Practice based commissioning: applying the research evidence

doi:10.1136/bmj.331.7529.1397

BMJ 2005;331:1397-1399 (10 December), doi:10.1136/bmj.331.7529.1397

Education and debate

The NHS revolution: health care in the market place

Practice based commissioning: applying the research evidence

Judith Smith, senior lecturer¹, Jennifer Dixon, director of policy², Nicholas Mays, professor of health policy³, Hugh McLeod, research fellow¹, Nick Goodwin, senior lecturer³, Siobhan McClelland, external professor⁴, Richard Lewis, senior fellow in health policy², Sally Wyke, professor of health and social care⁵

¹ Health Services Management Centre, School of Public Policy, University of Birmingham, Birmingham B15 2RT, ² King's Fund, London W1G 0AN, ³ Health Services Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, ⁴ Health Policy and Economics, Health Economics Research Unit, School of Care Sciences, University of Glamorgan, Glamorgan, ⁵ Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA

Correspondence to: J Smith j.a.smith.20@bham.ac.uk

General practitioners are being asked to retake responsibilityfor commissioning healthcare services. What can we learn fromprevious experience?

The first 150 words of the full text of this article appear below.

Introduction

The English NHS is unusual in its continuing faith in primarycare based organisations to carry out effective purchasing ofhealthcare services. The latest incarnation of this approachis to encourage all general practices to be responsible fora budget to purchase community health services and secondarycare on behalf of their enrolled populations by the end of 2006.^1
2The logic is that in doing so, they will act more cost effectively,scrutinising the demand for hospital care and redesigning servicesacross the hospital-community interface. Some evidence supportsthis logic.³ We assess current policy on purchasing in the lightof evidence from research concerning purchasing by primary careorganisations in the 1990s and more recent evaluations of primarycare groups and trusts and draw out some key messages that maybe helpful in its further development.

Commissioning by primary care

Purchasing is typically considered to be a process whereby servicesare specified upfront on . . . [Full text of this article]

Importance of context

Effect of practice based commissioning

Process of practice based commissioning

Challenges for the future

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