Achieving integrated care through commissioning of primary care services in the English NHS: a qualitative analysis.

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives
Since April 2015, Clinical Commissioning Groups (CCGs) have taken on the responsibility to commission primary care services. The aim of this paper is to analyse how CCGs have responded to this new responsibility and to identify challenges and factors that facilitated or inhibited achievement of integrated care systems.
Design
We undertook an exploratory approach, combining data from interviews and national telephone surveys, with analysis of policy documents and case studies in four CCGs. Data were analysed using thematic content analysis.
Setting/participants
We reviewed 147 CCG application documents and conducted two national telephone surveys with CCGs (n=49 and n=21). We interviewed 6 senior policymakers and 42 CCG staff who were involved in primary care co-commissioning (general practitioners and managers). We observed 74 primary care commissioning committee meetings and their sub-groups (approx. 111 hours).
Results
CCGs in our case studies focused their primary care commissioning activities on developing strategic plans, ‘new’ primary care initiatives, and dealing with legacy work. Many plans focused upon incentivising and supporting practices to work together and provide a broad range of services. There was a clear focus on ensuring the sustainability of general practice. Our respondents expressed mixed views as to what new collaborative service models, such as the new models of care and Sustainability and Transformation Partnerships (STPs), would mean for the future of primary care and the impact they could have on CCGs and their members.
Conclusions
There is a disconnect between locally-based primary care and the wider system. One of the major challenges we identified is the lack of knowledge and expertise in the field of primary care at STP level. Whilst primary care commissioning by CCGs seems to be supporting local collaborations between practices, there is some way to go before this is translated into broader integration initiatives across wider footprints.
Original languageEnglish
JournalBMJ Open
Early online date1 Apr 2019
DOIs
Publication statusPublished - 2019

Keywords

  • Integration
  • integrated care
  • primary care
  • commissioning
  • NHS

Fingerprint

Dive into the research topics of 'Achieving integrated care through commissioning of primary care services in the English NHS: a qualitative analysis.'. Together they form a unique fingerprint.

Cite this