An inside view
"There are already organisations WITHIN the NHS that can and do offer services like this at no cost to PCTs and Trusts".
There may be organisations that can and do offer services at 'no cost ' but that doesn't necessarily mean that they are free - it simply means the headcount costs are being absorbed somewhere else. It also potentially means that the resource somewhere else is under-utilised if the unused capacity exists in the first place.
I should declare an interest at this point as I *previously* worked with one of the organisations that has been selected for the new framework. My experience was that working with the PCTs was extremely rewarding - we were able to deliver sophisticated tools tailored to local needs that went far and above anything they had access to already. We listened very hard to the needs of PCT Information Management staff & Clinicians and worked with them to iteratively (and rapidly) develop the tools needed to inform a very detailed understanding of local health needs.
On the projects I worked on, the new capabilities helped the clients to successfully identify local patients at risk of future hospitalisations. The new information enabled local clinicians to intervene pro actively meaning that the patients received earlier and better care in the community and the avoidance of exposure to hospital acquired infections. The PCTs themselves avoided the cost of unplanned hospital admissions - those that chose to collaborate together to try and do a similar thing independently ultimately failed to deliver - potentially impacting patients and budgets.
The fact the company I worked for was external to the NHS meant we were highly accountable to our customers with clear SLAs, and not just providing a service as a favour. The new framework for information services means that more PCTs will now benefit from a wide choice of innovative organisations competing with each other. That should mean that the range and quality of services available to PCTs improves due to competition whilst also keeping costs manageable. It also enables Trusts to take a measured view of what service best meets their needs - internal or external with both having their merits.