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Telford and Wrekin Council and PCT have developed a Health and Well‐being Strategy that includes all health and council services that contribute to this area, including secondary health care. This article describes the challenges that they faced in understanding and agreeing shared priorities and how they used this whole‐systems framework to keep a clear focus on what local people want and need, bringing together and making sense of national policy such as World Class Commissioning and Putting People First.

Persistent and particular health and social care challenges face socially excluded groups and communities in the more deprived areas of the country. Involvement of communities in design and delivery of services, including those whose voices have traditionally not been heard, will help to shape services to meet better their health and well‐being needs. Effective community‐led commissioning can empower individuals and communities by giving them the chance to voice their needs, while local ownership of the process will increase the relevance of services, and improve their uptake and sustainability. For commissioners, the ‘World Class’ commissioning agenda is about connecting development of services with the real requirements of communities, and increasing engagement and satisfaction with services.

This article describes a process undertaken to develop a set of commissioning principles to support the commissioning of secure learning disability services across England. The principles, shaped around the 11 competencies laid down in the World Class Commissioning competencies framework (Department of Health, 2008a), were produced following a scoping exercise that looked at provision and commissioning of secure learning disability services within each strategic health authority (SHA) area in England. Specific details were collected about types of services provided, including detailed service specification, quality indicators, how these (specialist) services link with local services (secure and non secure) and cost of services. Information collected about commissioning concentrated on strategic vision, practical commissioning arrangements, how the quality of services was monitored, how access to services was controlled and how ‘secure’ service users are reintegrated back into local (non secure) services and communities. This scoping exercise was augmented by qualitative data obtained from interview with a group of former service users. Themes generated through the interviews were integrated within the general guidance. A quality assurance framework based on the World Class Commissioning Competencies is proposed, against which specialist and local commissioners can benchmark their current commissioning arrangements.

With the recent publication of The Engagement Cycle (DH, 2009a), exploring the issues surrounding patient and public involvement (PPI) in World Class Commissioning, it seems timely to look at how this type of involvement/engagement has developed in recent years. Set against official rhetoric that emphasises the importance of PPI in the NHS, this paper is informed by evidence emerging from a three‐year research project into the development of practice‐based commissioning conducted at Manchester University. It is suggested that commissioners (primary care trusts and practice‐based commissioners) need to think deeply about the meaning of public involvement in their context, while at national level strategies should be flexible enough to allow a diversity of approaches which may ultimately allow PPI to flourish.

Current English health policy is focused on strengthening the ‘demand-side’ of the health care system. Recent reforms are designed to significantly enhance the capability and status of the organisations responsible for commissioning health care services and, in so doing, to address some of the perceived problems of a historically provider/supplierled health system. In this context, commissioning organisations are being encouraged to draw on concepts and processes derived from commercial procurement and supply chain management (SCM) as they develop their expertise. While the application of such principles in the health sector is not new, existing work in the UK has not often considered the role of health care purchasers in the management of health service supply-chains. This paper describes the status of commissioning in the NHS, briefly reviews the procurement and SCM literature and begins to explore the links between them. It lays the foundations for further work which will test the extent to which lessons can be extracted in principle from the procurement literature and applied in practice by health care commissioners.

While the NHS and local government are developing their understanding of commissioning and are busy with plans for the personalisation of services and ‘world class commissioning’, other partner organisations are left wondering what this all means. In this first article, Deborah Klée explains how national policy is changing the way services are planned and commissioned and what this means for older people and provider services.

As many states recognise the need to enter into new relationships with the third sector, strategic commissioning of services has moved up the political agenda. The establishment of the Office of the Third Sector in the UK Cabinet Office heralded a commitment to engage the “voice” and “choice” of third sector organizations in designing, delivering and measuring public service delivery. This paper seeks to report on the findings gathered from a series of workshops and other data collection on public sector commissioning of third sector service delivery, and to highlight some tensions and emerging issues in this policy field.

Qualitative data from workshops were supplemented with observations, interview data, existing research, and secondary data from a number of government agencies and third sector representative organizations.

The findings from the workshops and other data collection methods will feed into future design and development of training programmes for public sector and third sector officers. They should also inform the policy debate and enhance understanding of some of the tensions and problems facing practitioners in this policy field.

Little research exists on third sector or public sector commissioning, and this work will be of value to policy makers, practitioners and academics concerned with strategic commissioning. The paper augments existing theory on state and non‐governmental relationships and the contribution of third sector agencies to public service delivery.

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.

The purpose of this paper is to present the outline of a methodological approach to help address ten key challenges for the implementation of Recovery‐orientated services.

At the onset of the project the authors produced a policy paper, Making Recovery a Reality. This formed the basis of a series of workshops on implementing Recovery in organisations that were held in five mental health trusts in 2008 and 2009.

A key element driving the transformation of Recovery‐orientated mental health services will be the joint work of local systems, setting priorities, agreeing goals and contracts and then monitoring progress and reviewing.

The impetus for the project arose out of the increasing attention being given to the principles of recovery in government policy and in local mental health services, combined with an increasing frustration that there was little to guide how these principles could be put into practice.

The language used by National Health Service (NHS) “commissioning” managers when discussing their roles and responsibilities can be seen as a manifestation of “identity work”, defined as a process of identifying. This paper aims to offer a novel approach to analysing “identity work” by triangulation of multiple analytical methods, combining analysis of the content of text with analysis of its form.

Fairclough's discourse analytic methodology is used as a framework. Following Fairclough, the authors use analytical methods associated with Halliday's systemic functional linguistics.

While analysis of the content of interviews provides some information about NHS Commissioners' perceptions of their roles and responsibilities, analysis of the form of discourse that they use provides a more detailed and nuanced view. Overall, the authors found that commissioning managers have a higher level of certainty about what commissioning is not rather than what commissioning is; GP managers have a high level of certainty of their identity as a GP rather than as a manager; and both GP managers and non‐GP managers oscillate between multiple identities depending on the different situations they are in.

This paper offers a novel approach to triangulation, based not on the usual comparison of multiple data sources, but rather based on the application of multiple analytical methods to a single source of data. This paper also shows the latent uncertainty about the nature of commissioning enterprise in the English NHS.