Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the effectiveness of the commissioning process for primary medical care services under circumstances where no prospective providers come forward.

NHS England has a statutory responsibility to ensure that all patients have access to high-quality primary medical care services and enters into contractual arrangements with a range of general practitioner providers to secure those services for the population of England.

The commissioning process to secure services includes, where necessary, approaches to stimulate the provider market. These include engaging with patients and the public, and hosting provider events, working with professional representative groups and other key stakeholders. Options available to commissioners include:

- Procurement through an Alternative Provider Medical Services contract, which allow the widest range of providers to bid for delivery;

- Re-procurement through General Medical Services or Personal Medical Services contracts, which are contracts that can only be held by general practitioners or wider members of the National Health Service family; and

- List dispersal in the case of generally small practices where there is reasonable provision from neighbouring practices.