The NHS is the UK's largest public sector client — and one of the most active buyers of design, research, and digital services. Across integrated care boards (ICBs), NHS trusts, NHS England, and arm's-length bodies, there are hundreds of design and digital contracts published every year.
Most agencies miss almost all of them.
Not because they're not eligible — but because NHS procurement is fragmented across dozens of organisations, routes, and portals. If you're only watching Contracts Finder, you're seeing a fraction of what's actually out there.
This guide explains the landscape clearly, so your agency can start finding and bidding on NHS design work.
Why NHS Procurement Is Different
NHS procurement doesn't flow through a single central buyer. Each NHS organisation — trust, ICB, NHSE arm — has a degree of procurement autonomy. That means:
- An NHS trust in Leeds can run its own tender for a digital service, independent of anything in London
- NHS England (NHSE) runs its own direct awards and framework call-offs at scale
- NHS Shared Business Services (NHS SBS) manages procurement on behalf of member organisations
The result: NHS design contracts appear across multiple portals, under multiple buyers, often simultaneously. Volume is high; visibility is low unless you're watching all the right places.
The Main Routes for NHS Design and Digital Contracts
1. Open tenders via Contracts Finder and Find a Tender Service
Below the £140,000 threshold, NHS organisations publish on Contracts Finder. Above it (and for complex scopes), they use Find a Tender Service (FTS).
Types of work common here:
- Website redesign and digital transformation projects
- Patient-facing service design and UX research
- Staff portal and intranet development
- Communications and campaign design
- Health data visualisation
Search terms worth monitoring: digital services, user research, UX, design, website, service design, communications design, patient experience. Buyer categories to watch: NHS trusts, integrated care boards, NHS England.
2. NHS Shared Business Services (NHS SBS) frameworks
NHS SBS operates a suite of procurement frameworks that member NHS organisations can use to call off services without running a full tender. The most relevant for design and digital agencies:
Digital, Data and Technology (DDaT) Framework
Covers digital transformation services, UX design, and technology consultancy. NHS organisations on the framework can award contracts directly (below threshold) or mini-competition within a lot. Being on this framework significantly reduces friction for buyers who want to work with you repeatedly.
Professional Services Framework
Covers consultancy and advisory services — relevant for research-led agencies or those offering strategy alongside design.
To get onto NHS SBS frameworks, you apply during open windows. Missing a window means waiting for the next iteration (typically 2–4 years). If you're not on any NHS SBS framework, it's worth checking current open lots at nhssbs.co.uk/procurement-frameworks.
3. Crown Commercial Service (CCS) frameworks
Several CCS frameworks are used by NHS buyers — not just central government. The most relevant:
- G-Cloud — used for cloud-hosted digital tools and platforms
- Technology Services 3 (TS3) — used for managed and professional IT services, including some design and digital work
- Management Consultancy — occasionally used for research and strategy projects
NHS organisations can and do call off G-Cloud for hosted platforms, digital research tools, and content management systems. If your agency offers a SaaS product alongside services, G-Cloud is worth pursuing.
4. Direct awards and waivers
NHS organisations sometimes waive competitive procurement for contracts below £25,000 (the typical waiver threshold varies by trust policy). This creates opportunities for direct relationship-based awards — but you need to be in the conversation before the brief is written.
This is why BD intelligence matters: knowing which NHS bodies are planning digital work in the next 6–12 months lets you make the right introductions early. Pre-market engagement is encouraged under the Procurement Act 2023 (see below).
What the Procurement Act 2023 Changes for NHS Buyers
The Procurement Act 2023 came into force in February 2025 and applies to NHS buyers. Key changes that affect agencies:
Increased notice periods. Buyers must publish a Pipeline Notice for contracts over £2 million, giving suppliers early visibility of upcoming work.
Preliminary Market Engagement. NHS buyers can now have structured pre-market conversations with suppliers before publishing a tender — without creating a conflict of interest. This is significant: it means an NHS trust can formally consult you on a brief before it's written.
Transparency Notices. More information is now published at every stage of a procurement, including reasons for direct awards. This makes it easier to see what your competitors have been awarded and why.
SME-friendly intent. The Act explicitly encourages buyers to consider SME suitability in lot design and evaluation. NHS buyers increasingly must explain why they haven't broken up large contracts into lots accessible to smaller suppliers.
Common NHS Design Requirements
If you're new to NHS tendering, here's what buyers typically ask for:
Experience with regulated or complex stakeholder environments. NHS commissioners want evidence you've worked in complex public-sector or regulated settings — not necessarily NHS specifically, but contexts where care was taken around compliance, accessibility, and user research with vulnerable populations.
Accessibility compliance. WCAG 2.2 AA compliance is non-negotiable for anything patient-facing. Many NHS briefs now specify EN 301 549 (European accessibility standard). Have your accessibility credentials clear.
NHS brand adherence. For anything public-facing, NHS Identity Guidelines apply. Familiarity with the NHS design system (service-manual.nhs.uk) and component library is a practical advantage.
Information governance and data handling. If your work involves any patient-adjacent data (even anonymised research transcripts), you'll need DSPT (Data Security and Protection Toolkit) compliance or a clear data handling statement. This doesn't need to be complex, but it does need to exist.
Social value. NHS buyers must evaluate social value as part of procurement (Cabinet Office policy applies). Have a clear social value statement — staff development, local economic benefit, environmental commitments — ready to adapt per tender.
How Much NHS Design Work Is There?
Significant. NHS organisations collectively spend hundreds of millions annually on digital and technology services. Design and UX is embedded across patient experience, staff tools, communications, and transformation programmes.
Some orientation:
- NHS England's digital transformation programme (FEDIP-aligned) has funded dozens of design and service design contracts in the last two years
- ICBs (there are 42 of them across England) increasingly have their own digital strategies and design budgets
- NHS trusts (there are over 200 acute trusts alone) run their own digital programmes independently
The total addressable market for design agencies is large. The challenge is visibility — knowing which contracts are live, which are coming, and where to register.
The Monitoring Problem
Most agencies track NHS opportunities informally: someone googles it, or a framework email lands in the inbox. The result is inconsistent coverage — you catch the contracts someone happens to notice, and miss the rest.
A systematic approach requires monitoring:
- Contracts Finder (for sub-threshold tenders)
- Find a Tender Service (for above-threshold)
- NHS SBS portal (for framework call-offs)
- Relevant buyer pages for key trusts and ICBs in your target geography
Manually, this takes hours each week and still leaves gaps. The volume of NHS procurement activity means that even a diligent manual search will miss relevant opportunities — simply because the search terms vary, the buyer names vary, and the timing is unpredictable.
A Practical Starting Point
If you're serious about building an NHS pipeline, here's where to start:
- Audit your existing NHS client relationships. Warm introductions to procurement contacts matter — frame them as BD conversations, not sales calls.
- Check NHS SBS framework windows. If a relevant lot is open, apply now. The next opportunity may be years away.
- Register on Find a Tender Service. Set up alerts for your key search terms. It's free and catches above-threshold NHS contracts.
- Review NHSE's digital programme plans. NHS England publishes its strategic intentions — understanding where investment is going helps you target your BD conversations.
- Set up systematic monitoring. Because NHS contracts appear across multiple buyers and portals simultaneously, manual monitoring is genuinely difficult at scale. Services like Tandara filter live UK procurement data daily and flag relevant tenders — including NHS digital and design work — directly to your inbox.
If you're spending more than an hour a week on procurement monitoring and still not confident you're seeing everything, it's worth trying a different approach.
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