GP engagement in commissioning

What happens when GPs engage in commissioning? Two decades of experience in the English NHS.

J Health Serv Res Policy. 2015 Jul 8.

• A review of the evidence on commissioning schemes involving clinicians in the NHS (1991- 2010), found that the extent of clinical engagement varies between the various schemes. Schemes allowing clinicians to act autonomously were more likely to generate significant engagement, with 'virtuous cycles' (experience of being able to make changes feeding back to encourage greater engagement) and 'vicious cycles' (failure to influence services generating disengagement) observed. 
• Engagement of the wider GP membership was an important determinant of success. 
• Most impact was seen in GP prescribing and the establishment of services in general practices. 
• There was little evidence of GPs engaging more widely with public health issues.