Perceived benefits of joint commissioning lag behind reality, new study shows

January 9, 2013, University of Birmingham

A major new report on joint commissioning in health and social care has found the perceived benefits of collaborative working, such as efficiency savings and improvements to services, often lagged behind the reality.

The study, carried out by professors at the University of Birmingham for the National Institute of , warns that new financial pressures will make joint commissioning and joint working even harder in the future.

"Our research finds no that joint commissioning improves outcomes across the board. Even though we picked sites of 'best practice' for the study, most sites found it difficult to demonstrate what joint commissioning had achieved locally," says Dr Helen Dickinson, one of the co-authors of the report.

"The government needs to communicate the objectives of joint commissioning much more clearly to local organisations because those doing the joint commissioning don't always understand what the process is meant to achieve.

"If the government does not have a clear sense of what joint commissioning should deliver then there is a question over whether it should be pressurising CCGs and to combine budgets."

The report, entitled: Joint Commissioning in Health and : An Exploration of Definitions, Processes, Services and Outcomes says: "Faced with less money, but also with an , rising need and demand and higher public expectations, health and social care will have to work together more than in the past."

The study found that the necessary reform involved in joint commissioning was often difficult, disruptive and time consuming.

"Regardless of whether or not clinical commissioning can provide better or more responsive service for patients, the process of reform is disrupting exiting relationships and focusing attention on internal organisational concerns rather than external user-professional relationships," the report states.

Prof Jon Glasby, another co-author of the report added: "Joint commissioning has long been seen as a good thing by policy makers – but our research suggests it is more complicated than that."

"Many of the joint commissioners in this study struggled to say what makes joint commissioning distinct from other ways of working, or what it achieves in terms of outcomes.

"Rather than seeing joint commissioning as a discrete way of organising that produces certain results, perhaps we should see it as a more general way of bringing partners together and helping to mobilise staff locally."

Warning that joint commissioning and joint working could become even harder in the future, the report states: "Many of our case study sites have been trying to work together for many years, and have built significant expertise and trust over time.

"However, as increase there is a danger that some agencies could retreat back into their own organisational and professional identities, and that joint working could suffer."

The report warned that as structures change there is a real risk that previous relationships and organisational memory will be lost while fully integrated commissioning organisations such as PCT-based care trusts may also cease to exist in their current form.

"It would be ironic in the extreme if broader policy began to emphasise the importance of integrated care at exactly the same time that clinical commissioning led to the breakup of some of our most integrates structures and systems," the report states. "There seems a real risk of throwing the baby out with the bath water, and a key test of the current reforms will be their ability to build on what is already working well rather than undermining existing joint work."

Explore further: Doctoral student develops ethical guidelines for GPs

Related Stories

Doctoral student develops ethical guidelines for GPs

November 4, 2011
Malcolm Oswald, a doctoral student in Bioethics and Medical Jurisprudence in the School of Law, is a co-author of the new guide, entitled, Making Difficult Choices - Ethical Commissioning Guidance to General Practitioners. ...

New formula can help set commissioning budgets for general practices

November 23, 2011
A new formula that can predict future health costs more accurately than previous models could help guide commissioning budgets for general practices under the government's new Health Bill, finds a study published on British ...

Get rid of the Bill, former vice chair of Local Commissioning Group tells Lansley

February 14, 2012
With news of the Health and Social Care Bill facing further challenge in the House of Lords, Cambridgeshire GP Dr Peter Bailey asks the Health Secretary Andrew Lansley to "Get rid of the Bill" in an article published today ...

Forefoot joints don't improve 28-joint count measurement

July 26, 2012
(HealthDay) -- For the assessment of patients with early rheumatoid arthritis (RA), including forefoot joints does not significantly improve the precision or range of measurement of the 28-tender and swollen joint count, ...

UK health reforms will be the end of free care for all, warn experts

March 8, 2012
Entitlement to free health services will be curtailed by the Health and Social Care Bill currently before parliament, warn experts today.

Study finds accreditation improves safety culture at nursing homes

April 27, 2012
Accredited nursing homes report a stronger resident safety culture than nonaccredited facilities, according to a new study published in the May 2012 issue of The Joint Commission Journal on Quality and Patient Safety.

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.