Healthcare Law and Ethics: A Case Study on NHS Procurement Regulations

This report provides an analysis of healthcare law and ethics within the context of the UK's National Health Service (NHS). It examines the legal and ethical considerations that Clinical Commissioning Groups (CCGs) must consider when acting in accordance with the National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations 2013. The report covers the evolution of the UK healthcare system, the phenomenon of outsourcing, relevant statistics, competition, public procurement, patient choice, and key legislation such as the Competition Act 1998 and the Network and Information Systems Regulation 2018. A case study involving Primary Care Trust and Trinity Hospital is used to illustrate these concepts, highlighting the importance of factors like cost, service quality, and integration with local practices when making outsourcing decisions. The report also emphasizes the need for transparency and proportionality in contracting processes to ensure effective and efficient healthcare service delivery while complying with legal and ethical obligations.

HEALTHCARE LAW AND ETHICS
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Executive summary
Health and social care is one of the going sector with increase in number of diseases in
external environment to provide qualitative care to individuals that are living in society. This
report has base on the case study of Primary Care Trust, that is community blood screening
service has expanded its business for three years. So, it has discussed about the what all things
need to be considered by CCG for acting consistently with the Page 3 of 7 requirements of the
National Health Service (Procurement, Patient Choice and Competition) (No.2) Regulations
2013.

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
1. Evolution of Healthcare system in the UK..............................................................................3
2. The phenomenon of outsourcing.............................................................................................4
3. Statistics to the source of outsourcing.....................................................................................5
4. Competition public procurement and patient choice...............................................................6
5. Legislation...............................................................................................................................6
6.The scope of CA 1998..............................................................................................................8
CONCLUSION................................................................................................................................8
REFERENCES..............................................................................................................................10
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INTRODUCTION
Healthcare is the improvement or maintenance of health via the prevention and other
physical and mental impairments which are provided by the health care professionals. With
increase in number of diseases, healthcare system has been improved to improve the health and
well-being of people living in society.
The report will analyze the relevant legislations and examples by critically discussing the
Clinical Commissioning Group (CCG) is taken into account for ensuring it is acting consistently
with the requirements of National Health Service (NHS) by following regulations 2013. This will
further involve evolution of healthcare system in UK, the phenomenon of outsourcing, statistics
to the source of outsourcing, competition public procurement and patient choice, legislation T,
the scope of CA 1998. These are the essential aspects which will be explained under the
healthcare sector and for this the case study is provided which will help in delivering the
information at large scale. All these aspects will help in providing all the information regarding
the Primary Care Trust in collaboration with Trinity Hospital on significant scales.
MAIN BODY
1. Evolution of Healthcare system in the UK
United Kingdom is sovereign states that is located at north-western coast of Europe,
more over it has population of 62,262,000 people and $2.260 trillion Great Britain Pounds as
GDP. After the second world war, the UK healthcare system has come into the existence and
become operational on 5 July 1948. Before it, the healthcare system has been available to only
wealthy people, unless and until the treatment is offered to patient through charity at free of cost.
Moreover, in 1911, the national insurance act has been introduced by David Lloyd George that
contribute in deducting small amount of money from the wages of employees so that they can be
entitled to healthcare services (Maynard and Williams, 2018). So, after the world war, steps has
been taken to endeavour launch of public healthcare system with an motivate to offer health care
services to diverse range of people at free of cost. In 1974, the tripartite system has been
formulated that contribute in splitting the services into primary care, hospital services and
community services. So, such reformation has continued which further lead in development of
NHS with an aim to improve healthcare standard by lowering cost and waiting time.
Currently, there are more changes that has been brought in NHS in 2014 that would result
in putting 30000 administrators of work. Furthermore, around 80% of bugdet of NHS will be

utilised for having specialized doctor in order to encourage ongoing privatisation in healthcare
industry so that patient have more choice. In recent scenario, National health services is
government sponsored universal health care system under which citizen are entitled to have good
healthcare services (Fahy and et.al., 2017). UK has most efficient health care system in the world
as NHS plan promise to delivered more bed, hospitals, doctors and nurses, power and
information to patient. Along with shorter waiting time for appointment so that they can be cured
in minimum time frame possible.
2. The phenomenon of outsourcing
Outsourcing is the process of hiring third party that is outside the company in order to
perform its services on behalf of the company. This is a practice that is mainly undertaken by
firm with an motivate as cost-cutting measure so that maximum benefits can be rendered to
people living in the society. Phenomenon can be defined as act or event in the society that need
to be considered while deciding the outsourcing of services for maximum benefits of company.
In the context of the case study of primary care trust that is community blood screening services
has spread its business into different market since three years for which it has selected trinity
hospital (Land and Lewis, 2018). The phenomenon or facts that needs to be considered by the
Primary care trust is Competition, patient choice and procurement while outsourcing for better
results. Such as:
1. The trinity hospital has well integrated with the local practices, that has contributed in
effectively providing services to the patient in limited time frame and as per their needs
and requirements. Thereby it has complete knowledge about the market situation, people
need thus able to provide effective services to them (Liu and et.al., 2018).
2. Second phenomenon that need to be considered while outsourcing is the overall cost that
people have to make in order to get the services. Such as Trinity hospital provide services
at relative low price or reasonable cost and have good link with the local charity that
contribute in delivering range of healthcare services to patient. Thus, people can easily
access the healthcare services as it is provided by the organisation at low price to them.
3. In terms of competitors, King Hospital is another healthcare that has expressed interest in
providing services. Moreover, the organisation has currently made investment in
development of new sensor technology with an motivate to reduce overall waiting time
for patient (Meehan, Menzies and Michaelides, 2017). Thereby it has lead in offering
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services to patient at higher price so only people that have high income can access to
healthcare services.
4. Moreover the major driving force behind the outsourcing in healthcare is cut down of
public spending. So, company focus on providing more efficient and innovative ideas to
delivered qualitative healthcare services to patient. At the same time, it contribute in
pooling range of knowledgeable, pool of expertise people to make use of their skills and
capabilities to deliver services as per patient requirements.
So, Clinical Commissioning Group while outsourcing its services needs to considered all
the elements such as well integration of Trinity hospital, its qualitative services that are
reasonable offered to customers at limited time frame and cost. Along with that, the existing
competition in the healthcare sector need to be considered to decide the outsourcing of firm (Ata,
Ding and Zenios, 2021). Such as King Hospital have advantages that it has highly invested in
sensor technology which would contribute in providing better experience to patient. As they does
not have to waste time in getting the services to get cure or for better treatment.
3. Statistics to the source of outsourcing
With globalisation, many companies are outsourcing their work in order to delivered
services to people at limited or minimum price possible. Likewise, as per market study of 2019,
the global healthcare outsources will be projected to reach by $449.6 billion at a 12.3 percent
compound annual growth rate till 2023. The overall reduce in operational cost and better services
will contribute in driving market growth. Furthermore, it is forecasted that global healthcare will
outsources the IT integration market by $61.2 billion till 2023, due to rise in demand for electric
bill and payment system. Healthcare is making use of electronic health record and implementing
cloud computing in order to delivered qualitative services to patient so that they can easily
overcome form the health issue (Sanderson, Allen and Osipovic, 2017). In addition to this,
outsourcing of healthcare system will lead in number of benefits such as provide access to
trained professionals and industry expert at lower cost, maximise the staff efficiency and
production. Moreover, it lead in improving the patient care, outcome and the experience and
increase cost saving to maximum extend. IT is one of the most common outsources areas in
healthcare with increase in focus on electronic health records, data management, assets
management and operational management.

In addition to this, outsourcing in healthcare is become important because it lead error free
medical billing as hundreds of medical bills are process every day. So, outsourcing helps
healthcare organisation in getting more specialised and trained team that can easily maintained
record of data (Longo and et.al., 2019).
4. Competition public procurement and patient choice
In current scenario, there is high competition in external environment, but healthcare
services have main motivate to improve the health condition of people so it does not operate to
earn high profit margin. Moreover, patient choice needs to be considered while selecting specific
organisation pertaining to contract for delivering improved, effective and qualitative services to
customers in better manner. Likewise, if patient want to have quick services and does not want to
waste their time at all then contracting with King Hospital is fruitful as company have invested in
new technology that contributed in saving time of the patient waiting for good health care
services (Kaehne and et.al., 2017).
5. Legislation
Legislation are legal rules and regulation that are made by the government of country
which needs to be abided by organisation while performing its respective task and
responsibilities. These are made with an motivate to maintained peace and equality in the
society. Therefore, the legal laws that needs to be considered by Clinical Commissioning Group
while ensuring consistently with requirements of national health services regulation 2013. Such
as:
1. Competition Act 1998: It is one of the acts that prohibits any type of agreement,
business practice and conduct that lead in causing damaging effect on competition in
United Kingdom. In another words, unethical practices that are used by company to stay
ahead in competition for longer time frame. Likewise, the Clinical Commissioning Group
while considered the new tender process needs to make agreement with the company that
ethical behave and provide maximum benefits to people (Kaehne and et.al., 2017).
2. The Network and Information Systems Regulation 2018: It is one of the regulations
that has to be abided by the organisation in healthcare. This emphasis that operations of
essential services and digital services provider must make use of security measure and
incident management procedure. In case of outsourcing arrangement for avoiding any
complication in future scenario.
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3. Procurement law: it states that the healthcare services as per Section 75(2) of the 2012
Act, secure needs of people that make use of services through procuring qualitative
material. Improve the quality of services and efficiency in provision of services for better
outcome. Therefore, as per the law, all the services need to be provided in integrated
manner. So, while deciding to formulate contract with other healthcare services, act in a
transparent and proportionate way that is the contract made between the companies
should be transparent and clear.
In addition to this, CCG must also consider provider equally on the basis of their ownership
so that best suitable company can be contracted for delivered effective services to patient. The
company is best which provided maximum value for money, allow patient to have choice of
provider of services and services are being integrated. Therefore, as per the legislation contract
awarded by CCG complies with duties as of effectiveness, efficiency, promoting integrating and
improvement in quality of services. Likewise, the Trinity Hospital was effective as well as
efficient, along with that well integrated with the local practices and providing healthcare
services to patient (The National Health Service (Procurement, Patient Choice and Competition)
(No. 2) Regulations 2013). On the other hand, King Hospital is focusing on improving the
quality of services through making investment in sensor technology in order to reduce the
waiting time of patient to have services. These has also contributed in reducing overall price of
the services that are offered by healthcare to the patient.
4. Patient choice: primary medical services: It is another law that is apply to list of
patients of practice of individual choice. Furthermore, it defined the meaning of contract-
which is arrangement for provision of primary medical services as per section 83(2) of
the 2006 Act. Likewise, to apply for inclusion in list of patients of practice of individual
choice. Secondly to express a preference in receiving the services from particular
performer in relation to specific condition. So, with the context of the case study, e
Clinical Commissioning Group while making contract with any firm need to consult
about the choice of the patient (Storsjö and Kachali, 2017). Such as most of the people
are well integrated with the services of Trinity Hospital so it has to extend its contract
with the same to delivered qualitative healthcare services to patient.
5. Patient care and elective care: This is legislation that set out the right of patient to
selected particular organisation services for treatment of the health problem. It also helps

patient in selecting maximum waiting time and reasonable steps that need to be taken by
NHS to provide best alternative options for care. Likewise, the regulation 12 of
Procurement, Patient Choice and Competition Regulations is mainly made to protect right
of choice of maximum waiting time are not going to meet.
6. Award of a new contract without a competition: It is also one of the legislations that
should be taken into consideration by Clinical Commissioning Group while deciding the
contract with specific firm while ensuring requirement of national health services
Regulations 2013. This states that relevant body may award a new contract for provision
of health care services to single provider without any type of advertisement where the
body is satisfied to provide qualitative services to patient (Kemp, 2020). While relevant
body are not treated having award of new contract, whose rights and liabilities under
contract has transferred to primary care trust. Or there has been changed in the terms and
condition as per drafted by the Board under that regulation.
6.The scope of CA 1998
The scope of CA i.,e company act 1998 is wide as any business whatever it is having legal
size, sector and status should have complete knowledge related to competition. So, that it can
easily meet the obligation, avoid heavy penalties and effectively assert its own right and protect
its position in external market. Two main anti-competitive activity has been prohibited in the EU
and UK competition law such as anti-competitive agreements and abuse of a dominant market
position. Likewise, the anti-competitive agreement prohibits all the business practice and
agreement that are distorting, restricting and preventing competition thereby directly affect trade
within EU and UK. It scope is such as agreement that directly lead in fixing selling price and
other trading condition likewise to offer services at discount or rebates (Skipworth and et.al.,
2020). Agreement related to sources of supply or that limit the control products and technical
development, companies need not to be added in the agreement. At the same time, the agreement
that place other tradition party at disadvantage should be also dismissed. While, abuse of a
dominant market position, states that companies that are unfairly exploiting their strong market
position or abuse of dominance. For examples: unfair trade terms, discriminatory pricing and
refuse to provide access to essential facilities to the individual living in the society. Therefore,
competition law is also applied in context of the case study, that has to be considered by CCG
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while taking decision related to whether to extend the contract with Trinity Hospital or formulate
new one with King Hospital.
CONCLUSION
Thus, it is concluded form the above report that all essential aspects were explained at large
scale and in elaborative manner. Along with this, the case study of Primary Care Trust was
described which helped in knowing the basis of how healthcare was being known effectively
through the case study. Moreover, it can be summarised that CCG while taking decision related
to making contract with Trinity Hospital or King Hospital needs to considered all the legal laws
related to National Health Service (Procurement, Patient Choice and Competition) (No.2)
Regulations 2013. At last, it can be concluded that extending contract with Trinity Hospital will
be fruitful because it has well integrated with the local community.

REFERENCES
Books and journals
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allocation policy design with endogenous patient choice. Manufacturing & Service
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Fahy, N and et.al., 2017. How will Brexit affect health and health services in the UK? Evaluating
three possible scenarios. The Lancet, 390(10107). pp.2110-2118.
Kaehne, A and et.al., 2017. Bringing integration home: Policy on health and social care
integration in the four nations of the UK. Journal of Integrated Care.
Kemp, K., 2020. Concealed data practices and competition law: why privacy matters. European
Competition Journal, 16(2-3). pp.628-672.
Land, H. and Lewis, J., 2018. Gender, Care and the Changing Role of the State in the UK.
In Gender, social care and welfare state restructuring in Europe (pp. 51-84). Routledge.
Liu, Y and et.al., 2018. Why patients prefer high-level healthcare facilities: a qualitative study
using focus groups in rural and urban China. BMJ global health, 3(5). p.e000854.
Longo, F and et.al., 2019. Does hospital competition improve efficiency? The effect of the
patient choice reform in England. Health economics, 28(5). pp.618-640.
Maynard, A. and Williams, A., 2018. Privatisation and the National Health Service.
In Privatisation and the welfare state (pp. 95-110). Routledge.
Meehan, J., Menzies, L. and Michaelides, R., 2017. The long shadow of public policy; Barriers
to a value-based approach in healthcare procurement. Journal of Purchasing and Supply
Management, 23(4). pp.229-241.
Sanderson, M., Allen, P. and Osipovic, D., 2017. The regulation of competition in the National
Health Service (NHS): what difference has the Health and Social Care Act 2012
made?. Health Economics, Policy and Law, 12(1). pp.1-19.
Skipworth, H and et.al., 2020. Logistics and procurement outsourcing in the healthcare sector: A
comparative analysis. European Management Journal, 38(3). pp.518-532.
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Storsjö, I.T. and Kachali, H., 2017. Public procurement for innovation and civil preparedness: a
policy-practice gap. International Journal of Public Sector Management.
Online
The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations
2013, [Online]. Available Through: <
https://www.legislation.gov.uk/uksi/2013/500/regulation/6/made >.