A networking approach to commissioning

Directors of commissioning are taking up posts in reconfigured primary care trusts. Practice-based commissioners and their consortiums are getting to grips with turning plans into operational realities. And the partners who have been waiting to continue the dialogue - on health inequalities, joint commissioning and a dozen other whole-system issues - can look forward to meetings with people who are in a position to take matters forward.

There are healthy traditions of networking and collaboration within the NHS (and between the NHS and its partners) which should flourish in the new world of commissioning. They bridge the gaps in understanding and flex around the boundaries of the hundreds of organisations and tribes that make up the NHS. Practice-based commissioning and greater diversity of providers may add new layers of complexity but they also bring new opportunities for breaking down barriers and creating productive new relationships.

Intelligent commissioning will not succeed unless commissioners at all levels are able to profit from the experience of others and understand their own contribution in the context of the contributions of others. NHS Networks' Learning From Practice database provides an opportunity to do just that.

We began by collecting examples of demand management practice from the service in March and April 2006, and have details of over 200 initiatives shifting activity into primary care and managing referrals in various ways.

However, commissioners also need to look further upstream - at the contributions of many others in averting or delaying the onset of disease, and how, at each level of commissioning, we best harness, focus or align with these, and take coherent decisions about investment in prevention and services.

In September we began collecting examples to inform the second stage of the Department of Health's commissioning framework (due out this month). We have been looking for the ingredients of practice-based commissioning, commissioning for health and well-being, joint commissioning and commissioning from the third sector from which the right local mix can be made.

Contributions received so far show a wide range of experience of work at locality and neighbourhood level involving all sorts of organisations and professions from local authorities, and the third sector of community and voluntary organisations and social enterprises. Much of this work could be better connected to primary care services. Equally, practice based commissioners looking for health and well-being gains may find much to learn in reviewing these experiences.

Examples also show a range of approaches to joint commissioning, working not just with local authority social care, but also with leisure services, regeneration and education. Others demonstrate that nurses, allied health professionals, pharmacists and other health professionals have much to offer the promotion of health and well being at practice and consortium level.

The 400-plus entries are not validated or endorsed as best practice. It is up to commissioners and providers to judge what to transfer to their own contexts, and enrich local dialogues and collaborations. It is a self-improving NHS in action. Your contribution may be what others are looking for.

John Callaghan is associate editor of NHS Networks www.networks.nhs.uk/commissioning