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Commissioning Healthcare in EnglandEvidence, Policy and Practice$
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Pauline Allen, Kath Checkland, Valerie Moran, and Stephen Peckham

Print publication date: 2020

Print ISBN-13: 9781447346111

Published to Policy Press Scholarship Online: September 2020

DOI: 10.1332/policypress/9781447346111.001.0001

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PRINTED FROM POLICY PRESS SCHOLARSHIP ONLINE (www.policypress.universitypressscholarship.com). (c) Copyright Policy Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in PPSO for personal use.date: 22 May 2022

Clinical engagement in commissioning: past and present

Clinical engagement in commissioning: past and present

(p.49) 4 Clinical engagement in commissioning: past and present
Commissioning Healthcare in England

Kath Checkland

Anna Coleman

Imelda McDermott

Rosalind Miller

Stephen Peckham

Julia Segar

Stephen Harrison

Neil Perkins

Policy Press

Chapter 4 looks at the evidence about clinical engagement in primary care-led commissioning. Extending and strengthening clinical leadership was one of the key elements of the HSCA12. However, this idea was not new, and this chapter reviews the evidence on the role of clinicians in primary care-led commissioning and how this has contributed to the delivery of healthcare services since the early 1990s. It examines the nature of clinical engagement/involvement in the various primary care-led commissioning models that have been introduced into the NHS. Drawing on a review of the literature and our research on Clinical Commissioning Groups the chapter shows how the extent of clinical engagement has varied between the various schemes. GP commissioners have historically been more successful in influencing the work done by GP practices than in making broader changes to services provided by secondary care. The chapter goes on to explore the claims made both by those involved and in official documents about how greater involvement of clinicians in CCGs – and in particular GPs – will enhance commissioning practice. We test this against evidence from our study of CCGs, showing how the engagement and involvement of GPs requires careful attention to detail. Using a realist approach to evaluation, we highlight the contexts and mechanisms associated with successful – and unsuccessful – GP involvement in commissioning.

Keywords:   GPs, Clinical engagement, Commissioning, CCGs

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