As part of the 2008/09 NHS operating framework, the Department of Health published Principles and rules for cooperation and competition (PRCC).
The PRCC was intended as guidance for system managers, commissioners and providers on the expected behaviours and rules governing cooperation and competition. As well as outlining plans to develop an independent competition panel, the document set out 10 principles that would apply from April 2008.
Key provisions included a requirement that commissioners should contract with the provider best able to meet the needs of their local population and both commissioners and providers were required to foster patient choice. With regard to mergers and acquisitions, the guidance stated that these transactions were acceptable when in the best interest of patients and taxpayers, as long as sufficient choice and competition remained to ensure high quality services.
The 10 principles were as follows:
1. Commissioners should commission services from the providers best placed to meet the needs of their population.
2. Providers and commissioners should cooperate to ensure a seamless patient experience.
3. Commissioning and procurement should be transparent.
4. Commissioners and providers should foster patient choice and provide appropriate information.
5. Appropriate promotional activity was encouraged if in line with patients’ best interests.
6. Providers were required to promote equality and not discriminate against patients.
7. Payment regimes should be transparent and fair.
8. Financial intervention should be transparent and fair.
9. Mergers and acquisitions were permissible when demonstrated to be in the best interest of patients and taxpayers and sufficient choice and competition remained.
10. Vertical integration was permissible when demonstrated to be in the best interest of patients and taxpayers and sufficient choice and competition remained.