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Need to Nuture: Outcomes-based commissioning in the NHS

‘Outcomes-based commissioning’ is an enigma. Its definition is complex, its evidence base uncertain, and its early adoption in the English NHS has met with a number of issues. Yet it is being lauded as the future of health care by many people, both within the NHS and internationally. This paper examines what outcomes-based commissioning means, the evidence to support it, progress to date on introducing the approach in England, and the optimum role of national policy in response to it. It
is aimed at policy makers who are considering how best to support outcomes-based commissioning, and local areas that may be considering adopting the approach. It is based on a rapid literature review and interviews with national policy makers as well as those in the NHS who are leading its development.