The Provider Selection Regime (PSR) for NHS-funded care providers
The Provider Selection Regime is the set of rules that govern how NHS-funded healthcare services in England are awarded, in place since the Health Care Services (Provider Selection Regime) Regulations 2023 came into force on 1 January 2024. It lets a relevant authority award a contract without a competitive tender, either through a Direct Award or by naming you the most suitable provider, so you can sometimes keep or win NHS work without running a full bid. Crucially it sits outside both the Public Contracts Regulations 2015 and the Procurement Act 2023, and applies only to in-scope NHS healthcare services, not to council-commissioned adult social care. That distinction decides which rules, notices and timescales apply to a given contract, so we check for free which regime your specific opportunity falls under before you commit to writing anything.
What the Provider Selection Regime is and why it changed
The Provider Selection Regime (PSR) is a bespoke procurement regime for NHS-funded healthcare in England, brought in because clinical services do not always suit open competitive tendering. It is governed by the Health Care Services (Provider Selection Regime) Regulations 2023, which came into force on 1 January 2024 according to NHS England's statutory guidance. As DLA Piper notes, the regime removed the procurement of in-scope NHS healthcare services from the Public Contracts Regulations 2015, and those services also sit outside the Procurement Act 2023. This matters for continuing healthcare (CHC), community health, mental health and integrated care providers because the default is no longer a points-scored tender against all comers. Authorities now choose a route that fits the service, and continuity of care, stability and integration are treated as legitimate reasons to keep a capable existing provider rather than forcing a re-bid every few years. Scope is set by Common Procurement Vocabulary (CPV) health codes, so the first job on any opportunity is confirming whether your contract is genuinely in scope. Get that wrong and you prepare for the wrong process entirely, with the wrong notices and the wrong deadlines.
The three award routes (not lots)
The PSR gives a relevant authority three award routes, and which one applies decides whether you bid at all. The first is Direct Award, split into Processes A, B and C. The second is the Most Suitable Provider Process. The third is the Competitive Process, the closest thing to a traditional tender. These are distinct routes, not lots within one tender, so do not treat them as sub-sections of a single bid. Direct Award Process A is used where there is only one provider that can deliver the service. Process B applies where patients have a choice of provider on agreed terms, for example an approved list. Direct Award Process C is the route that retains your work: an authority can keep an existing provider where the service is not changing considerably and the provider is satisfying its existing contract. That is a genuine way to hold a CHC or community health contract without re-bidding. The Most Suitable Provider Process is used when the authority can identify the best provider without competition. Only when none of these fit does it run a Competitive Process, which functions like a scored tender with full bid discipline.
The five Regulation 5 criteria for most suitable provider
When an authority decides who is most suitable, it scores you against five key criteria set out in Regulation 5 of the PSR Regulations. According to NHS England's statutory guidance, these are: quality and innovation; value; integration, collaboration and service sustainability; improving access, reducing health inequalities and facilitating choice; and social value. The authority sets the weighting between them itself, so the balance shifts from one Integrated Care Board (ICB) to the next, and you must read the published weighting before you write a word. This is where evidence wins or loses you the work. Quality and innovation rewards CQC standing, outcomes data and demonstrable service improvement. Value is whole-life value, not lowest price, so a costed case for fewer admissions or better outcomes carries weight. Integration credits how you work with the wider system, GPs, hospitals and other providers, and how sustainable your staffing and finances are. The access criterion looks for reduced waiting, reach into underserved groups and genuine patient choice. Social value mirrors wider procurement expectations around local employment, carbon and community benefit. Weight your evidence to match what that authority has prioritised, rather than spreading it evenly and hoping.
The 8 working-day standstill and challenging a decision
Before signing many PSR contracts, an authority publishes a notice of intention and observes a standstill period of 8 working days, beginning the day after the notice is published, according to NHS England's statutory guidance and procurement lawyers such as Burges Salmon. Note it is 8 working days, not calendar days, so a bank holiday or weekend extends the real window, and you should diarise the end date carefully rather than assume a fortnight. If no written representations are received during the standstill, the authority can sign the contract once the period ends. If you believe a decision was wrong, the standstill is your window to make written representations to the authority setting out your grounds, and the regime expects the authority to consider those representations before proceeding. This is a far lighter mechanism than the automatic suspension and court timetable under the old Public Contracts Regulations 2015, so speed and a clear written argument matter more than ever. You are not filing a claim, you are persuading the commissioner to pause and reconsider on the evidence. We monitor intention notices for clients on NHS contracts they hold or want, so an unexpected award does not slip past inside the short window unanswered.
Who the PSR applies to, and who it does not
The PSR binds only relevant authorities commissioning in-scope NHS healthcare services: NHS England, Integrated Care Boards (ICBs), NHS trusts and foundation trusts, and local authorities and combined authorities when they commission in-scope healthcare. If your funder is an ICB or NHS trust buying CHC, community health, mental health or integrated care, you are almost certainly under the PSR rather than under wider procurement law. The trap is mixed providers serving both NHS and council budgets. Pure adult social care commissioned by a council under the Care Act usually stays under the Procurement Act 2023, which has been live since 24 February 2025, not the PSR. So a domiciliary or supported living contract from a council and a CHC package from an ICB can follow entirely different rules, with different notices, timescales and award routes, even for the same provider in the same week. Scope turns on the CPV health codes attached to the specific opportunity, not on how you describe your own organisation. Always confirm the regime per contract rather than assuming your whole sector sits in one or the other, because guessing wrong wastes the lead time you need to respond well.
How a provider gets named most suitable provider
You become the most suitable provider by giving the authority enough evidence to justify choosing you without competition, mapped cleanly to the five Regulation 5 criteria. In practice that means holding a current, organised evidence base before any opportunity arises: CQC registration and rating, outcomes and quality data, documented integration with local NHS and community partners, evidence that your staffing and finances are sustainable, and a real social value record. For Direct Award Process C, the work is keeping your existing contract clean: meet your KPIs, document performance month on month, and be ready to show the service is not changing considerably. For the Most Suitable Provider Process, build a working relationship with the commissioning ICB so they can identify you as the obvious choice and defend that choice in their notice. Where a Competitive Process is used, it behaves like a scored tender and the usual bid discipline applies, from method statements to social value commitments. We help providers assemble the criteria-by-criteria evidence pack the PSR rewards, then write the representations or competitive bids that follow, so the case for choosing you is already on the page when the authority looks for it.
The three PSR award routes at a glance
How a relevant authority can award an in-scope NHS healthcare contract under the Provider Selection Regime, and what each route means for you as a provider.
| Route | When the authority uses it | What it means for a provider |
|---|---|---|
| Direct Award Process A | Only one provider can deliver the service | No competition; you must be the sole capable provider |
| Direct Award Process B | Patients choose their provider on agreed terms, for example listed providers | Get onto the list and meet the standard terms; no scored bid |
| Direct Award Process C | Existing service not changing considerably and current provider is satisfying its contract | Route to retain a CHC or community health contract without re-bidding |
| Most Suitable Provider Process | Authority can identify the best provider without competition | Win on evidence against the five Regulation 5 criteria, no open tender |
| Competitive Process | No direct award or most-suitable route fits | Closest to a traditional scored tender; full bid required |
Not sure if you qualify for a tender? We check it for free, before you pay anything, and we only take bids we believe you can win. Text TENDER to get started.
Common questions
What is the Provider Selection Regime in the NHS?
The Provider Selection Regime (PSR) is the procurement regime for NHS-funded healthcare services in England, governed by the Health Care Services (Provider Selection Regime) Regulations 2023. It replaced competitive-tender-by-default for in-scope clinical services with three flexible award routes: Direct Award (Processes A, B and C), the Most Suitable Provider Process, and the Competitive Process. It lets a relevant authority award a contract without a full tender where that is justified, for example by keeping a satisfactory existing provider.
When did the Provider Selection Regime come into force?
The PSR came into force on 1 January 2024, when the Health Care Services (Provider Selection Regime) Regulations 2023 took effect, according to NHS England's statutory guidance. From that date, in-scope NHS healthcare services in England were removed from the Public Contracts Regulations 2015. The PSR has applied to relevant authorities commissioning those services ever since, and sits outside the Procurement Act 2023.
What are the five key criteria of the Provider Selection Regime?
Under Regulation 5, the most suitable provider is assessed against five key criteria: quality and innovation; value; integration, collaboration and service sustainability; improving access, reducing health inequalities and facilitating choice; and social value. The relevant authority sets the weighting between these criteria itself, so the balance varies from one ICB to another. Read the published weighting before you write your evidence, then weight your case to match it.
Does the Provider Selection Regime replace competitive tendering?
Not entirely. The PSR makes competitive tendering one of three routes rather than the default. An authority can use a Direct Award or name the most suitable provider without competition where that is justified, for example keeping a satisfactory existing provider under Direct Award Process C where the service is not changing considerably. It only runs a full Competitive Process when no direct award or most-suitable route fits the situation.
Who does the Provider Selection Regime apply to?
The PSR applies to relevant authorities commissioning in-scope NHS healthcare services: NHS England, Integrated Care Boards, NHS trusts and foundation trusts, and local authorities and combined authorities when they commission in-scope healthcare. It does not cover pure adult social care commissioned by a council under the Care Act, which usually falls under the Procurement Act 2023. Scope is set by Common Procurement Vocabulary health codes, so check each contract individually.
How much does it cost to have Selective Care Match help with an NHS contract?
Your first tender is £795, with standard bids at £3,000. We only take bids we believe you can win, and if a loss is clearly down to our writing error we rewrite the next one free. Our win rate is 96 percent. We start with a free eligibility check that confirms whether your contract falls under the PSR or the Procurement Act 2023 before you commit, so you are not paying to chase work under the wrong rules.
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