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Models of commissioning health services in the British National Health Service: a literature review

Lookup NU author(s): Dr David Chappel, Emeritus Professor Richard Thomson


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The commissioning of health services is an under-researched area and yet it is critical to the way services meet health needs and to the quality of care. Recent emphasis in the United Kingdom and elsewhere has been on a 'primary care led National Health Service', particularly on locality commissioning through primary care groups. However, there are other models of commissioning using 'programmes of care' (focused on diseases or patient groups rather than geography) which may offer greater benefits. There is little research comparing the benefits and costs of these models, and most are not even clearly enough described to be replicated. There will always be a political dimension to models of commissioning, dependent, for example, on the balance of power in the decision-making process. None the less, a broader knowledge of possible models and a willingness to evaluate rigorously are needed if commissioning of health services is to result in better patient care.

Publication metadata

Author(s): Chappel D, Miller P, Parkin D, Thomson R

Publication type: Review

Publication status: Published

Journal: Journal of Public Health Medicine

Year: 1999

Volume: 21

Issue: 2

Pages: 221-227

Print publication date: 01/06/1999

ISSN (print): 0957-4832

ISSN (electronic): 1464-3782


DOI: 10.1093/pubmed/21.2.221

PubMed id: 10432254