Health Committee - Fourth Report
Commissioning
Here you can browse the report together with the Proceedings of the Committee. The published report was ordered by the House of Commons to be printed 18 March 2010.
CONTENTS
Terms of Reference
REPORT
1 INTRODUCTION
2 COMMISSIONING 1948-2010
History
The purchaser/provider split 1991-2010
Present System
Practice-based commissioning
3 COMMISSIONING FOR SPECIALISED
SERVICES
The structure of specialist commissioning
Criticisms of specialised commissioning
Conclusions
4 WEAKNESSES IN COMMISSIONING
How do PCTs think they are doing?
Weaknesses
Passivity vis à vis providers
Failure to improve the quality of services
Failure to change patterns of service provision
where necessary
Reasons for weaknesses
Shortcomings in data and data analysis
Lack of other skills and knowledge
Quality and status of commissioners
Imbalance of power and lack of levers
Practice Based Commissioning
Conclusions
5 THE EFFECTS OF WIDER REFORMS
IN THE NHS ON COMMISSIONING
Payment by Results (PbR)
Integrated Care Pilots
The overall impact of reforms on commissioning
Conclusions
6 HOW THE GOVERNMENT HAS RESPONDED
TO WEAKNESSES IN COMMISSIONING
World Class Commissioning
Darzi Reforms
PROMs
Quality Accounts
Never Events
Framework for External Support for Commissioning
(FESC)
7 THE WAY FORWARD
Keep PCTs but do more to integrate care
Retain PCTs, but introduce "local clinical
partnerships"
The Department of Health commissions services
from hospitals
Retain and strengthen PCTs
Impending Cuts
Conclusions
CONCLUSIONS AND RECOMMENDATIONS
FORMAL MINUTES
WITNESSES
LIST OF WRITTEN EVIDENCE
LIST OF FURTHER WRITTEN EVIDENCE
LIST OF REPORTS FROM THE COMMITTEE DURING
THE CURRENT PARLIAMENT
MINUTES OF EVIDENCE - VOLUME II (HC 268-II)
WRITTEN EVIDENCE - VOLUME II (HC 268-II)
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