CCGs urged to switch focus from collaboration to outcomes

PCT commissioners of long-term conditions evolved a labour-intensive and highly collaborative approach at the expense of outcomes, according to Nuffield Trust research.

Dr Smith: 'This research revealed the 'labour' of commissioning to be extensive.'
Dr Smith: 'This research revealed the 'labour' of commissioning to be extensive.'

Researchers looked at the work of three leading commissioning communities in England (Somerset, the Wirral, Merseyside and Calderdale, West Yorkshire) between November 2010 and January 2012.

Report Commissioning high-quality care for people with long-term conditions says commissioners often seemed reluctant to use data to review investment made and decommission services. ‘Financial matters seemed frequently peripheral,’ it said.

Dr Judith Smith, lead investigator and Nuffield Trust director of policy, said: ‘This research revealed the ‘labour’ of commissioning to be extensive and resource-hungry, especially when designing and specifying services.

‘What was less evident was a robust approach to assessing the performance, quality and impact of local services, and willingness to provide necessary challenge to existing local providers.’

Co-author Sara Shaw, Nuffield Trust visiting fellow, blogging for’s Inside Commissioning blog wrote: ‘The message for CCGs is that the effort involved in commissioning has to be worth the outcomes.

‘CCGs will need to think hard about the time and energy they commit to service redesign, and make clear and legitimate choices about how much engagement and development work they can afford to do … using contracts in a more focused way, and exploring opportunities for reviewing, discontinuing and re-commissioning services.’

* Inside Commissioning blog: Commissioning for long-term conditions: lessons from PCTs

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