When practice-based commissioning (PbC) was first introduced the objective of the policy was to increase the involvement of primary care clinicians in identifying the needs of their local communities, designing services best suited to meet those needs, and managing the resources available to secure those services.
There is evidence that since PbC was put on a formal footing in April 2005, some practice-based commissioners have made progress in redesigning services to improve access, efficiency and local service delivery.
Overall, however, there is a sense that PbC has largely failed to capture the imagination of clinicians, NHS managers and the general public.
Recently, both World Class Commissioning and the NHS Next Stage Review have put the purpose and potential of practice-based commissioning back under the spotlight.
It is therefore a good time to look again at the strengths and weaknesses of existing practice-based commissioning arrangements and to explore how the policy can be re-invigorated.