The NHS is on the cusp of transformation, with the newly elected Labour government determined to make sweeping changes to improve the health service. A central theme of their campaign was the idea that the NHS is “broken,” and now they aim to fix it. But while policy reforms are being crafted, one major obstacle that needs immediate attention is the NHS framework agreement system.
The NHS, often compared to a slow-moving oil tanker, is notorious for its sluggish pace of change. Even when change is set into motion, it can take years before we start seeing results, and often, by the time we do, leadership has changed, and we’re onto the next wave of reforms. The framework agreements that govern procurement within the NHS are a prime example of this inefficiency. These agreements are supposed to streamline and standardize the process, but in reality, they are hampering the very innovation the NHS desperately needs.
A Real-World Example: Stuck in Bureaucratic Limbo
Let me share a recent experience to illustrate the problem. At a healthcare conference, I was approached by a healthcare provider running pharmacy services who desperately needed support for their GP practices. They wanted to work with my organization but were restricted by the requirement to work with a company on an existing NHS framework.
Eager to help, I contacted NHS England and completed the necessary forms. The response? We could not be awarded a place on any framework until their next renewal dates—March 2026 or even January 2027. Essentially, any hope of helping this provider or others like them was put on hold for years, purely due to an outdated system.
Meanwhile, the government emphasizes the need for NHS reform: moving from hospitals to community care, transitioning from analogue to digital, and focusing on prevention rather than treatment. These are all noble goals, but how can they be realized when companies with innovative solutions are kept waiting for years to even be considered?
Framework Agreements: A System That Stifles Innovation
The current framework agreements are outdated and ill-suited for an NHS that must be agile and adaptable to meet modern healthcare challenges. These agreements create a closed marketplace, making it nearly impossible for new, innovative companies to break in and contribute. Instead, trusts often stick to the same old providers, offering the same services with little room for new ideas or approaches. This lack of competition not only limits innovation but also hinders improvements in patient care.
Consider how quickly technology is advancing. In two years, the AI tools and healthcare technologies available today will have evolved significantly. Yet, companies that could bring these innovations into the NHS are locked out, waiting for the next tender opportunity. This means that by the time these companies are finally able to engage, their solutions might already be outdated.
The Solution: An NHS Accredited Provider System
We need a new system—one that supports innovation rather than stifles it. An NHS Accredited Provider system would offer a flexible and dynamic alternative to the current rigid framework agreements. Such a system would allow new companies to contribute without waiting years to be considered, enabling the NHS to adopt cutting-edge solutions that could benefit providers and patients continuously.
In my experience navigating the hoops of NHS procurement, the framework system doesn’t drive meaningful change. Trusts revert to the same old providers, delivering the same old services, without fostering innovation or improvement. We need a procurement process that allows the NHS to be proactive in seeking out the best solutions, not reactive, and certainly not stuck in the past.
Why Change is Urgent
If the NHS is truly going to embrace change—if it’s going to shift from hospital to community care, from analog to digital, and from treatment to prevention—then it needs a procurement system that is fit for purpose. A system that doesn’t trap innovative companies in a years-long waiting game.
The stakes are high, and the NHS can’t afford to wait until 2026 or 2027 to adopt innovations that could save lives today. We need a system that supports progress, not one that hinders it. An NHS Accredited Provider system would be a step in the right direction, allowing companies like mine to contribute to the future of healthcare and, ultimately, improve patient outcomes.
It’s time to rethink NHS framework agreements and replace them with a system that encourages innovation, competition, and, most importantly, better care for patients.
