The procurement of local health services by means of competitive tendering is a matter for the local National Health Service. We are advised by NHS England that Greenwich Clinical Commissioning Group’s Turnaround Director and Musculoskeletal (MSK) Programme Manager met the senior management team of Lewisham and Greenwich Healthcare Trust in March 2016. We understand that the implications of the MSK service procurement were discussed in detail, and that there were no concerns with regard to the viability of any other services the Trust provides. We are further advised by NHS England that it undertook an assurance of the procurement process for the MSK service in Greenwich in August 2016 and as part of this also met with the Trust to discuss the implications of the procurement for the trust. We understand that Circle Health has been engaging with Lewisham and Greenwich Healthcare Trust as part of the mobilisation process, including developing clinical and operational delivery plans to provide integrated services.