Chapter Seven: Creeping Privatisation? Examining Procurement Choices in the ‘New’ NHS in England

Calovski, Vid; Calnan, Michael

doi:10.1007/978-981-32-9208-6_7

Cited by 4 publications

(14 citation statements)

References 34 publications

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“…64,72,79,93 Co-production was understood to be time and resource intensive. 57,62,63,66,68,76,79,82,84,89,99 The funding of longer-term pilot projects was considered an enabler. 57,64,65,74,79 This facilitated sufficient time to recruit participants from different parts of the community (including seldom heard groups), acclimatise to new ways of working and develop the service at a community-driven pace.…”

Section: Complexity Of the Commissioning Landscapementioning

confidence: 99%

“…66,82 However, the sociopolitical climate in which commissioners operated was a significant challenge to developing this transformational leadership. 62 Commissioners were subject to centrally driven mandates. 60,62 Pressures on the health and care system took precedence over co-production when budgets are stretched.…”

Section: Commissioners As Leaders Of Co-productionmentioning

confidence: 99%

“…64,89,91 Clarity of purpose and shared vision of the proposed health and care outcomes to be achieved and the scope and capacity to deliver them were central to effective co-production. 59,61,62,88 Where this was lacking, it fostered distrust. 58,61,69,88,98 Service users and communities valued transparency and regular feedback to understand how their involvement impacted the design and delivery of services.…”

Section: Navigating Relationshipsmentioning

confidence: 99%

“…Positive relationships afforded opportunities to influence others, 63,75,77,80 but this was sometimes tempered by rigid organisational structures and financial constraints. 61,62 A rebalancing of power is central to co-production. This required a change in commissioners and providers' perspectives to recognise the strengths and assets of service users and communities.…”

Section: Navigating Relationshipsmentioning

confidence: 99%

“…56,62,66,68,73,80,100 It was perceived that the service users most involved in co-production and commissioning activities were a homogenous group consisting of white, middle class, retired individuals. 62,68,80 Increasing diversity was considered critical to ensure services meet the needs of seldom heard and marginalised groups and address health inequalities. 66,70 It was also deemed important that service user representation in commissioning reflected the evolving demographic profile of the local area.…”

Section: The Collective Voicementioning

confidence: 99%

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Commissioning and co‐production in health and care services in the United Kingdom and Ireland: An exploratory literature review

Scott,

Mathie,

Newman

et al. 2024

Health Expectations

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IntroductionThis exploratory literature review seeks to examine the literature around commissioning processes in the co‐production of health and care services, focusing on two questions: How do health and care commissioning processes facilitate and/or pose barriers to co‐production in service design and delivery? What are the contextual factors that influence these processes?MethodA systematic search of three databases (Medline, Public Health and Social Policy and Practice) and a search platform (Web of Science) was conducted for the period 2008–2023. A total of 2675 records were retrieved. After deduplication, 1925 were screened at title and abstract level. Forty‐seven reports from 42 United Kingdom and Ireland studies were included in the review. A thematic synthesis of included studies was conducted in relation to the research questions.ResultsThe review identified one overarching theme across the synthesised literature: the complexity of the commissioning landscape. Three interconnected subthemes illuminate the contextual factors that influence this landscape: commissioners as leaders of co‐production; navigating relationships and the collective voice.ConclusionCommissioning processes were commonly a barrier to the co‐production of health and care services. Though co‐production was an aspiration for many commissioners, the political and economic environment and service pressures meant that it was often not fully realised. More flexible funding models, longer‐term pilot projects, an increased emphasis in social value across the health and care system and building capacity for strong leadership in commissioning is needed.Patient and Public ContributionPatients and the public did not contribute to this review as it was a small piece of work following on from a completed project, with no budget for public involvement.

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