Commissioning's identity crisis

Nigel Edwards argues that, if current trends in commissioning continue, holding on to the N in NHS may become much more difficult.

Journal article

Published: 18/11/2015

Journal article information


Almost since its inception, in the early 1990s, NHS commissioning—the process of buying and planning healthcare for local areas—has suffered from a crisis of identity and confidence. Critics have denounced it as unnecessary bureaucracy; even those involved have questioned its purpose or effectiveness; and frequent mergers and wholesale reorganisations of the bodies involved in commissioning have destroyed organisational memory, removed talented staff, and disillusioned many of the few clinicians who could be persuaded to become involved.