Commissioning policy

This section outlines the core national policies relating directly to commissioning:

• The Commissioning Framework for Health and Well-being
• World class commissioning
• Joint strategic needs assessment

You can link to separate sections contain further information on specific elements of each policy area, and related resources.

You will find documents that provide an overall policy context for the commissioning function elsewhere on this site.

General policy

These policies were the first indication of a move towards a purchaser/provider split in healthcare.

Commissioning a patient-led NHS (Department of Health 2005)
This outlines the changes required to shift to a commissioning-driven service. It sets out expectations and responsibilities, including for PCTs to enhance contestability by securing services from a range of providers while minimising direct PCT provision.

Health reform in England: Update and commissioning framework (Department of Health 2006)
This reaffirms the government's commitment to changes to commissioning to drive health reform and outlines how practice-based commissioning (PBC) will enable GPs to develop new services. An annexe focuses on the commissioning role of PCTs.

Commissioning for health and well-being

Commissioning for health and well-being focuses on commissioning services to treat people when they are ill and to keep individuals and communities healthy and independent. It builds on the White Paper Our health, our care, our say, with its emphasis on prevention, choice, care closer to home and tackling inequalities.

Commissioning framework for health and well-being(Department of Health 2007)
This identifies obstacles to effective commissioning and emphasises the benefits of partnership. Annexes offer guidance on carrying out joint strategic needs assessments, investing in prevention, and high impact changes to reduce health inequalities.

The Commissioning framework for health and well-being identifies eight steps to more effective commissioning. You can find resources to support these in the Eight steps to effective commissioning section of this website.

Impact assessment: Commissioning framework for health and well-being (Department of Health 2007)
This looks at potential costs and impact of the policy on small firms, competition and rural areas. It highlights concerns about data handling and market development. An annexe has statistical information on minority ethnic groups and disability.

Commissioning framework for health and well-being: Making it happen (Department of Health 2008)
This looks at key concerns around effective commissioning, including commissioning children's and young people's services, engaging socially excluded groups, gaps in information and the time required to develop a wider range of providers.

World class commissioning (WCC)

World class commissioning aims to raise ambitions for a new form of commissioning to be implemented in a comprehensive way across the developed healthcare economies. The vision is to 'add life to years and years to life'.

World class commissioning: Vision (Department of Health 2007)
This explains the WCC vision for commissioning that maximises potential to increase choice and innovation, led by the local NHS, with a strong mandate from its population and partners. It sets out 11 organisational competencies PCTs should develop to underpin effective commissioning.

World class commissioning: Competencies (Department of Health 2007)
This examines each competency, identifying component skills, processes and knowledge requirements, and examples of outputs. It looks at competencies in the context of training and development and personal goals.

You can find resources to support development of each of the 11 competencies in the World class commissioning competencies section.

These tools are a good starting point for improving commissioning arrangements.

Commissioning diagnostic tool (Department of Health 2007)
This describes all activities necessary for good commissioning at PCT level, expected standards and best practice at UK and international level. It helps identify gaps and provides the basis for operational and financial plans.

There are four separate diagnostic tools and user guides, measuring:

• strategic planning
• care pathway management
• provider management
• monitoring and remediation

Achieving the competencies: Practical tips for NHS commissioners (Department of Health 2008)

This sets out success indicators and criteria for each WCC competency, with tips on reaching level 2 and progressing to world class, such as different research methods, suggestions for supporting evidence and links to further information.

Fitness for purpose database
This database provides a 'snapshot' of a PCT's commissioning capability in a format that allows PCTs to benchmark their own strengths and weaknesses against others. The database is access restricted to PCTs and SHAs.

The delivery of the world class commissioning vision and competencies will take place within a commissioning assurance system to drive performance and development, and reward PCTs as they move towards becoming world class commissioners.

The Department of Health Commissioning assurance handbook and toolkit will help PCTs and SHAs to implement the commissioning assurance system.

The Department of Health is providing some support and development for PCTs through a national approach, such as a PCT board development framework and a framework for procuring external commissioning expertise.

Joint strategic needs assessment

Since April 2008 there has been a statutory duty on all upper tier local authorities and PCTs to produce a joint strategic needs assessment (JSNA), as set out in the Local Government and Public Involvement in Health Act 2007. The JSNA concept was first described in the Green Paper Independence, well-being and choice and the White Paper Our health, our care, our say .

The idea behind JSNA is that all key decision makers in a local area work together to produce a wide-ranging needs assessment that deals with the whole population and identifies the health and well-being needs and inequalities that exist within that population.

Delivering health and well-being in partnership: The crucial role of the new local performance framework (Department for Communities and Local Government 2007)
This outlines the components of the wider local performance framework, incorporating joint strategic needs assessment, local area agreement, national indicator set and comprehensive area assessment.

You can find resources to support implementation of local JSNAs in the Joint strategic needs assessment section.