1.12 Developing effective joint commissioning for adult services: Lessons from history and future prospects

by Nick Goodwin (Published 21 July 2006)

This paper argues that effective joint commissioning between health and social care is a necessary component of Government plans for adult services manifest in the policies of its 2006 White Paper Our Health, Our Care, Our Say. The paper begins with a reaffirmation of the importance of the move towards new models of integrated care that emphasise community-based management of adults with chronic diseases and long-term conditions. It then provides a historical examination of policies to show how the mechanisms for promoting joint commissioning have never been fully mastered or made effective. The emerging lessons to be learned from this history are developed to distinguish between those factors that enable and that hinder the joint commissioning process. Finally, lessons for effective joint commissioning are then compared with the current commissioning plans for health and social care in England. In particular, the strategic commissioning approach emphasised in the consultation over the future delivery of adult services is contrasted with NHS policies that emphasise choice and contestability and a return to practice-based commissioning.

The paper finishes with the implications that these differing policies and arrangements impose on the future of joint commissioning for adult services. It concludes that, although there is tremendous potential for a substantial reinvestment into community-based services to tackle long-term conditions more appropriately, the incentives within the NHS and social care systems are likely to make the achievement of such goals problematic.

• Developing effective joint commissioning for adult services: Lessons from history and future prospects (pdf - 227Kb)