Investigating recent developments in the commissioning system

Since the Health and Social Care Act 2012 (HSCA 2012), there has been a number of important policy developments affecting the commissioning system. In 2014, The Five Year Forward View focused on how organisations in the NHS need to cooperate with each other, and at times merge to form larger organisations, known as ‘new care models’ or ‘Vanguards’. The NHS Planning Guidance 2016/17 – 2020/21 introduced the concept of local cooperative, place-based planning, known as Sustainability and Transformation Plans (STPs). The implications of these recent developments are that there is now a more complex local landscape of organisations (and configurations of organisations) all of which need to be involved in planning and commissioning of local services. Clinical Commissioning Groups (CCGs) will need to work collaboratively with stakeholders over whom they have no formal authority including: GPs; independent and voluntary sector organisations; local authorities; other CCGs; NHS England; Vanguards, NHS trusts and NHS Foundation Trusts. The aim of this research is to investigate how these recent developments have affected the process of commissioning and planning at local level.

This was an eighteen-month study (2017 – 2018) in which we conducted a series of in-depth case studies of four local health economies. The project examined the role of the individual CCG in the current commissioning landscape and how CCGs maintain accountability; how CCG internal processes of decision making are changing; the relevance of competition and the current pricing regime to CCGs’ commissioning decisions; and the future development of commissioning. The final report was published in September 2018.