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The capacity of health service commissioners to use evidence: a case study

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Currie, Graeme, Croft, Charlotte, Chen, Yaru, Kiefer, Tina, Staniszewska, Sophie and Lilford, Richard (2018) The capacity of health service commissioners to use evidence: a case study. Health Services and Delivery Research, 6 (12). doi:10.3310/hsdr06120 ISSN 2050-4349.

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Official URL: http://dx.doi.org/10.3310/hsdr06120

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Abstract

Clinical Commissioning Groups (CCGs) lead a network of organisations that plan and make decisions about what services to provide through the NHS. By examining decision-making about service interventions designed to reduce potentially avoidable elderly care admissions into acute hospitals, our study explores the capacity of CCG-led commissioning networks to make decisions that are based on evidence. Empirically, we study 13 cases of representative (region, size, urban/rural) commissioning networks in England, drawing on interviews with commissioning managers, general practitioners (GPs), patient and public involvement (PPI) representatives and other relevant stakeholders. CCGs can not only draw on evidence about what is most clinically effective or cost-effective, but can also consider patient experience and local knowledge held by doctors. However, the inclusion of GPs and PPI representatives is limited, so the local knowledge of doctors and the patient experience are not considered as fully as they might be in commissioning decisions. CCGs can use government agencies, such as commissioning support units, that provide external information about local population and existing service provision, but they fail to do so adequately. The voluntary sector can play a key role in providing local knowledge about individual patients and their needs. Finally, given the need for health and social care organisations to collaborate to support older people so that they do not experience potentially avoidable admissions to acute hospitals, there is a need for organisations to develop joint evidence-based strategies and work together in real time to exchange information. From our research, in collaboration with a PPI reference group, a self-assessment questionnaire for CCG-led commissioning networks was developed, which allows CCGs to assess and develop their capacity to acquire and use different types of evidence in their decision-making.questionnaire for CCG-led commissioning networks was developed, which allows CCGs to assess and develop their capacity to acquire and use different types of evidence in their decision-making.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET)
Faculty of Social Sciences > Warwick Business School
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Health services administration -- Great Britain, Health planning -- Great Britain, Medical policy -- Great Britain, Patient participation -- Great Britain, Older people -- Medical care -- Great Britain
Journal or Publication Title: Health Services and Delivery Research
Publisher: NIHR Journals Library
ISSN: 2050-4349
Official Date: 23 March 2018
Dates:
DateEvent
23 March 2018Published
1 August 2017Accepted
Volume: 6
Number: 12
DOI: 10.3310/hsdr06120
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 27 March 2018
Date of first compliant Open Access: 27 March 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
Health Services and Delivery Research Programme: 12/5002/01National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Open Access Version:
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