Nottingham University Business School

Centre for Health Innovation, Leadership and Learning (CHILL)

The Implementation of New Commissioning Models

Clinical Commissioning Groups (CCG’s) are responsible for ensuring healthcare provision meets local population needs. Commissioning has been criticised for failing to improve the quality and efficiency of healthcare. A lack of fit between commissioning and the institutional characteristics of NHS organisations has been suggested as a cause for the perceived failure. Different NHS organisations may have their own institutional logic, which makes it difficult for organisations to work collaboratively. The Five Year Forward View (2014) suggests new models of commissioning need to be considered to address the problems the NHS is facing. New models place the patient at the centre of care and call for greater integration between different care organisations. These new models are particularly relevant for conditions like stroke where care is required in both the acute and community setting, and involves numerous professionals and organisations. CCG’s must now work closely with stakeholder organisations to determine which of these new models of care are most appropriate for their local context and how they can be implemented in practice.

Project aims

The over-arching aim of the research is to determine if the underlying institutional logics of NHS organisations allow new models of care to be commissioned collaboratively. Using stroke services as a contextual example, case studies will be used to explore different approaches to commissioning, the institutional logics of the organisations involved and the outcome of commissioning processes.

Project highlights

  • Case study methodology using interviews, observation and documentary evidence is being used to explore the perspectives of commissioning stakeholders in up to four locations within one clinical network region.
  • REC approval for the research granted in January 2015.
  • Data collection completed March 2016. This is now in data analysis phase with final results and report expected to be competed by 2017.

Project team

Student: Rebecca O’Connor

Supervised by: Professor Justin Waring, Dr. Rebecca Fisher (School of Medicine)

Funder: The Health Foundation

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