Where next for commissioning in the English NHS?

This research report analyses the current state of commissioning in the English NHS and makes recommendations for strengthening the process.

Commissioning is subject to much debate in the English NHS. It is often suggested that if only commissioning were to be ‘strong’ or ‘world class’, much more progress would be made in areas such as moving care out of hospital into the community, or gaining greater productivity from healthcare providers. The theory is that having commissioners focused on the funding, planning and purchasing of services will enable powerful providers to be held to account for the quality and volume of care delivered, as well as being challenged to come up with new forms of care that can replace, rather than simply add to, current services. As the NHS faces a period of major financial challenge, the effectiveness of commissioning is a pressing concern.

As the NHS faces a period of major financial challenge, the effectiveness of commissioning is a pressing concern

In Where next for commissioning in the English NHS? the authors, who have studied the development of NHS commissioning for over 15 years, use research evidence as the basis for examining current commissioning arrangements, analysing the nature of the ‘commissioning problem’, and setting out practical suggestions for how commissioning might be strengthened to meet the challenges ahead.

This report will be of interest to healthcare policy-makers, senior managers and clinicians, and others involved in commissioning, as well as academics and students in the fields of healthcare and social policy.

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Suggested citation

Smith J, Curry N, Mays N and Dixon J (2010) Where next for commissioning in the English NHS? Research report. Nuffield Trust and King's Fund.