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Table 4 Discourses of joint commissioning identified through literature search

From: Making sense of joint commissioning: three discourses of prevention, empowerment and efficiency


Joint commissioning as prevention

Joint commissioning as empowerment

Joint commissioning as efficiency

What joint commissioning should achieve

Deliver preventative services through early intervention. This should in turn reduce inequalities, improve the quality of services and make services more accessible.

This should involve patients, service users and carers in the co-production of services. A user-led approach to care should be adopted that promotes self-care and in doing so transforms health and social care away from being professionally-led.

What is important is improving efficiency and reducing waste and duplication in health and social care services. In turn this should also improve access and performance of services.

Organisational processes to promote joint commissioning

Service re-design is important here and thinking about the needs of individuals and providing services around these. A key role for the alignment of strategies and budgets and the development of care pathways.

Personalisation of services plays an important role here with service users being given budgets with which to determine their own care. Fairness, inclusion and respect should be at the heart of all processes.

Increasing the number of providers that are available to health and social care commissioners will give more choice and competition. Greater freedoms and flexibilities for providers and the freedom to innovate should be supported by incentive-based reward and quality will be assured through inspection.

Organisational practices that support joint commissioning

The focus here is around commissioning practices and making full use of the Joint Strategic Needs Assessment to identify gaps in need.

What is important is how we work with service users and carers and the management of complex relationships. Workforce development and training may help with this.

More effective management of information may help to identify waste. What is important is the relationship with providers of care and how these are contracted with and performance managed.