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What is commissioning?

Commissioning is the process of ensuring that care services are provided effectively and that they meet the needs of the population. It is a complex process with responsibilities ranging from assessing local population needs, prioritising outcomes, procuring products and services to achieve those outcomes and supporting service providers to enable them to deliver outcomes for individual service users.

Commissioning covers a wider range of activities than the procurement of services. Experience gained from procurement activities can be applied to strategic commissioning but commissioning is different.

Commissioning can happen at many levels, including the strategic level, the locality level and the community level. The task of an authority will be to decide at which level responsibility for commissioning should lie.

Definition

Commissioning is a broad concept and there are many definitions. The Department of Health describes commissioning as the means to secure the best value for local citizens and taxpayers. It is the process of translating aspirations and need, by specifying and procuring services for the local population, into services for users which deliver the best possible health and wellbeing outcomes and provide the best possible health and social care provision within the best use of available resources.

Commissioning is an on-going process which applies to all services, whether they are provided by the local authority, the NHS, other public agencies or the independent sector. Most definitions of commissioning paint a picture of a cycle of activities at a strategic level - concerned with whole groups of people, including:

  • assessing the needs of a population;
  • setting priorities and developing commissioning strategies to meet those needs in line with local and national targets;
  • securing services from providers to meet those needs and targets;
  • monitoring and evaluating outcomes; and
  • the above combined with an explicit requirement to consult and involve a range of stakeholders, patients/service users and carers in the process.

Commissioning has become established over the past decade through a number of papers emerging from the government which have set out the aims for service delivery and defined approaches to commissioning services. A timeline is provided on this site providing an outline of the key documents which describe and define commissioning.