Provider Selection Regime (PSR) – what GP practices need to know

PSR is the legal framework the NHS must use when it commissions (buys) most healthcare services. It sets out the permitted ways a commissioner can award, renew or change a contract.

Why does the commissioner need to run a ‘procurement’ for some GP services?

• It is spending public money and must have a lawful route to award a contract (or renew/replace one).
• This includes some services delivered in general practice (e.g. LIS/LES schemes).
• It may be a new service, a replacement for an expiring contract, or a change in delivery model.

What PSR routes exist?

Also refer to the above quick guide for more info.

What does Direct Award B mean for GP practices?

• The commissioner has decided not to restrict (or is not permitted to restrict) the number of providers who can deliver certain services, such as phlebotomy and simple wound care.
• It is effectively an ‘open contract offer’: contracts can be awarded to all providers that want to deliver the service and meet the minimum requirements. It is not a competitive tender: you are not ‘bidding against’ other practices.
• The commissioner will typically run a short EOI/questionnaire to confirm (1) you want to opt in; (2) you can deliver the service; and (3) you pass basic ‘exclusion’ checks used across public procurement.
• The commissioner will outline the timescales for submitting your expression of interest. In some cases, the process may not be time limited, and practices may be able to sign up at any time.

What type of questions will practices be asked?

• Commissioners typically base their EOI forms on a standard UK Government set of procurement questions used across the public sector and often include ‘selection’ and ‘exclusion’ declarations (for example, serious offences or tax compliance).
• These questions are written to cover all supplier types, so the wording can feel disproportionate for general practice. For more detailed explanation of each question, please refer to: PSR Direct Award B – Annex B EOI Selection Questions QUICK GUIDE.
• LMCs have raised concerns with commissioners that some exclusion questions, as written, could be interpreted as requiring assurance about matters a practice cannot reasonably and fully verify. The expectation should be a proportionate declaration that still meets legal requirements.

What should practices do?

• Read the service specification and confirm that you can meet the requirements.
• Check the deadline for submission of the EOI. If unsure, contact the commissioner (and copy your LMC). You must submit according to the deadlines set by the commissioner.
• Complete the EOI/questionnaire accurately – In PSR Direct Award B, the commissioner still needs a clear audit trail that basic checks were completed.
• Answer every question. They will typically be ‘Yes’/’No’ questions. If you answer ‘Yes’ to any exclusion question, you must give details and explain any mitigations or remedial actions.
• Keep a copy of your submission and any supporting evidence.
• If requirements or processes are unclear, raise this early to the commissioner (and copy your LMC).

References

• NHS England PSR guidance
• Annex B – standard selection questionnaire 
• Annex D – exclusion grounds: public procurement

Expression of Interest forms used for PSR Direct Award B processes typically contain a number of standard questions:

• to confirm that your practice wants to opt in to deliver the service and can meet the key requirements in the service specification;
• to give the commissioner a lawful ‘audit trail’ under PSR Direct Award B that basic checks were completed before offering a contract;
• to capture standard public‑sector declarations (e.g. serious offences, tax compliance) that apply across all sectors.

Commissioners commonly use the UK Government’s Standard Selection Questionnaire (Annex B) as a template.

Proportionality (key reassurance)

LMCs have raised with commissioners that the Annex B questions are designed to work for any type of supplier, and the wording of some exclusion questions can appear disproportionate for general practice – specifically, where compliance is sought ‘anywhere in the world’. LMCs believe that a proportionate interpretation should be expected, while still staying within the legal requirements. Declarations should be made to the best of the practice’s knowledge and based on information reasonably available to the organisation. Practices should not be reasonably expected to conduct global or investigatory checks beyond normal processes such as:

• UK employment and recruitment checks (including right to work).
• DBS checks (where applicable).
• Verification of professional registration (e.g. GMC, NMC).
• Self-declarations from partners, directors, or senior staff.

How the questions are structured

Part 1 – General information: practice details and service readiness (often short yes/no confirmations).

Part 2 – Grounds for Mandatory and/or Discretionary exclusions:

• Mandatory exclusions (serious offences): yes/no declarations about specified offences (normally ‘No’ for practices).
• Tax and social security: confirmation you have met obligations (normally ‘Yes’).
• Discretionary exclusions and Modern Slavery Act: further risk checks (often ‘No’ or ‘N/A’ for practices).

Commissioners may also decide to include additional questions specific to a procurement/service. For example:

• they may ask the provider to identify genuinely confidential parts of your submission (if any) for FOI purposes;
• they may ask practices to confirm they have read the service specification and that they confirm they are eligible and able to meet all the requirements in the spec to deliver the service.

Please see table further below for detailed description of questions.

This guide is provided for general information only and does not constitute legal, financial or professional advice. Any model responses are illustrative examples intended to help practices understand the questions; they are not definitive. Each practice must determine its own responses based on its specific circumstances and should obtain independent advice if uncertain.