The research highlighted two main issues related to the policy development of WCC. These included the level of centralised control (i.e. the DH) in the development, implementation, and monitoring of WCC, and the extent to which the policy and its implementation would fulfil the aim and intentions set out in the WCC vision.
Our findings suggest that the dominance of the Department of Health in exerting control over commissioning, subjecting commissioners to continual changes that destabilised commissioning, and developing policies that lacked coherence and alignment with WCC was viewed as hindering commissioners’ ability to improve commissioning.
The research highlighted three main issues concerned with the implementation of the WCC policy, these are:
Organisational structures and culture: in particular the complex nature of the commissioning landscape, historical processes and ways of working and issues regarding power and leadership.
Engagement: the quality of engagement varied across the local authority, strategic health authorities, practice based commissioners, patients and public and providers. Perceived hindrances included competing organisational interests and objectives and historical relationships and disputes.
Knowledge and capacity: particularly human capacity and time were found to be insufficient and this was deemed to be a particular disadvantage in negotiations with providers.
McCafferty, S., Williams, I., Hunter, D.J., Robinson, S., Donaldson, C., Bate, A. (2012) Implementing World Class Commissioning Competencies: A case-study evaluation. Journal of Health Services Research and Policy, HREP Supplement, January 2012.
Research lead: Professor Cam Donaldson, Institute of Health and Society, Newcastle University
HSMC researchers: Dr Iestyn Williams and Dr Suzanne Robinson
Department of Health Policy Research Programme