and within the budgets set.
It should be noted that a good tender does not mean that it will be a winning tender, only that it stands a greater chance of becoming one.
NHS Trusts consider a good tender to be:

  • Free of significant errors and / or omissions
  • Tailored to the exact requirements of the contract
  • Detailed with supporting evidence and additional documentation clearly referenced
  • States what benefits they can bring to the Trust
  • Demonstrates commitment to the Trust
  • Shows they have put theory into practice
  • Clearly written and legible
  • Clearly committed to continuous improvement and best practice
  • Clearly detailed in terms of possible variations and innovations (where applicable)
  • Inclusive of added value to the contract (where applicable)
  • Compiled in line with the instructions

Individual NHS Trust websites provide additional advice and information on this topic. An example of this can be found here -

Innovation Partnership and Technology Adoption

Organisations and processes have now been created which allow businesses to engage with NHS organisations on technology adoption and the development of new ideas. These do not provide businesses with guarantees that products / services will be adopted into the NHS however they provide a mechanism for partnership working with the NHS around unmet clinical needs.

Small Business Research Initiative

SBRI Competitions, (which focus on unmet public sector needs, requiring innovative solutions) create excellent opportunities for businesses to engage with DH/NHS to prove their technology or idea. Successful companies will gain support for the development of solutions, and will retain their intellectual property rights. They will receive a contract for the full cost of demonstrating the feasibility of their technology and the opportunity for subsequent funding for prototype development. This provides a reliable source of early stage funding, a potential route to market and establishes credibility for further investment. Any company can submit an application, although the structure of the scheme is particularly beneficial to early stage companies and small and medium-sized enterprises.

Further details can be found at:

Supply Chain – Innovation Scorecard

You can submit CE marked innovative products through the Innovation Scorecard. You will need to complete a questionnaire in the online submission. Once completed, your product will be assessed for its level of innovation and then be considered for a pilot agreement.

Click here to view the Innovation Scorecard and submit your innovative products for evaluation –

Academic Health Science Networks (AHSNs)

With effect from July 2013, 15 Academic Health Science Networks AHSN have been created across England. The AHSN's will have a major remit to rapidly adopt new technologies in order to transform healthcare delivery and create patient benefit. To this end major emphasis will be placed on partnering with the business community. Whilst different mechanisms for engagement will operate in different AHSN's, a common theme will be to develop practical working models for NHS business engagement.

Further details can be found at:

National Institute for Health Research (NIHR) Health Technology Cooperatives (HTCs)

The National Institute for Health Research (NIHR) launched 8 HTCs in January 2013 which focus on key areas of unmet clinical needs. The HTCs are centres of excellence in specific clinical areas of high morbidity, and provide a NHS pull for the development of new Medical Devices / Technologies.

The aims of the NIHR Healthcare Technology Co-operatives are to:

  • Act as a catalyst for NHS "pull" for the development of new medical devices, healthcare technologies and technology-dependent interventions.
  • Focus on clinical areas and/or themes of high morbidity which have high potential for improving quality of life of NHS patients and improving the effectiveness of healthcare services that support them.
  • Work collaboratively with patients and patient groups, charities, industry and academics.

Further details can be found at:

Medical Technologies Evaluation Programme (MTEP)

This programme operated by NICE, provides a vehicle for businesses to have a robust evaluation undertaken of new and innovative medical technologies. This can result in a NICE recommendation for the product to be adopted by the NHS. It should be noted that it is not currently mandatory for NHS organisations to adopt products recommended through this programme.

Further details can be found at: