Thinking differently about commissioning: new approaches to local planning

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Final report

The final report for this project, Thinking differently about commissioning, is now available.

Case study interviews

Why we did 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 are changing how some of the key commissioning ‘tasks’ – ie, the activities like setting priorities, procuring services and monitoring performance – are delivered and potentially who does them.

This project sought 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 did

We sought 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
  • 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 drew on published literature and undertook field work in three case study systems in England.

Key milestones

Our report was published on 6 February 2020.

Project team


Ruth Robertson

Senior Fellow, Policy


Leo Ewbank

Researcher, Policy

Ros West

Senior Co-ordinator, Policy