The government has extended its NHS choice agenda to include community and mental health services.
It means NHS patients will be able to choose the provider of these services whether that be NHS, independent sector, or voluntary or third sector organisations.
The list of services recommended by the Department of Health (DoH) as the most suitable for this next step included back and neck pain and diagnostic testing.
Previously the option to choose provider when referred by a GP was only available in non-urgent hospital care.
Every area across England will be expected to offer more choice in a minimum of three services by September 2012 - either from the recommended list or for another community or mental health service that is a high local priority.
The number of services will be expanded further from April 2013.
However, the government has been forced to implement the policy more slowly than was originally planned and clarified that providers will be paid a fixed price determined by a national or local tariff.
It emphasised that competition would be on quality, not price.
A national qualification process will be established to ensure that providers meet NHS quality standards, along with a national directory of qualified providers to inform commissioners and patients.
The DoH received advice from patient groups, clinicians and voluntary organisations, to draw up the list of recommended services, which is:
• Services for back and neck pain
• Adult hearing services in the community
• Continence services (adults and children)
• Diagnostic tests closer to home
• Wheelchair services (children)
• Podiatry (feet) services
• Leg ulcer and wound healing
• Talking Therapies (Primary Care Psychological therapies, adults)
Dr Hamish Meldrum, chairman of council at the British Medical Association (BMA), questioned the potential impacts of the decision.
"We support greater choice for patients, although in an NHS with finite resources it will always be limited," he said.
"What we would question is the assumption that increasing competition necessarily means improved choice.
"When competition results in market failure in the NHS, the ultimate consequence is the closure of services, and the restriction of choice for the patients who would have wished to use them," he added.
