What is commissioning?

Commissioning is the process of planning and purchasing the services required for a given area or population. This can involve:

  • understanding the health needs of a population
  • deciding what services are needed to meet those needs
  • designing the routes people with follow through the different services
  • purchasing services and negotiating contracts with provides
  • undertaking quality assessment

Commissioning is a key process in the health and care system as it determines which services will be available and how they will be provided. It has been an area of concern for the Neurological Alliance as services for people with neurological conditions have a long history of being under-prioritised and overlooked by commissioners. This can result in in low-quality, fragmented services.

How services for people affected by neurological conditions are planned and commissioned

From 2022, the way in which health and care is planned, provided and delivered in England is changing. Below is a short summary of key terms and organisations.  We hope this will help anyone with an interest in improving services for people affected by neurological conditions  to campaign for better health and care.

Key organisations

The NHS and care is a complex system, which can sometimes make it difficult to understand – especially working out who is responsible for what. It’s made up of a wide range of different organisations with different roles, responsibilities and specialities. These organisations provide a variety of services and support to people affected by neurological conditions.

NHS England is responsible for providing national direction on service improvement and transformation, governance and accountability, standards of best practice, and quality of data and information.

The Care Quality Commission’s (CQC) role is to register care providers and monitor, inspect and rate their services in order to protect users. CQC publishes independent views on major quality issues in health and social care.

Regional NHS England teams are responsible for the quality, financial and operational performance of all NHS organisations in their region. Increasingly, they are working with local systems (ICSs) to oversee performance, support their development and make interventions when necessary.

You can find out more about the NHS structure in England and who does what by visiting the NHS website. The King’s Fund has also produced a series of structure diagrams and a  short animation about the NHS.