The reality of joint commissioning in health and social care often falls short of expectations, according to a report.
University of Birmingham researchers completed the study for the National Institute of Health Research, finding that efficiency savings and improvements are often not as significant as the perceived benefits.
The study, Joint Commissioning in Health and Social Care: An Exploration of Definitions, Processes, Services and Outcomes, also pointed out that new financial pressures will make combined commissioning and working more difficult in future.
Helen Dickinson, who co-authored the report, said: “Our research finds no clear evidence that joint commissioning improves outcomes across the board. Even though we picked sites of best practice for the study, most sites found it difficult to demonstrate what joint commissioning had achieved locally.”
She added the government needs to ensure local organisations understand the main ambitions of joint commissioning as there is some confusion.
She said: “If the government does not have a clear sense of what joint commissioning should deliver, then there is a question over whether it should be pressurising clinical commissioning groups and local authorities to combine budgets.”
Researchers acknowledged that due to financial restrictions, an ageing population, increased demand and higher expectations, health and social care services will need to start collaborating more.
But they found that the reform needed to make joint commissioning work is often disruptive, difficult and time consuming.
The report states that the reform is “disrupting exiting relationships and focusing attention on internal organisational concerns rather than external user-professional relationship”.
Jon Glasby, who also co-wrote the report, said their findings show joint commissioning is more complicated than many thought.
He explained that during the study, many joint commissioners found it hard to outline the benefits of the system and what makes it distinct from other ways of working.
He added: “Rather than seeing joint commissioning as a discrete way of organising that produces certain results, perhaps we should see it as a more general way of bringing partners together and helping to mobilise staff locally.”
Researchers warned that as a result of structure changes there is a chance that previous relationships and organisational memory could be lost.
They also suggested fully-integrated commissioning organisations such as PCT-based care trusts could cease to exist in their current form.