Weak and fragmented NHS commissioning threatens service improvement

BMJ 2014; 348 doi: (Published 12 February 2014) Cite this as: BMJ 2014;348:g1517
  1. Adrian O’Dowd
  1. 1London

Commissioning since last year’s NHS reorganisation took effect is too weak, fragmented, and overpopulated with bodies to the extent that it is threatening expected improvements in services, MPs have warned.

In a report published on 12 February by the parliamentary health select committee,1 MPs also warned that low pay rises for NHS staff, bureaucracy that was blocking service change, and an imbalance in funding between health and social care were all hampering improvements in the NHS.

The report says that the health and care system still needs major change before it can start to meet the needs of patients.

It cites the facts that 48% of NHS trusts in England are forecasting a deficit in the current financial …

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