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Making sense of commissioning

Commissioning in the English National Health Service (NHS) is a multi-faceted process, ranging from health-needs assessment to design of patient pathways, to service specification and to contract negotiation, all with a requirement for continuous quality assessment. The process of commissioning has undergone numerous modifications since it was introduced, with the latest changes brought in by the government’s Health and Social Care Act of 2012. In this issue we publish three separate but related articles on this very current topic.

In his commentary SRH commissioning in England: moving beyond transition, Chris Wilkinson, the President of the Faculty of Sexual & Reproductive Healthcare, draws our attention to the present confused arrangements and uncertainties in the commissioning of sexual and reproductive health (SRH) services, with different groups being responsible for the various aspects of what should be integrated specialties. SRH provision could be one of the key measures of quality in local healthcare programmes, but to achieve this will require urgent changes to the current arrangements. Wilkinson sets out his views on those changes and expresses his determination that the quality of SRH care provided to both women and men must become a more central feature of local health planning. See page 5

As Wilkinson points out, commissioners of services often have insufficient understanding of what should be commissioned, and for whom. ‘Patient and public engagement’ (PPE) is a legal duty for healthcare commissioners, but in A tool to improve patient and public engagement in commissioning sexual and reproductive health and HIV services, Lorenc and Robinson state that there still remains a gap in practical guidance on the methods, processes and standards for PPE in the NHS. They report on the development of SHAPE (Sexual Health And Public Engagement), an online training resource on PPE for commissioners of SRH services, that …

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