Practice-based commissioning

Practice-based commissioning (PBC) was a government policy, introduced in 2005, designed to give general practitioners, nurses and other primary care professionals the power to decide how NHS money is spent in their local area.

In 2006 we began a research project to assess the progress of PBC in four case study sites in England.

Our two-year investigation into the implementation and impact of practice-based commissioning (PBC) assessed progress against the policy's three main objectives – better clinical engagement, better locally-provided services for patients and better use of resources – and identified barriers that were limiting its success.

What did we do in this project?

The final report from this project was published in November 2008: Practice-based commissioning: reinvigorate, replace or abandon?

The study was a qualitative project based on semi-structured interviews in four case study sites. It was not designed to provide a representative picture of the state of practice-based commissioning in England, but rather to provide an in-depth look at its implementation and impact locally. The research tried to identify factors that facilitated, and factors that were barriers to, the implementation of PBC.

Further work

In July 2009 we published a poll of GPs and practice managers that found commitment to PBC and optimism about its potential but also suggested that progress is still hampered by a lack of local vision, a lack of clarity over roles and responsibilities and bureaucratic governance processes.

Project team

• Natasha Curry

• Ruth Robertson

• Nick Goodwin

• Chris Naylor

Expert advisers: Nick Mays and Richard Lewis