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This paper seeks to understand relationships between prison healthcare and integrated care systems (ICS), including how these affect the delivery of new healthcare interventions. It also aims to understand how closer integration between prison and ICS could improve cross system working between community and prison healthcare teams, and highlights challenges that exist to integration between prison healthcare and ICS.

The study uses evidence from research on the implementation of a pilot study to establish telemedicine secondary care appointments between prisons and an acute trust in one English region (a cross-system intervention). Qualitative interview data were collected from prison (n = 12) and community (n = 8) healthcare staff related to the experience of implementing a cross-system telemedicine initiative. Thematic analysis was undertaken on interview data, guided by an implementation theory and framework.

The research found four main themes related to the closer integration between prison healthcare and ICS: (1) Recognition of prison health as a priority; (2) Finding a way to reconcile networks and finances between community and prison commissioning; (3) Awareness of prison service influence on NHS healthcare planning and delivery; and (4) Shared investment in prison health can lead to benefits.

This is the first article to provide research evidence to support or challenge the integration of specialist health and justice (H&J) commissioning into local population health.

Securing better health and better care outcomes for people by effective use of public resources is at the heart of the commissioning agenda. Commissioning should ensure that the needs and wishes of people are well understood, and the market managed, so there are a range of local supports and provision available at a reasonable price. This is particularly important for people with intellectual disability whose behaviour is challenging, where effective clinically informed leadership is essential. Although models of good practice have been demonstrated for more than 20 years, making this happen on a wider scale remains the real challenge. Common wisdom about positive practice is not common practice in meeting identified needs. This paper aims to demystify the ‘commissioning’ role, and highlights the case for change in current practice, exploring some of the key barriers that must be addressed and suggesting ways to achieve better outcomes.

This paper explores the potential application of public value management theory to the practice of UK healthcare procurement. By conducting a literature review, key elements of public value theory and practice that can be applied to healthcare procurement are identified together with mechanisms that can be used in procurement to protect public values and enhance the creation of public value. These are formed into a Public Value Healthcare Procurement Framework which represents a fresh normative approach to healthcare procurement by focussing on a broader, societal view of value; by providing a blue print for procurement leaders centred around Moore's vision of “exploring” and “moral” public managers; and by promoting a public service ethos amongst all providers including the private sector.

There can be no doubt that literature regarding healthcare commissioning is on the increase. In particular, documentation is continuously emerging on the innovative models which have been designed and implemented to secure effective healthcare for the future. However, the literature tends to focus on the processes that have been designed rather than any required changes in human skills and outlook. While this article examines some of the organisational issues surrounding healthcare commissioning, it also covers the changes and demands required of the personnel practising within the purchasing arms of the National Health Service.

The purpose of this paper is to explore potential benefits in aligning Joint Strategic Needs Assessments (JSNAs) with implementation of the Equality Delivery System (EDS) to improve commissioning of healthcare for minority ethnic groups.

The paper draws on data gathered for a large research study carried out in England exploring the use of evidence in commissioning for multi‐ethnic populations, to present a reflective discussion on the potential synergies between JSNA and EDS processes. Qualitative data were collected from 62 interviews with stakeholders in Sheffield, Leeds and Bradford, who, as part of their normal role, had an active responsibility to contribute to decision making for commissioning healthcare. 19 individuals working in national roles with experience in evidence use, ethnicity and commissioning across NHS, local authorities and third sector were also interviewed. Observational data were collected through regular attendance at an NHS Equality Group, which had Equality Delivery System implementation within its remit, and from a regional workshop focussing on Joint Strategic Needs Assessment improvements. Observations also came via participation in local EDS implementation meetings across Sheffield, Leeds and Bradford. These data were supplemented by a review of local and national policy literature about implementing JSNA and EDS.

Formally strengthening the connection between JSNAs and the EDS has potential benefits for enhancing the evidence base about health and wellbeing needs of minority groups in general, and ethnic minorities in particular.

NHS and Local Authority organisations need to establish structural processes to formally connect these two workstreams and to ensure adequate resource is made available, with clear direction from senior management.

The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry.

A rapid evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches.

The review found that English prison healthcare has undergone “transformation” during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources.

Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered a small number of countries, which may limit the transferability of findings. The lack of quantitative data necessitated the use of qualitative data gathered from key informants. However, this enabled a good understanding of current practice.

The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the “whole prison approach” recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community.

This is unique research which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes.

The purpose of this paper is to present an evaluation of a collaborative commissioning approach to improve quality and experience and reduce cost within integrated health and social care.

A multi-method approach is used involving qualitative interviews, documentary analysis and non-participant observation.

The findings suggest that the approach provides a suitable framework for the collaborative commissioning of integrated health and social care services.

Further research is now needed to provide a definitive evaluation of its value outside of Wales.

With the significant scrutiny on health systems, the approach demonstrates effectiveness in securing quality improvements, achievement of recognised care standards and patient outcomes, while providing scope for financial gains and a goal for stakeholders to engage in effective communication.

This research presents an innovative method for collaborative commissioning and reveals activities that appear to contribute to more effective commissioning processes.

The aim of this paper is to set out the role of clinical governance within the new commissioning framework. It starts by considering the historical development of clinical governance and lays out ideas for the new arrangements around the concept of the primary care home and concludes with challenging questions for the future.

The paper draws on the author's role and experience as a senior policy maker in the UK Department of Health.

If we are to fulfil the defined attributes of clinical governance the NHS needs to adopt a more reflective self‐auditing leadership culture. Whether that supposition is accepted or not, a set of questions arises. Why, given for instance the gross failures of care for the frail elderly, have the principles of clinical governance not been systematically embedded? Why, given the NHS can no longer be described as poorly resourced, are clinical outcomes for many conditions lagging behind equivalent international healthcare systems? Why have the improved access and clinical outcomes of recent years been dependent on political rather than NHS leadership? And why in our publicly funded NHS is there frequently a culture of regarding patients as grateful supplicants rather than true partners to whom we should account? Clinical governance for personal, population and system care. Does this represent a coming of age?

This article provides a contribution to the emerging policy debate around clinical governance in the new commissioned NHS, rooted in experience from both the clinical front line and the heart of national health policy making.

UK policy seeks to shift commissioning of services ‘closer to the people’ with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. The participation of older people with mental health problems and their carers in the strategic planning process has been patchy, however. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.

The purpose of this paper is to contribute knowledge on ethical issues and reasoning in expert reports concerning healthcare governance, commissioned by the Swedish healthcare system.

An in-depth analysis of ethical issues and reasoning in 36 commissioned expert reports was performed. Twenty-seven interviews with commissioners and producers of the reports were also carried out and analysed.

Some ethical issues were identified in the reports. But ethical reasoning was rarely evident. The meaning of ethical concepts could be devalued and changed over time and thereby deviate from statutory ethical goals and values. Several ethical issues of great concern for the Swedish public healthcare were also absent.

The commissioner of expert reports needs to ensure that comprehensive ethical considerations and ethical analysis are integrated in the expert reports.

Based on an extensive data material this paper reveals an ethical void in expert reports on healthcare governance. By avoiding ethical issues there is a risk that the expert reports could bring about reforms and control models that have ethically undesirable consequences for people and society.