Purpose and scope

This book is intended to assist all those charged with commissioning health andsocial care in the UK and in other jurisdictions that have similarorganisational arrangements. The term ‘values-based commissioning’begs for definitions. These are discussed in some detail in this chapter andelsewhere. At this point it is worth clarifying the broad purpose and scope ofthe book.

Commissioning is a complex, iterative process that ensures that health and socialcare provision for a population is clinically and cost-effective and appropriateto the needs of the people for whom it is intended. Commissioning is not simplyplanning or procurement. Commissioning has a number of stages described indifferent ways by various authors, and in different countries and jurisdictions,but all contain something along the following lines.

Commissioning has a cyclical form that begins with assessing the health andsocial care needs in the communities served; consults and involves patients andthe public alongside community, patients and service user organisations; definesthe care outcomes appropriate to the population served; identifies the types ofinterventions (medical, surgical, social or psychological) that may beappropriate to the conditions to be treated or ameliorated; gathers informationon all those providers that may be able to or wish to contribute a component ofthe care pathway (subject to some over-arching policy on the use of NHSproviders); invests in capacity-building organisations to provide tailored andeffective care; encourages all reasonable providers to become involved throughensuring that contracting processes are fair and transparent; developsacceptable risk-sharing arrangements; and establishes feedback processes thatcatalyse further innovation and engagement of patients and the public.