Document, titled Successful Futures, Positive Futures and areadvanced in the NHS SOTW Road Map, titled, 'RethinkingRelationships'. Both documents are available online at:
Stage two examined the supply chain and focused onprovider impact, market position and strategic relevance. This part of the programme involved an assessment of theproviders ability and agility to meet and successfully executecommissioning strategy.Included was spend and patient flow analysis, as well as areview of the overall market structure, competitive dynamicand provider behaviour.
Findings – stage one and two.
There are three main learning points.Firstly, that the introduction of competition in areasconcerned with clinical and managerial leadership is counterproductive and works against joint supply.Secondly, services are conditioned to meet the needs of individuals and fail to look beyond that which theirorganisation, alone, can provide. This does little to addressthe needs of families and communities. Thirdly, commissioning models based solely on supply sideservice substitution, will in the long term, fail to meet theuniversal service obligation.In short, this method of commissioning is flawed.
World Class Commissioning is surprisingly silent on the roleof competition when buying health services, other than tosay the threat of competition is needed. This leaves it tocommissioners to work out the extent to which competitionis used and which competition model applies. Nevertheless,commissioners must at all times comply with the law.Where does this leave us?