This is the fifth in a series of articles about the science of quality improvement. We examine the nature of healthcare commissioning and its role as a driver for quality improvement. We draw on evidence from previous forms of primary-care-led commissioning (PCLC) and consider how the quality of care might be improved through the processes of commissioning.

OBJECTIVES From April 2015, NHS England (NHSE) started to devolve responsibility for commissioning primary care services to clinical commissioning groups (CCGs). The aim of this paper is to explore how CCGs are managing potential conflicts of interest associated with groups of GPs commissioning themselves or their practices to provide services. DESIGN We carried out two telephone surveys usin...

A retrospective study was carried out to assess the potential of 16 hysterectomized women to achieve surrogate pregnancies. A total of 11 patients completed 16 cycles of assisted conception treatment incorporating in-vitro fertilization and gestational surrogacy. Three other women failed to respond to ovulation induction while two more patients produced few oocytes which also failed to fertiliz...

The commissioning process has seldom used simulation as part of the commissioning process to date. It has been used for isolated retrocommissioning projects (e.g. Liu and Claridge 1995, Liu et al. 1999). However, there appears to be significant opportunity to utilize simulations as part of the commissioning process, particularly when simulation models are used as (1) part of the design process,...

The paper considers the overarching objectives of the UK healthcare system, and the ways in which commissioning was originally intended to contribute to the achievement of these objectives. It also reviews a number of existing frameworks describing the activities of commissioners and the competencies required to perform these tasks effectively. From this, fourteen domains of competency for worl...

Aims and method Previous studies have shown variations in commissioning of neuropsychiatry services and this makes access to neuropsychiatric services a post-code lottery. In this survey, we approached all mental health and neuropsychiatric service commissioners within London to map current funding and commissioning arrangements, and explored perceived barriers to neuropsychiatric service commi...

A history of the commissioning and the very successful early operation of the Large Hadron Collider (LHC) is described. The accident that interrupted the first commissioning, its repair and the enhanced protection system put in place are fully described. The LHC beam commissioning and operational performance are reviewed for the period from 2010 to mid-2011. Preliminary plans for operation and ...

We investigate the sensitivity of IMRT commissioning using the TG-119 C-shape phantom and credentialing with the IROC head and neck phantom to treatment planning system commissioning errors. We introduced errors into the various aspects of the commissioning process for a 6X photon energy modeled using the analytical anisotropic algorithm within a commercial treatment planning system. Errors wer...

OBJECTIVES The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. SETTING NHS com...