Evaluating the design and implementation of the whole systems integrated care programme in North West London: why commissioning proved (again) to be the weakest link
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Summary
This summary is machine-generated.Commissioning in the UK
Area Of Science
- Health Services Research
- Health Policy
- Integrated Care Systems
Background
- Commissioning, termed health planning or strategic purchasing in other systems, is central to the UK's National Health Service (NHS).
- This study examines commissioning's role in driving large-scale change for integrated care, focusing on complex long-term conditions.
- Research is based on a mixed-methods study of an integrated care initiative in North West London.
Purpose Of The Study
- To investigate the effectiveness of commissioning in achieving large-scale service change within health and social care.
- To understand the challenges and facilitators of integrated care delivery through commissioning.
- To inform revised models of commissioning for complex long-term conditions.
Main Methods
- A mixed-methods approach was employed, integrating qualitative and quantitative data.
- Data collection included semi-structured interviews, surveys, workshops, and non-participant observations.
- Thematic analysis utilized a framework derived from commissioning and integrated care literature, supplemented by inductive coding.
Main Results
- Commissioning faces significant limitations in facilitating large-scale health service transformation.
- Key challenges include provider engagement, implementation support, and balancing transactional and relational aspects.
- Insufficient attention to implementation hinders the success of commissioning initiatives.
Conclusions
- Effective commissioning requires robust implementation processes, not just service procurement.
- Commissioners must actively enable, support, and performance manage service delivery.
- Close, continuous collaboration with providers is essential for successful large-scale change.
- A revised commissioning cycle model is proposed, emphasizing implementation within large-scale change initiatives.
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