Choice and competition have applied to the NHS for some time. The 1990s saw the introduction of an internal market, with a split between the commissioning and provision of healthcare services. More recently, since the publication of the NHS Five year forward view the tendency has been towards collaboration across local areas to deliver more integrated care which has raised questions about the role competition will play in the future NHS. For the foreseeable future, though, competition law remains unchanged and governors will therefore find it helpful to have an understanding of when and how it applies to NHS foundation trusts and trusts.