Title: Policy Research Unit in Commissioning and the Healthcare System
Funder: Department of Health (England)

Abstract: Commissioning is a complex and difficult process. It is fundamentally about relationships and with the organisation and structure of the NHS currently in flux commissioners are constantly being faced with new challenges. The role of the Policy Research Unit in Commissioning and the Healthcare System (PRUComm) is to understand how commissioning processes work and how people are managing the complex challenges and relationships, so we can share the learning with colleagues. PRUComm is a collaboration between the Service Delivery and Organisation Research Group at the London School of Hygiene and Tropical Medicine and the Health Policy, Politics and Organisation Group in the School of Community-based Medicine, University of Manchester. The unit is funded by the Policy Research Programme of the Department of Health as a centre of excellence for research on commissioning. Our strategy is to provide a substantive programme of research that examines the functioning of health systems with a particular focus on the role of organisations involved in systems management (eg SHA and PCT, regulators) and the role of local commissioners (PCTs, PbCs, local authorities) in shaping and managing the provision of care and promoting health and wellbeing. PRUComm’s strategic objective is to develop a research unit on commissioning and health systems that supports the Department of Health’s policy development and analysis on commissioning. Further, it aims to inform how contemporary approaches to health services commissioning 'work' both as organisational processes in themselves, and as instruments to secure policy objectives such as improved services, greater equality of access, greater responsiveness to patients, and improved effectiveness. The unit will serve as a centre of excellence for research on commissioning, developing high quality research programmes that support healthcare commissioners and policy makers, providing a national resource on commissioning evidence and research. We aim to establish an international reputation by bringing together leading academic researchers of national and international standing with existing track records in health services and organisation research and who have been actively engaged in research on commissioning. Our primary aim is to support the Department of Health to manage and support the challenges of developing commissioning for health and wellbeing and to sustain high quality and effective commissioning. Key objectives for the research unit are to: - Develop high quality research programmes that support healthcare commissioners and policy makers - Provide a national resource, holding evidence and research on commissioning - Bring together academics who are nationally and internationally regarded as experts in health services, organisational and commissioning research Over the next five years our research programme Unit will: • Focus on all types of commissioning (PCTs—while they exist, clinically led commissioning, joint commissioning etc) • Utilise and further develop sound and credible methods for researching commissioning • Examine commissioning within the context of the health system • Develop strong links with policy makers, health regulators, and NHS managers and practitioners PRUComm’s immediate research programme includes research on the emerging clinical commissioning groups, research on new contracting arrangements and literature reviews on aspects of healthcare commissioning. Clinically-led commissioning This study will describe the various commissioning strategies employed by commissioning groups and assess their impact in terms of selected performance measures. The research will: • describe the processes of establishing Consortia, and the strategies adopted by them in relation to governance arrangements, management and organisational support, and the choice of initial priorities for action; • subsequently describe, classify and analyse the commissioning priorities and strategies adopted by Consortia in a range of local contexts; and • assess the impact of particular commissioning strategies on selected performance measures, taking into account local priorities and the contribution of different local contexts. Contractual mechanisms in commissioning This project will investigate how commissioners negotiate, specify, monitor and manage contractual mechanisms to improve services in their local health economies, looking at both acute services and community health care. The research questions are: • What is the range of formal provisions, including imposing penalties and incentives in respect of quality of care in contracts across the English NHS? This will entail examining both the locally developed service specifications and the nationally mandated core contractual terms • How are contractual penalties and incentives negotiated, specified, monitored and enforced in practice? • What are the effects of the use (or non use) of contractual mechanisms on service improvement? The unit will provide a unique resource on research about commissioning providing support for Department of Health policy development and support for healthcare commissioners. PRUComm’s work programme is developed in collaboration with policy makers and commissioners. The Research Unit will support policy development through the analysis of existing research, undertaking the evaluation of, and research on, developments in commissioning and facilitating knowledge exchange between researchers, policy makers and commissioners.


Research activity codes: 8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE