The changing face of clinical commissioning

Report showcases the unique perspective brought by clinical commissioners and argues they are essential components to developing integrated services.

23 May 2019

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The changing face of clinical commissioning showcases the unique perspective brought by clinical commissioners – the clinical expertise, collaborative working with provider and local government colleagues, and an understanding of the population’s needs in the system in which they operate – and argues that these are essential components to developing integrated services that are fit for purpose and get the best value for each NHS pound.

The report highlights the important patient centred work that is taking place across the country to drive through innovations and improvements across health and social care – often in partnership with other organisations – through a series of interviews with clinical commissioning leaders at nine CCGs.


The report makes three clear recommendations to national bodies, decision makers and ICS leaders that the following are retained as ICSs develop:

  • tangible ‘place’ level links and responsibilities – CCGs have formed working relationships with others in their ‘place’, especially local government. As they increasingly work at larger ‘system’ footprints, the important work at place level should not be lost
  • ‘stewards’ and the system perspective – CCGs can make sure providers are doing the right thing for their population as they’re the only ones without vested interest; their voices within systems must be heard
  • keeping clinical engagement at the core – CCGs have been successful in embedding clinical leaders and the expertise, credibility, and better health outcomes this brings. This must be maintained as we move to more system working.

Further reading

This publication adds to the body of work that NHSCC has developed on the changing commissioning landscape over the last few years. The Future of Commissioning (2016) set out our members’ strategic ambitions to work across the whole system. Steering Towards Strategic Commissioning (2017) demonstrated how, long before the NHS Long Term Plan, CCGs were already playing a key role as architects of the changing health and care landscape, recognising the need to move towards bigger footprints and a more strategic role. The ability of the commissioning sector to recognise where change is needed and the agility to put it in to action are assets that can only help the delivery of the Long Term Plan.