NIHR Service Delivery and Organisation programme, March 2013
- Researchers examined the ‘nitty-gritty’ of what commissioners do on a day-to-day basis, focusing on how they sought to develop and improve care for people with diabetes, dementia, and stroke.
- An in-depth two year study of commissioning practice in three high-performing primary care trust areas (Calderdale, Somerset and the Wirral).
- The most striking finding was the sheer scale of the ‘labour of commissioning’ – the amount of meetings, discussions, planning, and analysis that goes into the review and commissioning of often small-scale service changes.
- Several themes emerged from the study of commissioning across the sites-
- The question of money
- The scale and pace of change
- External drivers of commissioning
- The report concludes with a discussion of the observed activities most closely associated with effective commissioning, and suggestions for practical indicators that could be developed to assess their overall effectiveness.
