PRU Comm, June 2016
- Analysis of how commissioners in local health systems manage the interplay of competition and cooperation in their local health economies, looking at acute and community health services.
- Commissioners across the four CCG case study sites found it hard to pinpoint exactly what the rules on application of competition within the English NHS were and thus whether or not they had to change their commissioning practices in light of them
- The report includes a timeline of nationally reported key policy decisions, regulations, guidance and events pertaining to competition and cooperation in the English NHS covering the period between March 2013 and October 2015. (Appendix)
- The implications of our study for policy makers:
- "Local commissioners should be allowed to make their own decisions about which modes of commissioning are most appropriate in their particular circumstances, and in respect of particular services. Setting up nationally imposed rules about what mechanisms must be used is unhelpful (and probably will not be adhered to, in fact). It appears that in most circumstances, the use of cooperative modes of coordination are likely to be more appropriate. Fortunately, the recent policy developments under the 5YFV indicate this is the direction of travel. At the same time, it is important to clarify the rules of the game for local actors. It may be politically unpalatable, but the regulatory framework of the HSCA 2012 needs revisiting."
