Building high-quality commissioning: What role can external organisations play?

The research involved three main elements:

• Two national surveys of primary care trusts (PCTs).
• Focus groups with firms providing commissioning support services to the NHS.
• Case studies of NHS organisations that have used external support for commissioning.

National surveys

Representatives from all PCTs were invited to complete a web-based survey in 2009, and again in 2010. The surveys allowed us to collect information on how widespread the use of external support for commissioning is, what it is being used for, and who is providing it. It also measured satisfaction with services provided by external organisations, and with government policy in this area.

Focus groups

We conducted focus groups with representatives from 12 organisations providing commissioning support services to the NHS. A range of types of organisation were involved – reflecting the diversity existing in the market – including consultancy firms, health insurance providers, and commissioning support specialists.

The focus groups explored organisations' experiences of working with NHS commissioners, and their opinions regarding potential improvements to policy and practice in this area.

Case studies

We selected five NHS organisations as case studies (three PCTs and two strategic health authorities) that have used external support for commissioning. All five have been proactive users of external support, but they were selected so that the types of support procured, and the means used for procuring it, differed between them. They were also selected to represent a range of geographical areas and population types.

In each case study site, we explored experiences of using external support with both the NHS client and the external supplier.