 In February 2019, NHS England called for the repeal of the regulations made under section 75 of the Health and Social Care Act 2012 which require competitive tendering.From March 2019, with the effective merger of NHS Improvement and NHS England there was no longer any real purchaser/provider split at a national level.The move away from Payment by Results, which started in 2019, further undermines the principles of the internal market, as it is intended to reduce incentives for increases in hospital activity.