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

Increasing emphasis is being placed on the role that commissioning can play in improving health services. Commissioning is a multi-faceted process that aims to ensure that the purchasing of services on behalf of a population is based on an analysis of local health needs.

Primary care trusts (PCTs) are currently responsible for the commissioning of most NHS services. The government plans to transfer most of these responsibilities to groups of GPs.

In 2007 the Department of Health launched the ‘world class commissioning’ programme. This programme aims to improve the quality of commissioning by defining 11 competencies that commissioners should aspire to, and assessing PCTs against these using an annual assurance process.

The Department of Health has also produced a framework that commissioners can use to purchase support services from private sector organisations. This is intended to make it easier to harness the commissioning skills present in organisations outside the NHS.

PCTs are increasingly turning to external organisations to provide specialist skills, for example in data analysis, and also more generic financial and management skills needed in the commissioning process. There is huge variation in terms of the size and scope of such initiatives, but the most radical schemes can involve commissioners investing several million pounds in external support.

The King’s Fund conducted a research project to explore the role and impact that external organisations providing commissioning support services have had so far, and might have in the future. The project involved national surveys and a series of focus groups with representatives from PCTs, strategic health authorities and leading firms currently providing support to NHS commissioners.

The final report from the project provides commentary and recommendations for policy-makers and commissioners on the use of external support for commissioning in the NHS.