The roles and information needs of those involved in commissioning

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Commissioning is akin to a relay race, with colleagues from different disciplines, Directorates and organisations, needing to deliver on their part of the process and hand on the baton at the appropriate stage.

Across the piece it calls for an understanding of policy, duties and guidance, strategic analysis of local health needs, skills in handling data, the ability to involve service users, service specification, an understanding of the supplier market and the ability to forge partnerships with providers. It also requires financial acumen, negotiating techniques, contracting and performance management. Library and information staff need to understand the roles and information needs of all those involved in commissioning, as well as their changing priorities.

Tips on searching the web:

When searching the internet, suggested terms include…

  • (information need*” OR role*) AND
  • To limit to NHS papers, try combining your results with: (ccg OR nhs). To look for CCG publications add the following to your google search:  site: (note the space before the CCG.)
  • You can search for terms such as “board paper” / “strategy” to help to locate Trust papers
  • More focused commissioning terms to try:“joint commissioning” / “lead commissioning” / “locality Commissioning” / “personalised commissioning” / “practice-based commissioning” / pbc / “specialist commissioning” / “strategic commissioning”

Also have a look at our summary of tips on searching the web.

List of contents

Information needs of commissioners

Evidence based policy making and the ‘art’ of commissioning – how English healthcare commissioners access and use information and academic research in ‘real life’ decision-making: an empirical qualitative study.
Lesley Wye, Emer Brangan, Ailsa Cameron, John Gabbay, Jonathan H. Klein and Catherine Pope.
BMC Health Services Research 2015, 15:430
Findings from analysis of four case studies of commissioning organisations:
“The ‘art of commissioning’ entails juggling competing agendas, priorities, power relationships, demands and personal inclinations to build a persuasive, compelling case. Policymakers sought information to identify options, navigate ways through, justify decisions and convince others to approve and/or follow the suggested course. ‘Evidence-based policy-making’ usually meant pragmatic selection of ‘evidence’ such as best practice guidance, clinicians’ and users’ views of services and innovations from elsewhere. Inconclusive or negative research was unhelpful in developing policymaking plans and did not inform disinvestment decisions. Information was exchanged through conversations and stories, which were fast, flexible and suited the rapidly changing world of policymaking. Local data often trumped national or research-based evidence. Local evaluations were more useful than academic research.”

Knowledge exchange in health-care commissioning: case studies of the use of commercial, not-for-profit and public sector agencies, 2011–14.
Wye L, Brangan E, Cameron A, Gabbay J, Klein J, Pope C.
Health Serv Deliv Res 2015;3(19).
A research study based on interviews, observations and documentation (service providers and CCGs)  from early 2011 to mid-2013 examining where commissioners get their information to support commissioning decisions. 
Results include:
“Local data often trumped national or research-based information.”
“Negative research evidence did not trigger discussions of disinvestment opportunities.”
“Interpersonal relationships appeared most crucial in influencing commissioning decisions.”
” Knowledge became transformed, reshaped and repackaged in the act of acquisition and through these processes as commissioners manoeuvred knowledge through the system.”

Challenges to using evidence from systematic reviews to stop ineffective practice: An interview study J Health Serv Res Policy1355819613480142, first published on June 18, 2013.
Through interviews with commissioners barriers to using systematic review evidence to develop and implement decommissioning concludes that the micro practices of commissioners are shaped by the wider system of health policy, the knowledge
producing and delivery agencies associated with health care, and power dynamics within the health care system. For
 decommissioning to be guided by evidence requires long-term engagement of clinicians, alternatives to the decommissioned activity and tackling perverse incentives.

Information needs of commissioners. A presentation by Anne Gray to Commissioning Handbook Champions, May 2013

Evidence-based commissioning in the English NHS: who uses which sources of evidence? A survey 2010/11 A Clarke et al. BMJ Open 2013;3:e002714 doi:10.1136/bmjopen-2013-002714. A study of 345 commissioning staff from 11 PCTs. “The extend to which empirial evidence is used for commissioning decisions varies according to the professional background.”

Explaining Health Managers’ Information Seeking Behaviour and Use. Edwards C, et al NIHR Service Delivery and Organisation programme; 2013.
An analysis of health managers information seeking behaviour and use based on case studies of five innovative change projects in five health trusts,  a national survey of managers ; n=2092 across 59 trusts, carried out Feb-July2011 and online survey (n=151) plus in depth interviews (n=7) of NHS librarians.

Mind the gap: Understanding utilisation of evidence and policy in health care management practice  Journal of Health Organisation and Management,  2011;25(3):298-314.
A short report of a qualitative study conducted in four PCTs examining the relationship between policy/evidence and practice in commissioning organisations.
See a summary here: The need for clarity in evidence based commissioning, HSJ 23 May 2011.
To read the full report see Evidence in Management Decisions (EMD) – advancing knowledge utilization in healthcare management

Business case toolkit from the British Heart Foundation.
An outline of the five steps to a business case, points to include and template.

Information Needs for GP Consortia
A briefing from PRIMIS+ outlining the factors GP Consortia need to consider when determining data sources, and resources, to support their information requirements.

The Intelligent Practice: Understanding the information needs of GP commissioners
Dr Foster report (2007) setting out information framework for GP commissioners involved in Practice based Commissioning.

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Use of evidence and decision tools in Setting priorities in health: a study of English primary care trusts, Nuffield Trust, September 2011, p25-28.
This chapter summarises results of a survey around the use of evidence and decision tools used to support prioritisation in PCTs.

Commissioning Intelligence Report
This draft report from the NHS Commissioning Board (19 January 2012) was generated from a large-scale engagement exercise to understand the information and intelligence requirements of emerging clinical commissioning groups (CCGs).  It lays out the intelligence needs using a series of questions: How Healthy? – What’s really happening in this system? – How much? – How Do We Compare? – Are My Providers Delivering What They Agreed? – How could things be better? – What difference have we made? – What are our future plans? The model outlines the questions, types of services and tools or data which would answer them.

Assessment of evidence for clinical and cost effectiveness – one of the competencies described in Competency framework for local decision-making groups (NPC March 2012) to support local decision making around medicines and treatments but could be extrapolated across commissioning. Each competency includes an outline of the skills and underpinning knowledge and abilities needed which could be used by librarians to support their role in the process.

How knowledge services can support primary care commissioning – a presentation by Dr Diane Gray, PH Consultant Milton Keynes PCT, 2007

Using evidence in the development of local health policies: Some evidence from the United Kingdom. Weatherley and Drummond. International Journal of Technology Assessment in Health Care 2002, v18(4) p771-781. Based on a questionnaire to members of Health Improvement Programmes (n=68). Where evidence was used it was a mixture of einternal (experiential) and external evidence (eg government reports/NICE rather than published research).

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Commissioner networks

There is a growing number of networks facilitating exchange and cooperation between commissioners, such as those on NHS Networks – some are listed below.  Some networks are communication channels for growing commissioning groups/consortia, but others are regional or national networks.

Commissioning Zone
A portal for clinicians, managers and anyone else involved in commissioning, bringing together ithe best sources and resources.

Health Investment Network
Part of QIPP Right Care, established to help commissioners improve their ability to achieve the best health outcomes.

Commissioning for Long Term Conditions
For those interested in supporting the development of GP commissioning for Long Term Conditions.

LGA Knowledge Hub a secure online knowledge sharing platform for councillors and officers to connect, communicate and share learning with peers across local government.

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