Health Foundation, September 2015
- An examination of outcomes-based commissioning - what it means, the evidence to support it, progress to date on introducing the approach in England, and the optimum role of national policy in response to it.
- Key points
- Policy makers need a long-term plan to nurture outcomes-based commissioning to enable it to support the transformation of health care.
- Outcomes-based commissioning seeks to solve the issue of how financial flows and the commissioning process can best support quality and efficiency improves across the health care system.
- Outcomes-based commissioning shows promise as a means to help transform health care, but evidence to support it is limited and it is proving harder to implement than foreseen. Careful learning and significant support is needed to help it live up to its potential.
- Outcomes-based commissioning needs long-term support from policy makers, including NHS England to support the capability of commissioners, and the future NHS Improvement to help develop providers’ ability to respond, particularly in primary care.
- There needs to be far greater peer-to-peer learning between areas experimenting with the approach. This should include the development of a ‘learning network’ to connect and share knowledge not only from the NHS, but also from areas internationally and other parts of the public sector.
- The experience of commissioners to date has highlighted that an outcomes-based approach requires a different skill set to traditional commissioning. This involves a stronger focus on the strategic elements of commissioning, rather than the tactical, as can be seen in how the ‘commissioning cycle’ changes under outcomes-based commissioning, as shown below.
- 1: Work with population to determine outcomes, and develop data to track outcomes
- 2: Create and develop markets
- 3: Develop a payment approach
- 4: Lead system-wide working to enable procurement
- Includes a table and map showing details of outcomes-based commissioning contracts in England that have already been awarded, or are being planned.
