Provider Selection Regime · 3 of 4
The PSR Competitive Process
The competitive process is the PSR route where an authority invites and compares offers from multiple providers. It is not a Procurement Act tender. There is no fixed procedure, no standard selection questionnaire, and the authority designs the process around the five key criteria it must apply.
What we do
- Decode the process the authority has designed, since PSR competitions vary far more between ICBs than Procurement Act tenders do, and reading another authority's process into this one produces a compliant answer to the wrong questions.
- Map every response to the five key criteria and the published weightings, which is where most healthcare submissions leak marks by answering in service-description form instead.
- Build the outcomes evidence: measurable results from your own service data, not activity volumes, because the criteria are written about outcomes and evaluators score accordingly.
- Write the integration and collaboration response properly, which requires naming the local system, the pathways and the partners rather than asserting a general willingness to work with others.
- Handle access, health inequalities and social value as scored clinical commissioning criteria using local population data, rather than as a generic corporate social value annexe.
The mistake that costs the most
Treating a PSR competition like a Procurement Act tender. Bidders arrive with a library built for public procurement, answer in the shape a selection questionnaire expects, and produce a technically competent submission that does not address the key criteria the authority is legally required to apply. The submission reads as professional and scores as average.
Why this matters
The competitive process is the one PSR route a provider can reliably enter without an existing commissioner relationship, which makes it the realistic entry point for any organisation new to NHS-funded work. Losing it on a formatting and framing error rather than on capability is the most common and most avoidable outcome in the regime.
Common questions
How is a PSR competition different from a normal public tender?
There is no prescribed procedure. Under the Procurement Act 2023 a tender follows a defined route with familiar stages; under the PSR the authority designs its own process around the key criteria. Expect variation in stages, documentation and scoring between authorities, and read each process on its own terms.
When does an authority use the competitive process?
When it decides it cannot or should not award directly and wants to compare offers, for example where the service is changing considerably, where several providers could deliver, or where it wants to test the market. It must still apply the key criteria and publish transparency notices.
What scores well in a PSR competition?
Measurable outcomes rather than activity, genuine integration with the local system named specifically, workforce sustainability, and a credible answer on access and health inequalities using local data. Generic quality narrative that could apply to any authority scores poorly, however well written.
Do I need to be an existing NHS provider to bid?
No. The competitive process is the route most accessible to a provider without an existing commissioner relationship. You will need the eligibility position in place, including CQC registration for the regulated activities and the Data Security and Protection Toolkit where you access NHS-held data.
Is there a standstill period in a competitive process?
The PSR includes standstill and representation arrangements on relevant decisions, published through transparency notices. An unsuccessful bidder should read the notice as soon as it appears and act inside the window, because the opportunity to make representations is time-limited.
Reviewed 14 September 2026. This page explains the Health Care Services (Provider Selection Regime) Regulations 2023 and the accompanying NHS England guidance. It is not legal advice, and a decision you intend to challenge should be reviewed by your own advisers inside the standstill period.
The rest of the regime
Start at the Provider Selection Regime overview, check what you need in place at NHS supplier eligibility, or see how this plays out in dental and patient transport.
Facing a PSR decision?
Tell us the service, the authority and where you are in the process. A specialist will give you a straight read on the route and what is realistically available to you.
The PSR Competitive Process
Which service, which authority, and what stage are you at?