Chapter Three: Commissioning for health and wellbeing

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This chapter considers the history of NHS commissioning in England, the Labour government initiative for World Class Commissioning (2007-10) and the extent to which a public health-led model of commissioning is reflected in practice. Health needs assessment of a local population is described in detail as the first stage in a commissioning cycle and cornerstone of a public health-led approach to commissioning. Drawing on interview data from the study, the chapter discusses how ‘commissioning for health and wellbeing’ is understood and put into practice, and summarises GP involvement in the commissioning process. It reviews local approaches for tackling health inequalities and discusses enablers and barriers to implementation. It concludes by identifying lessons from the research for public health in local government following the major reforms in public health commissioning implemented by the Coalition government in 2013.

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