학술논문
The changing public health system: an examination of the new commissioning infrastructure
Document Type
Book
Source
Commissioning Healthcare in England: Evidence, Policy and Practice. :123-142
Subject
Language
Abstract
Chapter 8 reports research on the changing role of commissioning in the restructured public health system. The chapter will discuss how public health commissioning responsibilities have changed and become more fragmented, being split amongst a range of different organisations, most of which were newly created in 2013. It will focus on discussing how the re-organisation substantially changed the way public health commissioning is done, who is doing it, and what is commissioned, since the reforms. There have been significant changes in commissioning processes, with important consequences for what health improvement services are ultimately commissioned. Also new opportunities for creativity and joining public health with wider determinants of health (e.g. housing and leisure).
This book brings together selected research on commissioning healthcare in the English NHS carried out by national policy research unit in commissioning and the healthcare system (PRUComm) between 2011 and 2018. PRUComm is funded by the English Department of Health’s Policy Research Programme. The bookexplores the changes to commissioning in the English NHS quasi market introduced by the Health and Social Care Act 2012 (HSCA 2012). It focuses on threemain areas: first, the development and operation of the newly formed commissioning bodies named Clinical Commissioning Groups (CCGs) which were supposed to increase clinical engagement; secondly, technical aspects of commissioning being the use of competition and cooperation by CCGs to commission care in the HSCA 2012 regulatory context encouraging competition,and the allocation of financial risk through contracts between commissioners and providers of care (including new forms of contract such as alliances); and thirdly the reorganisation of the commissioning of public health services. The research demonstrates that the HSCA 2012 has had the effect of fragmenting commissioning responsibilities and in the process impaired good governance and strong accountability of commissioners. It shows how the use of market mechanisms has declined despite the pro competition regulatory regime of the HSCA 2012, and that more cooperative processes are used at local level to reconfigure health services. It concludes that strategic planning and monitoring of services will always be essential for the English NHS, whether the term ‘commissioning’ is used to describe these activities or not in the future.This timely book is the most comprehensive account yet of recent commissioning practice in the English NHS and its impact on health services and the healthcare system.Drawing on eight years of research, expert researchers in the field analyse crucial aspects of commissioning, including competition and cooperation, the development of Clinical Commissioning Groups and contractual mechanisms. They also consider the influence of recent commissioning reforms on public health infrastructure.For academics and policy makers in health services research and policy, this is a valuable collection of evidence that deepens understanding of how commissioning works.This timely book is the most comprehensive account yet of recent commissioning practice in the English NHS and its impact on health services and the healthcare system.
This book brings together selected research on commissioning healthcare in the English NHS carried out by national policy research unit in commissioning and the healthcare system (PRUComm) between 2011 and 2018. PRUComm is funded by the English Department of Health’s Policy Research Programme. The bookexplores the changes to commissioning in the English NHS quasi market introduced by the Health and Social Care Act 2012 (HSCA 2012). It focuses on threemain areas: first, the development and operation of the newly formed commissioning bodies named Clinical Commissioning Groups (CCGs) which were supposed to increase clinical engagement; secondly, technical aspects of commissioning being the use of competition and cooperation by CCGs to commission care in the HSCA 2012 regulatory context encouraging competition,and the allocation of financial risk through contracts between commissioners and providers of care (including new forms of contract such as alliances); and thirdly the reorganisation of the commissioning of public health services. The research demonstrates that the HSCA 2012 has had the effect of fragmenting commissioning responsibilities and in the process impaired good governance and strong accountability of commissioners. It shows how the use of market mechanisms has declined despite the pro competition regulatory regime of the HSCA 2012, and that more cooperative processes are used at local level to reconfigure health services. It concludes that strategic planning and monitoring of services will always be essential for the English NHS, whether the term ‘commissioning’ is used to describe these activities or not in the future.This timely book is the most comprehensive account yet of recent commissioning practice in the English NHS and its impact on health services and the healthcare system.Drawing on eight years of research, expert researchers in the field analyse crucial aspects of commissioning, including competition and cooperation, the development of Clinical Commissioning Groups and contractual mechanisms. They also consider the influence of recent commissioning reforms on public health infrastructure.For academics and policy makers in health services research and policy, this is a valuable collection of evidence that deepens understanding of how commissioning works.This timely book is the most comprehensive account yet of recent commissioning practice in the English NHS and its impact on health services and the healthcare system.