Can strategic commissioning deliver the change the NHS needs?

Amid ongoing restructuring and cost pressures, integrated care boards (ICB) are being asked to take on a greater strategic role as part of the next evolution in NHS commissioning. As leaner, more focused organisations, eventually aligning to new strategic authorities, ICBs are being tasked with improving population health and ensuring public money is spent well. This role is positioned as central to the delivery of the ambitions of the 10‑year health plan for England and Secretary of State Wes Streeting’s stated vision for "triple devolution: shifting power from the centre to places, providers, and patients". With entrenched inequalities and rising demands for care across the country, is a more integrated model of commissioning key to NHS reform? 

The recently published Strategic commissioning framework sets out how ICBs should move beyond transactional contracting to embrace a continuous cycle of planning, purchasing, monitoring, and evaluating services. The aim is integrated, outcomes-driven commissioning rooted in population health intelligence, with a sharper focus on equity, prevention, and value for money. In their role as strategic commissioners, ICBs will need to ensure this work takes place in genuine partnership with health and care providers, local government, and communities. 

Success will depend on the ability to bring health and care providers together to consider new ways of delivering care. Working closely with trusts is integral. Their experience, insight, and capacity to drive service redesign will be essential. In some cases, trusts may even take on commissioning functions themselves, where this leads to better integrated care and improved patient outcomes.