Around 15 million people in England have at least one long-term condition and their numbers are expected to rise. Our researchers undertook an in-depth two-year study to explore how NHS commissioning can improve care for those people living with long-term conditions.

Dr Alison Porter, report co-author discusses the main findings of the Nuffield Trust research into what commissioners do on a day-to-day basis.

Working closely with three study sites in Somerset, Wirral and Calderdale over a two-year period, researchers examined the ‘nitty-gritty’ of what commissioners do on a day-to-day basis, focusing on how they sought to develop and improve care for people with diabetes, dementia, and stroke.

Areas of specific attention included the organisation and processes of commissioning (needs assessment, service planning and specification, the design of incentives and performance management, use of contracts and data) as well as other influences known to shape success, such as the relationships between the key players and nature of managerial and clinical leadership.

Researchers examined the 'nitty gritty' of what commissioners do on a day-to-day basis

The study took a comparative case study approach, with the researchers working alongside three ‘commissioning communities’ (primary care trusts, GP commissioners and other local partner organisations) with a track record of undertaking competent and innovative commissioning work.

The project was funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme (project number 08/1806/264). A copy of the full research report: Commissioning high-quality care for people with long-term conditions is available to download from the NIHR website.

Alongside this the Nuffield Trust has produced a shorter research summary drawing together the implications for policy makers and commissioners.

The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR HS&DR Programme or the Department of Health.

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