Positive progress made in collaborative commissioning

A new report has found that although progress is at an early stage, the relationship between commissioners and providers in the health system is on the brink of significant change.

NHS Providers and NHS Clinical Commissioners, who have jointly published Driving forward system working: a snapshot of early progress in collaborative commissioning, claim that commissioners are now beginning to take a more strategic approach, commissioning for outcomes across larger population footprints.

As part of this development, NHS trusts are taking on or supporting activities previously undertaken by clinical commissioning groups (CCGs), such as developing pathways and service specifications.

A number of common success factors are already facilitating system working, with the two NHS organisations highlighting strong collaborative and clinical leadership transcending organisational boundaries and focusing on delivering care to meet the needs of a local population as one approach proving successful. The report also mentions the benefits of establishing 'one version of the truth' that can drive honest open and honest conversations, supporting staff to work flexibly across systems, potentially pooling resources or appointing joint posts and involving all system partners, including local authorities and the voluntary and independent sectors.

Miriam Deakin, NHS Providers director of policy and strategy, said: "This report provides a helpful and timely snapshot of how the relationship between commissioners and providers is evolving at the frontline, in the context of system working.  As commissioners increasingly seek to work strategically across a larger population footprint, there are opportunities for local partners to develop new collaborative relationships, and for NHS providers to take on some of the activities that CCGs currently deliver.

“Although many of the areas we spoke to were at the early stages of developing new ways of working, we were struck by providers and commissioners’ enthusiasm for a new, collaborative and constructive relationship based on the shared goal of serving their local populations.  Colleagues in the national bodies must now also ensure the policy and regulatory frameworks support this direction of travel by enabling commissioners and providers to work together constructively, within the current legal framework and in support of system working."

Julie Wood, chief executive of NHS Clinical Commissioners, said: "Whilst the commissioning landscape is undoubtedly evolving the core importance of clinical leadership within the commissioning function remains. With integration of care likely to be a key part of the long term plan for the NHS, and the right thing to do, this timely report highlights the willingness of both providers and commissioners to better work together as system partners through collaborative commissioning in order to deliver excellent care for our patients and populations, and to ensure the sustainability of the NHS.

“We need to learn from the promising examples in the report if we are to succeed in these aims. However, there are some barriers to such system-wide working that need to be overcome, and we will soon be publishing five key asks from our membership to enable and support integration across system and place."