The Provider Selection Regime (PSR) Explained
The Provider Selection Regime (PSR) is the set of rules that NHS bodies and other public authorities in England use to arrange healthcare services. It came into force on 1 January 2024 under the Health Care Services (Provider Selection Regime) Regulations 2023, replacing competitive procurement rules with five provider selection processes.
Key facts at a glance
- Came into force
- 1 January 2024
- Legal basis
- Health Care Services (Provider Selection Regime) Regulations 2023, under the Health and Care Act 2022
- Applies in
- England
- Replaces
- Public Contracts Regulations 2015 and the 2013 section 75 NHS procurement rules for in-scope health care services
- Selection processes
- Five: three direct award processes, the most suitable provider process, and the competitive process
- Oversight
- NHS England statutory guidance, with published transparency notices and a standstill period
What is the Provider Selection Regime?
The Provider Selection Regime (PSR) is a dedicated set of rules for how relevant authorities in England arrange health care services. It gives the NHS a flexible, proportionate way to select providers that focuses on the needs of patients and populations rather than defaulting to competitive tendering.
The PSR sits outside the general public procurement rules. Health care services that fall within its scope are decided under the PSR rather than the Procurement Act 2023, which is why understanding the regime matters for any organisation that delivers or wants to deliver NHS-funded care.
When did the PSR come into force?
The PSR came into force on 1 January 2024. It was created by the Health Care Services (Provider Selection Regime) Regulations 2023, made under powers in the Health and Care Act 2022, and is accompanied by statutory guidance published by NHS England.
Before the PSR, NHS commissioners arranged health care services under the Public Contracts Regulations 2015 and the National Health Service (Procurement, Patient Choice and Competition) Regulations 2013, often referred to as the section 75 rules. The PSR replaced both for in-scope services.
Who does the PSR apply to?
The PSR applies to "relevant authorities" when they arrange in-scope health care services. Relevant authorities include NHS England, integrated care boards (ICBs), NHS trusts and NHS foundation trusts, local authorities and combined authorities.
For providers, this means any organisation that delivers or bids for NHS-funded clinical services, from acute and community care to mental health, primary care services and the voluntary, community and social enterprise (VCSE) sector, is likely to be selected through a PSR process.
What are the five PSR processes?
The PSR sets out five provider selection processes. The three direct award processes (A, B and C) are used where there is, in effect, only one provider that can deliver the service, where the existing provider is the only realistic option, or where a relevant authority is continuing with an existing provider that is doing a good job and the service is not changing considerably.
Where a direct award does not apply, an authority can use the most suitable provider process to award a contract without running a competition, provided it can identify and justify the most suitable provider against the key criteria. The competitive process is used when the authority wants to invite and compare offers from multiple providers.
How do providers win work under the PSR?
Decisions under the PSR are made against a set of key criteria: quality and innovation; value; integration, collaboration and service sustainability; improving access, reducing health inequalities and facilitating patient choice; and social value. Strong PSR responses evidence each of these clearly and specifically.
Whether you are responding to a most suitable provider assessment or a competitive process, the bid must show measurable outcomes, a credible delivery model, and genuine alignment with the local integrated care strategy. This is where specialist NHS bid writing makes the difference. See our NHS framework specialists hub for the full picture.
For hands-on help, our team writes and manages PSR and wider NHS tender responses end to end, aligned to the key criteria and the local commissioning context.
Who should apply?
Any organisation that delivers, or wants to deliver, NHS-funded health care services in England may be selected through a PSR process. That includes:
Pricing
PSR / Tender Response
From £1,500
Single healthcare service response, evaluator-led writing aligned to the PSR key criteria. Fixed price, no hidden costs, same-day consultations available.
Frequently asked questions
Is the Provider Selection Regime a framework you can join?
No. The PSR is not a procurement framework or a supplier list. It is a set of rules that NHS bodies in England must follow when they arrange health care services. You do not "get onto" the PSR; you respond to opportunities that relevant authorities run under it.
Does the PSR mean the end of competitive tendering for NHS services?
No, but it reduces it. Competition is only one of five PSR processes. Many contracts are now awarded through the direct award or most suitable provider routes, which means providers must be ready to evidence their suitability even when no formal competition is run.
What health care services are in scope of the PSR?
The PSR covers the arrangement of health care services for the purposes of the NHS in England, identified by specific Common Procurement Vocabulary (CPV) codes. Goods, and most non-clinical services such as general estates or IT, remain under the Procurement Act 2023 rather than the PSR.
When must an NHS authority run a competitive process under the PSR?
A relevant authority uses the competitive process when it decides it cannot or should not award directly and wants to compare offers from multiple providers. It must still apply the PSR key criteria and publish the required transparency notices.
Can a provider challenge a PSR decision?
Yes. The PSR includes transparency requirements, a standstill period on certain decisions, and a process for providers to make representations and request a review before a contract is finalised. Acting quickly within the standstill window is essential.
How can Glaxtons help with a PSR opportunity?
Glaxtons writes and manages PSR responses for healthcare providers, evidencing the key criteria, the local integrated care strategy and measurable outcomes. We hold a 93% win rate across NHS and public sector bids, with senior specialists leading every engagement. PSR and tender responses start from £1,500.
Winning NHS work under the PSR
The Provider Selection Regime rewards providers who can evidence quality, value and real alignment with local NHS priorities. Glaxtons writes the responses that win. Talk to a specialist today.