Does Clinical Leadership through Commissioning Work?

In tune with much international practice, the NHS has been striving to transform health care provision to make it more affordable in the face of rising demand. Uniquely, at the heart of radical reforms in the UK has been the launch of the local Clinical Commissioning Groups (CCGs), usually led by GPs, to which more than half the total health budget has been devolved.

The narrative suggests that this allows the removal of significant numbers of managerial posts and transfers decision making to local clinicians. Indeed, policy statements make clear that the CCGs are expected to transform the organisation and provision of health services. It has been a bold experiment on a massive scale and one worthy of close scrutiny.

Drawing upon interviews, observation and analysis of internal documents, Clinical Leadership through Commissioning: Does it Work in Practice?, a paper by IKD members John Storey, Jean Hartley et al in press with Health Service Management Research, assesses the extent to which clinical leaders have seized the opportunity to transform service design.

Their findings suggest that, while there is much support in principle for the idea of clinical leadership through commissioning, implementation (apart from a few notable exceptions) remains uncertain and contested. And, for as long as other policies and institutions continue to place checks on the CCGs’ exercise of power, their scope to bring about significant change will remain unclear.

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