Accessing The NHS’ Increasing Capacity Framework

The NHS is struggling under the sheer weight of patient demand, with new statistics in 2023 demonstrating that there are over 7.22 million people on the NHS waiting list. Over 92% of these patients wait for up to 46 weeks. As the patient list continues to grow, the NHS is seeking ways to reduce the burden by sub-contracting private clinical providers.

To meet the expectations outlined by the Framework, contractors may need to source finance to build new facilities, recruit more skilled employees or bridge gaps in operating costs. Rangewell can support you in this process and help you equip your business with the right tools to meet the NHS' contractual expectations.

What is the NHS Increasing Capacity Framework?

In 2021, NHS England established the Increasing Capacity Framework, which aimed to streamline the process of approving new clinical providers and outsourcing their appointments and surgeries. The framework makes it far easier to win NHS contracts, as the previous subcontracting process was complicated and long-winded, often resulting in frustration, miscommunication and poor results. 

The Increasing Capacity Framework gives you a more direct route into NHS contract work, whilst also benefitting the general public by providing a high level of care and reducing waiting times. The current list of providers was updated in 2022, and agreed contracts are to remain active until 2024/25. 

Regardless of whether you’re already an approved provider or aspiring to become one, fulfilling the significant challenges imposed upon contractors by NHS patient demand often requires investment. 

Whether that is to fund the construction of a new surgery in your private facility, purchase healthcare equipment to help increase your capacity, or even help pay staff wages, you’ll need cash to invest in order to meet the ever-growing needs of the NHS. 

Rangewell can help clinical providers raise the finance you need, from standard business loans through to more complex agreements like property development finance. We’ll help you understand the lender’s market, identify the right lender for your needs and negotiate finance on your behalf. We work with healthcare professionals regularly, so we know the sector inside and out. 

Get in touch to learn more, or continue reading to find out more about how finance can help with your work through the Increasing Capacity Framework.  

Not a provider?

The benefits of the Increasing Capacity Framework reach beyond approved providers, as it makes Trusts of all kinds more familiar with awarding work to contractors. Oftentimes, a clinical provider may be approached using the same format as the Increasing Capacity Framework, potentially winning a valuable contract even whilst not appearing on the provider list. 

Whether you’re an approved provider or not, finance can help you meet the terms required in these contracts. You may need to hire new staff, expand your premises or acquire new equipment to meet the NHS’ demands, all of which you can do through finance. As a finance expert, Rangewell can negotiate on your behalf to help you achieve a loan that works better for your organisation and your future goals. 

How the framework functions

If you’re not already an approved provider, you must wait until the NHS invites new applicants to become part of the Framework. You can then submit a bid and await a decision. 

For approved providers, the framework functions as a streamlined process for bidding for NHS contracts. Whilst a traditional tender is published to a wide list of suppliers, attracting multiple bids which will create heavy competition and require far more time investment, the providers on the approved Increasing Capacity Framework list face a much simpler system: 

1. Either a commissioner, NHS trust or NHS foundation trust can browse the list of approved providers in a secure database. 
2. The provider then submits either a Direct Award of Mini-Comp template to chosen providers, which you’ll use to demonstrate your capacity to meet the requirements. 
3. If selected, the provider will award you with an NHS Standard Contract or Sub-contract.

The standardised templates used through the framework make it easier for providers to find and select resource, but also for approved contractors to submit bids and win the work. 

Awarding contracts

You’ll face two situations when approached through the Framework, a direct award or mini competition. A direct award is when the provider sends a ‘Statement of Requirements’ to outline their requirements. You’ll then fill out the NHS contract and show your capacity to meet the stated needs before acceptance. 

Direct awards can only be given to contractors who offer services within a geographical area that the awarding Trust deems reasonable for patients to attend. You must also submit the lowest price from other competitors in the area. 

In any other case, the NHS will hold a mini-competition where the NHS will send a statement of requirements and a mini-competition template to Framework providers in a geographic area. You’ll then have to submit information around the following criteria:

• The quality of the Services as determined by the Contracting Authority
• Accessibility of the Services to a patient/group of patients
• Experience of the clinical team providing the Services
• Capacity/availability of Services; local factors which are proportionate and relevant to the Services; and/or 
• Price 

The trust will then make a decision based on the responses. In all cases, the more capable you are of demonstrating competency to fulfil NHS demand, the more likely you are to win the contract. 

Limitations of the framework

For approved providers, the system provides a tangible route into regular NHS contracting – but there are some explicit limitations which you must be aware of. 

The first is ‘insourcing’, which refers to the idea of an external organisation supplying staff or equipment to NHS facilities. You can’t do this kind of work under the Increasing Capacity Framework, though there are some exceptions: such as if you hold a long-term lease in an unused part of an NHS facility and carry out your work from there. 

The second is around hiring equipment to NHS facilities. Supplies of goods and/or equipment is not covered, including hiring equipment on a day rate for use within the Trust or on NHS premises. 

How Rangewell can help you win more work

As a contractor, you’ll need to use the templates to demonstrate your capacity to meet the NHS’ expectations. Each job will require a different level of service, with some larger contracts potentially worth up to £10 million. The bigger contracts tend to require providers that can demonstrate expansive facilities, a high standard of equipment and strong levels of staffing to be able to meet patient demands.  

In the NHS’ own procurement guide, it is stated that contractors who can provide an Estimated Annual Value (EACV) can be paid on account by the awarding provider, which means there’s a great deal of potential value in being able to show you can meet the demand even if you don’t yet have the means to do so. 

Instead of ignoring contracts that may be highly lucrative, we’d suggest bidding for an Estimated Annual Value and then doing the work required to meet the contract’s needs. To meet requirements, you may need to expand your facility, increase staffing or purchase better equipment – all of which incur costs. 

Finance provides a tangible route for your business to acquire the funds you need to meet these contract requirements, though your approach will have to take lender considerations into account. 

Lenders will usually look at your historic revenue figures and past performance to determine their offer. If you’re already an approved provider, you’ll have more authority in commanding a better deal – but lenders will still hesitate if you’re trying to raise higher levels of finance without having a contract secured. 

That’s where our team can help the most, helping you polish your business plan and negotiate on your behalf to demonstrate your competency to a lender even before you are awarded the actual contract. This means they can agree to finance you before you prepare a contract response, helping increase your chances of winning it. 

Finance to start or improve private healthcare businesses 

Clinical contractors who may be chosen as part of the approved provider’s network will face a range of costs, some of which are common to all business sectors and others unique to healthcare. These costs can limit your ability to fulfil NHS contracts and to reply to contracts submitted through the Increasing Capacity Framework. 

Whether you want to improve your business to become an approved provider, or you’re an existing approved provider looking to expand your capacity and take on bigger contracts, you may need to fund the following:

Operating costs

Hospitals, surgeries and other facilities all have operating costs which include utilities, bills, leases and staffing. In most cases, specialist clinical facilities have higher costs due to a skilled workforce that will naturally command higher salaries. 

When bidding for contracts, you may be asked to provide care to more patients – which in turn will increase your operating costs. If you don’t have the cash capital to fund this, you can’t fulfil the contract. Finance can help you plug gaps in operating costs and enable you to take on the contract. 

Property 

One criterion that a provider can be judged on is the capacity and accessibility of your service. If your existing surgery or clinic is insufficient, you’ll need to buy or build a new property to accommodate the demand of local patients. Property development finance can help you make this a reality, expanding your facility or opening a new one to serve more NHS patients. 

There are lots of other situations in which property finance can help you win bigger contracts, or just generally strengthen your business. For example, raising the finance to purchase the freehold for your premises will help give you more authority and stability, which you can then reflect in any contract responses to NHS requests. 

See commercial property finance and property development finance to learn more. 

Equipment

Cutting-edge equipment helps you compete against other providers but may be prohibitively expensive. In some cases, contracts will outline specific requirements around certain equipment or machinery – which you’ll need to have to be able to win the work. 

Asset finance provides an accessible route to owning said equipment. In healthcare, where technology can cost millions of pounds, lenders can help you fund the purchase of an asset by securing their investment against that asset’s value. This means you’re essentially leasing the asset from the lender – but the asset will become yours once you’ve paid off the loan. 

For most borrowers, this route presents an affordable means by which to acquire cutting-edge equipment without risking personal assets as security. Asset finance can be arranged on all manner of equipment, so talk to our team to learn more. 

Whatever your financial requirements, Rangewell can lend support as you grow your business around the ever-increasing demand for capacity and patient care required by the NHS' Increasing Capacity Framework. Get in touch to apply for finance today.