BMC Health Services Research (2019) 19:648, 6 September 2019
- This paper explores the process by which commissioning organisations make their decisions to commission innovative health technologies. Based on a case study of four CCGs exploring the commissioning considerations for a new photoplethysmography-based diagnostic technology for peripheral arterial disease in primary care in the UK.
- Highlights include the importance of priority setting, valuing evidence, assessing value for money, cross-organisational collaboration, and negotiating commissioning pathways.
In summary,
"In summary this study reveals that the commissioning of innovative health technologies, such as a new diagnostic technology for PAD, is currently ‘messy and fragmented’. It involves high levels of protracted negotiations over funding between providers and commissioners, alliance building, conflict resolution and compromise of objectives where the outcomes of change are highly contingent upon interventions made across different care settings. Our evidence illustrates how reconfigurations of inter-organisational relations, and of clinical and related work practices required for the successful implementation of a new technology could become a major stumbling block to commissioning negotiations. In so doing, we aim to contribute to the growing area of health services commissioning by providing a more comprehensive analysis of the decision making processes surrounding the commissioning of new technologies. Learning more about how commissioners in the real world make their decisions to commission innovative health technologies is important in order to increase our understanding about the contribution that researchers and research evidence can make to policy-making."
