For providers, securing a contract under the NHS’s Provider Selection Regime (PSR) requires a comprehensive understanding of the regime’s framework and decision-making process. The PSR was introduced to replace traditional procurement methods in certain situations, allowing Integrated Care Boards (ICBs) to select providers directly when it serves the public interest. This regime is designed to balance the need for flexibility with transparency and accountability.
In this blog, we’ll break down how providers can best position themselves for a direct award and align with the five key criteria set out by the PSR statutory guidance.
How ICB Strategic Commissioning Will Shape Direct Award Decisions in 2026
Why the Strategic Commissioning Framework Matters
NHS England’s Strategic Commissioning Framework sets out what is expected from Integrated Care Boards (ICBs) in the strategic commissioner role, including an updated commissioning cycle and a clearer focus on using insight, priorities, contracting levers and evaluation to improve outcomes.
This is not a procurement route, and it does not replace the Provider Selection Regime (PSR). However, it does influence the context in which Direct Award decisions are made, because ICBs are being encouraged to adopt a more strategic commissioning approach from April 2026.
What This Means for Providers and Bidders
Even when a contract is awarded through Direct Award C, commissioners still need confidence that the service model fits the direction of travel locally. In practice, that often means stronger scrutiny of how your proposal supports:
- population health priorities, not only activity targets
- reducing inequalities in access, experience and outcomes
- prevention and earlier intervention where it is appropriate for the pathway
- digital enablement that improves delivery, reporting and user experience
- value and outcomes, including how improvement will be measured over time
If you want the wider context behind these shifts and what they mean for tender responses, our guide to NHS commissioning and ICB changes explains how ICB expectations are evolving for 2026/27.
Evidence to Prepare Now
To be ready for Direct Award C discussions and submissions, it helps to have a small evidence pack you can reuse across opportunities:
- needs insight: what demand and variation look like locally, and what cohorts face barriers
- outcomes logic: what will change, how, and how you will evidence it
- inequalities approach: specific barriers, practical mitigations, and measures by cohort
- mobilisation and continuity: how you protect service users during transition
- data and reporting: clear definitions, performance rhythm, learning and improvement actions
- pathway integration: interfaces, escalation routes, partner roles and handoffs
This keeps your Direct Award C position aligned to the PSR criteria, while also reflecting how commissioning expectations are shifting.
Against that wider commissioning context, the sections below explain how the Provider Selection Regime works and when Direct Award C may apply.
Understanding the PSR
The Provider Selection Regime is not a process that providers can opt into, but rather a decision-making framework used by commissioners like ICBs to choose the most appropriate providers without a full competitive procurement. The framework is guided by five key criteria, which ensure that selection processes remain fair and aligned with public needs, while supporting patient outcomes.
What Does the PSR Direct Award Process Entail?
Under the PSR, commissioners follow specific selection processes when competitive tendering is not necessary. However, even in cases where direct awards are made, providers must still meet the strict requirements set out by the PSR, particularly the five statutory criteria:
- Quality and Innovation
Providers must demonstrate the ability to deliver high-quality services and embrace innovation. This includes ensuring services are clinically safe, patient-focused, and continuously improving based on NHS standards. Providers are expected to show alignment with the NHS Outcomes Framework and highlight their unique contributions to service quality.
- Value for Money
This criterion evaluates the cost-effectiveness of the provider’s service delivery. Providers should be prepared to offer comprehensive data on how their services deliver financial sustainability without compromising quality, and how they contribute to broader NHS efficiency targets.
- Integration and Collaboration
Providers are required to demonstrate how their services contribute to integrated care pathways and collaborate effectively with local healthcare systems. A key aspect is showing alignment with local priorities established by ICBs and working in partnership with other NHS services.
- Social Value
Social value plays a significant role in the selection process. Providers need to show how their services benefit local communities beyond direct healthcare delivery. This could include reducing health inequalities, supporting local employment, or improving social cohesion.
- Continuity of Services
In situations where patient care continuity is critical, commissioners may award contracts directly to existing providers. Demonstrating proven capacity for service delivery, especially in times of disruption, is essential. Providers must illustrate their capability to maintain consistent care standards.
Steps Providers Can Take to Prepare
- Self-Assessment
Providers should begin by assessing their service delivery against the five PSR criteria. This includes reviewing clinical capabilities, patient outcomes, and engagement with local healthcare systems.
- Stakeholder Engagement
Working closely with both service users and local partners is vital for demonstrating integration and collaboration. Regular communication and engagement will help providers better align their services with the needs of the population and healthcare priorities.
- Data Collection and Analysis
Providers need robust data collection mechanisms to showcase their performance in areas such as quality, financial efficiency, and social value. This data is integral to making a compelling case for selection under the PSR framework.
- Collaborating with ICBs
Ongoing collaboration with ICBs is key to aligning with local healthcare strategies. Providers should actively participate in local healthcare discussions, ensuring that their services remain relevant and responsive to the needs of the population.
How We Can Support You
We understand the complexity of navigating the PSR framework. Our team has a deep understanding of NHS Procurement and has already helped various organisations retain contracts under PSR. Our team can help you assess your readiness, collect the necessary data, and prepare comprehensive submissions that highlight your strengths in meeting NHS objectives.
Here’s how we can assist:
- Co-Development Workshops: Collaborate with your team to develop a tailored service strategy that aligns with NHS and PSR objectives.
- Data Collection & Analysis: Facilitate stakeholder engagement and manage the data collection process to ensure you’re demonstrating quality, integration, and social value.
- Report Writing and Presentation Support: Ensure your reports and presentations to ICBs are polished, persuasive, and meet the PSR’s stringent requirements.
Ready to Succeed Under the PSR?
If you’re looking to prepare for a potential direct award under the PSR or enhance your chances of selection, we are here to guide you.
