How effective is joint commissioning? A study of five English localities

Abstract

Purpose

This paper reports research undertaken into the practices, processes and outcomes of joint commissioning at five English localities. This paper reflects on the implications of this study for the practice of joint commissioning.

Design/methodology/approach

A case study approach to the research was adopted where the assumptions about what joint commissioning should deliver in five “best practice” sites. These hypothesised relationships about organisational processes, services and outcomes were then tested through the collection of primary and secondary data. Methods of data collection included an online tool based on Q methodology, documentary analysis, interviews and focus groups.

Findings

Very little of what we found seemed to relate directly to issues of joint commissioning. Respondents often spoke of joint commissioning conflating it with issues of commissioning or joint working more generally. We found a variety of different definitions and meanings of joint commissioning in practice suggesting that this is not a coherent model but varies across localities. Little evidence of improved outcomes was found, due to practical and technical difficulties.

Research limitations/implications

Joint commissioning is not a coherent model and is applied in different ways across different contexts. As such we may need to ask very different questions of joint commissioning to those typically asked.

Practical implications

It is important that local sites are clear about what they are trying to deliver through joint commissioning or else risk that it becomes an end in itself. Some of the current reforms taking place in health and social care risk pulling apart existing relationships that have taken significant time and resource to develop.

Originality/value

This is one of the first large‐scale studies of joint commissioning conducted in England.

Citation

Dickinson, H. and Glasby, J. (2013), "How effective is joint commissioning? A study of five English localities", Journal of Integrated Care, Vol. 21 No. 4, pp. 221-232. https://doi.org/10.1108/JICA-04-2013-0012