The NHS is one of the biggest buyers in the country — but its procurement works differently depending on what's being bought. Clinical services follow their own rulebook; everything else follows mainstream procurement law. Getting this distinction right is the key to NHS work.
At a glance
- Healthcare services are procured under the Provider Selection Regime (PSR), in force since 1 January 2024.
- The PSR sits separately from the Procurement Act 2023 for in-scope clinical services.
- Non-clinical NHS purchases — IT, facilities, consultancy, equipment — follow the Procurement Act 2023 like any other public contract.
- NHS trusts count as central government for advertising, so contracts above £12,000 are published.
- Knowing which regime applies tells you where to look and how the buyer will decide.
Two regimes, not one
The single most important thing to understand about NHS procurement is that there are two different rulebooks, depending on what the NHS is buying:
- Clinical / health care services (services provided to patients) → the Provider Selection Regime (PSR).
- Goods and non-clinical services (IT, facilities, equipment, business consultancy, catering, admin) → the Procurement Act 2023, the same regime as the rest of the public sector.
Mistaking which one applies leads suppliers to expect the wrong process. So start by asking: is this a clinical service, or everything else?
The Provider Selection Regime (clinical services)
The Provider Selection Regime came into force on 1 January 2024, made under the Health and Care Act 2022 and the National Health Service Act 2006. It removed the procurement of in-scope health care services from the general procurement rules (first the Public Contracts Regulations 2015, now the Procurement Act 2023) and gave NHS commissioners a tailored framework.
It applies to "relevant authorities" — including NHS England, integrated care boards (ICBs), NHS trusts, NHS foundation trusts, local authorities and combined authorities — when they arrange relevant health care services.
The PSR gives commissioners several routes to select a provider:
- Direct Award Process A — where there's genuinely only one possible provider.
- Direct Award Process B — where patients choose their provider and the number isn't restricted.
- Direct Award Process C — where the existing provider is doing well, is likely to continue, and the contract isn't changing considerably.
- Most Suitable Provider Process — the authority can identify the most suitable provider without a competition.
- Competitive Process — used where none of the above fit, or the authority wants to test the market.
For suppliers, this means clinical work isn't always openly tendered — incumbency and suitability matter a great deal, so relationships and demonstrable quality count.
Non-clinical NHS work (the Procurement Act 2023)
If you sell IT, facilities, equipment, consultancy or similar to the NHS, you're in mainstream procurement territory — the Procurement Act 2023. These contracts are advertised on Find a Tender and scored against published award criteria, just like any other public contract. (See how bids are scored and how to write a winning tender response.)
A helpful quirk: NHS trusts and foundation trusts are classified as central government for publication thresholds, so they must advertise contracts above £12,000, not £30,000. That means more NHS opportunities are openly published than many suppliers assume.
How to win NHS work
- Know which regime applies — it shapes everything else.
- For non-clinical work, treat it like any public tender: target your niche, answer the criteria, evidence your claims.
- For clinical services, build relationships and a track record — incumbency and suitability weigh heavily under the PSR.
- Watch the thresholds — the £12,000 floor means plenty of smaller NHS contracts are advertised.
One structural point worth knowing: NHS trusts count as central government for advertising purposes, so their publication floor is £12,000 rather than £30,000. That means a lot of genuinely small NHS work is advertised publicly — often the most realistic entry point for a supplier without an NHS track record.
Frequently asked questions
How does NHS procurement work?
It depends on what's bought. Clinical health care services follow the Provider Selection Regime (since 1 January 2024); goods and non-clinical services follow the Procurement Act 2023 like other public contracts.
What is the Provider Selection Regime?
A tailored framework for procuring NHS health care services, in force since 1 January 2024. It gives commissioners several routes — including direct awards and a competitive process — outside the general procurement rules.
Do NHS IT and facilities contracts use the PSR?
No. Non-clinical goods and services follow the Procurement Act 2023, are advertised on Find a Tender, and are scored against published criteria.
What's the minimum NHS contract value that's advertised?
NHS trusts count as central government, so they must advertise contracts above £12,000 — a lower floor than the £30,000 that applies to much of the wider public sector.
Sources
- NHS England — The Provider Selection Regime: statutory guidance
- Legislation.gov.uk — The Health Care Services (Provider Selection Regime) Regulations 2023
- GOV.UK — Below-threshold contracts guidance