Since internal markets were created in the NHS, commissioners have purchased health care on behalf of patients and the public from a variety of competing providers. Commissioning was intended to drive improvements in the quality, accessibility and cost-effectiveness of services, but has so far largely failed to achieve these objectives. The world class commissioning programme was introduced in 2007 to raise standards in commissioning. To meet this challenge, NHS commissioners have increasingly looked to external organisations, particularly those in the independent sector, for support.
Building high-quality commissioning examines how external support is being used by primary care trusts and strategic health authorities and whether it is helping them to develop more effective commissioning. Our research shows that the use of external support is now standard practice in the NHS. There was evidence that in many cases external organisations had succeeded in improving commissioning processes and could provide support in key areas such as data analysis and commercial skills. However, it was also clear that external support is not always used effectively. This report provides guidance for commissioners, policy-makers and providers of support on how to avoid those pitfalls and ensure best value from external support. The recommendations made will be relevant to GP commissioning consortia as well as to PCTs.
The coalition government’s intention to transfer commissioning responsibilities from PCTs to GP consortia may increase the need for external support in the future. In the context of the financial pressures the NHS is currently under, it is vital that commissioners at all levels use external support in a way that delivers good value for money and helps to improve the productivity and quality of care in the NHS.