World class commissioning: a health policy chimera?

Journal of Health Services Research & Policy
Chris Ham

Abstract

The health reforms in England have entered a phase in which greater emphasis is being placed on market-like mechanisms. The ability of the commissioners of care to negotiate on equal terms with providers will be of critical importance in the emerging market. The government has set out plans to develop 'world class commissioning' and this essay reviews experience in Europe, New Zealand and the United States to understand what is involved in working towards this goal. The evidence reviewed shows that in no system is commissioning done consistently well and highlights the obstacles to the development of world class commissioning. The reasons for this centre on the complexity of health care and the inherent difficulty of commissioning health services in publicly financed systems. Commissioners will need to be able to access a range of expertise and are likely to incur significant expenditure in so doing. There are warning signs from other systems of health reforms that result in adversarial and legalistic approaches, and do not give sufficient attention to relational contracting. Even if world class commissioning is developed, it may fall short of its potential in the absence of other changes in the design of the reforms, such as a...Continue Reading

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Citations

Apr 12, 2008·BMJ : British Medical Journal·Chris Ham
Mar 17, 2011·Clinical Medicine : Journal of the Royal College of Physicians of London·Elizabeth Wade
May 19, 2010·Health Economics, Policy, and Law·Gwyn Bevan, Wynand P M M van de Ven
Jul 4, 2012·Revista de calidad asistencial : organo de la Sociedad Española de Calidad Asistencial·C Campillo-Artero
Oct 15, 2009·Journal of Clinical Nursing·Andy Young
Sep 24, 2008·Health & Social Care in the Community·Helen Parker, Jon Glasby
Sep 29, 2009·BMC Public Health·Rebecca K SimmonsLincoln A Sargeant
Jun 25, 2013·Health Policy·Liina-Kaisa TynkkynenJuhani Lehto
Feb 20, 2010·Healthcare Management Forum·Francois DionneMorris Barer
Mar 17, 2018·Health Economics, Policy, and Law·Gwyn BevanSabina Nuti
Feb 15, 2012·Journal of Health Services Research & Policy·Fiona SampsonLisa Esmonde
Feb 15, 2012·Journal of Health Services Research & Policy·Sara McCaffertyAngela Bate
Jan 15, 2010·Journal of Health Services Research & Policy·Anna Dixon
Sep 23, 2009·Journal of Health Services Research & Policy·Graham MartinRachael Finn
Dec 6, 2008·British Journal of Community Nursing·Helen Parker, Jon Glasby
Dec 1, 2015·Australian Journal of Primary Health·Sinéad O'BrienSimon Clark
May 14, 2016·The Medical Journal of Australia·Patrick D McGorry, Matthew P Hamilton
Jul 30, 2016·Australian Journal of Primary Health·Suzanne RobinsonLearne Durrington
Feb 26, 2016·Australian Journal of Primary Health·Mark Booth, Anne-Marie Boxall
Nov 14, 2017·The Medical Journal of Australia·Matthew P HamiltonPatrick D McGorry

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