Purpose and scope

This book is intended to assist all those charged with commissioning health and social care in the UK and in other jurisdictions that have similar organisational arrangements. The term ‘values-based commissioning’ begs for definitions. These are discussed in some detail in this chapter and elsewhere. At this point it is worth clarifying the broad purpose and scope of the book.

Commissioning is a complex, iterative process that ensures that health and social care provision for a population is clinically and cost-effective and appropriate to the needs of the people for whom it is intended. Commissioning is not simply planning or procurement. Commissioning has a number of stages described in different ways by various authors, and in different countries and jurisdictions, but all contain something along the following lines.

Commissioning has a cyclical form that begins with assessing the health and social care needs in the communities served; consults and involves patients and the public alongside community, patients and service user organisations; defines the care outcomes appropriate to the population served; identifies the types of interventions (medical, surgical, social or psychological) that may be appropriate to the conditions to be treated or ameliorated; gathers information on all those providers that may be able to or wish to contribute a component of the care pathway (subject to some over-arching policy on the use of NHS providers); invests in capacity-building organisations to provide tailored and effective care; encourages all reasonable providers to become involved through ensuring that contracting processes are fair and transparent; develops acceptable risk-sharing arrangements; and establishes feedback processes that catalyse further innovation and engagement of patients and the public.