• NHS Providers launches new publication series "Provider Voices" 
• New series will promote the views of trust leaders and other parts of the health service on the key issues facing the NHS 
• First edition explores "Where next for commissioning" and features eight interviews

NHS Providers has launched a new publication series “Provider Voices” which promotes the views of leaders from a range of trusts and other parts of the service on some of the key issues facing the NHS today.

The first report Where next for commissioning? includes eight interviews that address concerns including the role of Sustainability and Transformation Partnerships (STPs) and accountable care systems (ACSs), the challenge of integrating health and care commissioning, and the future of the purchaser-provider split.

Contributors include leaders of hospital, mental health and community trusts and ambulance services, with additional perspectives from a clinical commissioning group (CCG) and local government.

Commissioning in the NHS is at a crossroads

In an overview, the director of policy and strategy at NHS Providers, Saffron Cordery, says now is a good time to ask trust leaders and people involved in commissioning for their views on commissioning’s future and how it needs to change to deliver better health outcomes:

“After 25 years, it feels like the concept of commissioning in the NHS is at a crossroads. Questions over its effectiveness, structure and value for money abound, as do questions about the effectiveness of the internal market. Sustainability and transformation partnerships, new care models and accountable care organisations and systems all challenge the concept of a separate commissioning structure and the long standing 'purchaser-provider split'.”

The overview explores five key themes that emerge from the discussions: 

• The value of commissioning in getting closer to people…
• …and understanding local places
• The need to accept the emerging diversity of approach to commissioning structures
• The rapid blurring of the purchaser/provider split
• The need to focus on commissioning as a strategic function

Many interviewees queried whether the purchaser-provider split had actually had its day, what contribution it now made and, by extension, whether the existing structures in health and care are fit for purpose.

In conclusion Saffron Cordery highlights scepticism about the continuing value and relevance of the purchaser-provider split:

“When done well, commissioning performs a key, strategic, function. However, many interviewees queried whether the purchaser-provider split had actually had its day, what contribution it now made and, by extension, whether the existing structures in health and care are fit for purpose. These questions have become particularly important and relevant given the new national policy focus on place-based collaboration, exemplified by STPs and the move to accountable care models.

“We are beginning to see large and rapid shifts in the previously rigid boundary between commissioners and providers, and whether or not that boundary should remain (or even matters) is a live question.”

Interviews:

The interviews were carried out by Andy Cowper. He spoke to:

David Evans – chief executive Northumbria Healthcare NHS Foundation Trust

Marie Gabriel – chair East London NHS Foundation Trust

Jeremy Hughes – chief executive Alzheimer’s Society

Anthony Marsh – chief executive West Midlands Ambulance Service NHS Foundation Trust

Nick Moberly – chief executive King’s College Hospital NHS Foundation Trust 

Carolyn Regan – chief executive West London Mental Health NHS Trust

Councillor Izzi Seccombe – chair Local Government Association Community Wellbeing Board

Katherine Sheerin – chief officer NHS Liverpool Clinical Commissioning Group

The next report in the “Provider Voices” series will be published later this year.

An overview of the report was first published by the HSJ on 16 June 2017

Read our blog on the overview by Saffron Cordery. 

Read a blog in response to the report by Julie Wood, chief executive for NHS Clinical Commissioners.