Strategic commissioning: what does it mean?

The Secretary of State set out that ICBs should be ‘pioneers of reform’ through ‘strategic commissioning’ to deliver the government’s three shifts for health: from hospital to community, from illness to prevention and from analogue to digital. The government has now announced it will move NHS England into the Department of Health and Social Care and a significant reduction in ICBs’ running and programme cuts as well as reductions in corporate costs among providers. 

As the functions of the different parts of the health service are clarified, it is likely that strategic commissioning will become an even more important function for ICBs and a common vision for it must be developed. Ahead of ICBs making any structural changes to adapt a reduced running cost allowance, the meaning of strategic commissioning should be clarified so that form follows function.

Based on engagement with ICS leaders and their partners, we have developed a vision for strategic commissioning and identified its key features. We hope this will inform NHS England’s planned strategic commissioning framework. 

Vision for strategic commissioning and its key features

ICBs are best placed to convene partners and facilitate the shift towards a different way of commissioning. We define strategic commissioning as:

‘The pursuit of the best possible health outcomes for a given population and experience for patients through the planning, purchasing, evaluation, integration and transformation of services, promotion of self-care and exercising system leadership to that end.’

It means:

• Proactively addressing populations’ health needs by developing a strong understanding of need, harnessing quantitative and qualitative insights.
• Shifting a greater share of resources from downstream acute services to anticipatory interventions in the community and better support for longer-term and complex conditions.
• Collaborating across local government, the VCSE sector and the breadth of the NHS and involving patients and communities.
• Transforming services and commissioning whole pathways for population cohorts.
• Achieving better value and focusing on outcome measures.
• Empowering local leaders to lead, innovate and listen, rather than just look upwards for instruction.
• Transitioning to a strategic commissioning approach will take time and require organisations and systems to develop the right skills and capabilities.