Why we're doing this project
NHS commissioning is changing. Growing numbers of clinical commissioning groups (CCGs) are working together or formally merging, and some are arranging services jointly with local authorities; sustainability and transformation partnerships are bringing together providers and commissioners to plan services; and, in some places, integrated care systems are going further: developing new approaches which may see providers take on responsibility for much of the day-to-day work of commissioning. While commissioners and providers remain separated in law, the line between the two is becoming increasingly blurred in practice.
These moves will change how key commissioning ‘tasks’– ie, the activities like setting priorities, procuring services and monitoring performance – are delivered and potentially who does them. Most of these tasks (which are often described as a ‘commissioning cycle’) will continue, whatever changes are implemented to local structures.
This project seeks to understand these developments and support local health and care systems to evolve their commissioning approach by sharing learning from local systems which are re-thinking the role of commissioning.
What we're doing
We will seek to inform local systems as they evolve their commissioning approach by exploring a number of strands of evidence, in particular:
- lessons from previous models of commissioning in the English NHS
- how planning operates in the Scottish NHS, where a formal purchaser–provider split has been abolished
- learning from innovative systems in England – both the ‘philosophy’ they are using to develop their commissioning approach, and what this means for how they practically deliver the key planning activities.
To do this, we will draw on published literature and undertake field work in three case study systems in England and in Scotland.