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Ambition, challenge, transition: Reflections on a decade of NHS commissioning

This report has been produced by the NHS Confederation to mark the end of a significant period of transition for NHS commissioning. Since the publication of the NHS white paper Equity and excellence: liberating the NHS in July 2010, commissioning arrangements have been through a process of unprecedented change and reorganisation, culminating on 1 April 2013 with the transfer of commissioning functions from primary care trusts (PCTs) to clinical commissioning groups (CCGs), local authorities, NHS England and other national bodies.

This report explores the achievements and challenges experienced over more than a decade of commissioning through the voices of those who lived it on the ground. The material for this report was gathered from interviews, carried out between November 2012 and February 2013, with 20 leading figures from and around PCTs. The interviewees’ job titles used in the paper refer to their roles during the period they were reflecting on. A full list of interviewees is provided at the end of the report.

This report captures critical lessons from the past, and translates these into messages that are relevant to new commissioners. It is intended to be a practical and supportive tool for colleagues in the new system, with resonance for commissioners in CCGs, local authorities and NHS England, as well as an acknowledgement of the contribution and legacy of PCTs. Crucially, it asks what reflections PCT leaders would share with new commissioners.