David Evans chief executive of Northumbria Healthcare NHS Foundation Trust shares his view on where next for commissioning as part of Provider Voices | NHS Providers.
My honest opinion is that the purchaser-provider split has outlived its usefulness. The NHS environment has changed hugely from the time when commissioning seemed like a good idea. Back then, there was plenty of money in the system, and options for getting better deals for your money by managing the market.
Now money is tight, the question must be whether money spent on commissioning wouldn’t be better used delivering services. Look at the situation nationally: some providers are in dire financial straits and their commissioners sit on surpluses. In other places, the reverse applies.
We have seen private providers hit this wall too, as well as some high-profile commissioning decisions (as in Cambridgeshire) that fall foul of the reality of providing services.
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