Commissioning for health improvement: policy and practice
Healthcare policy in the United Kingdom is placing an increasing priority on the innovation and creativity of healthcare commissioning purchasing for health improvement and the skills and competencies of those charged with its leadership and management. The combination of demand and supply side reforms resulted in the National Health Service (NHS) in England being in transition from a public monopoly insurer and provider of healthcare, governed from Whitehall, to an insurer with devolved commissioning from a mixed market of providers. The final act of devolved decision making within the framework for NHS reforms is to devolve purchasing to the lowest organisational level - individual General Practitioner (GP) practices. Practice Based Commissioning is where funds from the Primary Care Trust (PCT) are passed to individual GP practices for them to commission services for their practice population as they see best and within the overall strategic aims of the PCT.