Developing Relational Commissioning #5 – Barriers to Implementing a New Approach

Thinking differently about commissioning Kings Fund (2022)

TBAC summary (print).pdf (kingsfund.org.uk)

Barriers to implementing a new approach to commissioning

• Tight finances, which dragged organisations back to focusing on their bottom line rather than system needs.
• Linked to this, national NHS bodies continuing to regulate organisations rather than systems, which sometimes led to siloed behaviours during system-wide discussions.
• Providers are often working with a range of CCGs who are working in different ways and using different contract and payment approaches – this is complicated for them in terms of organising their services and administering their contracts.
• Bringing independent, voluntary and community sector providers into the collaborative decision-making approaches, when there are multiple small providers in an area.
• Ingrained behaviours that have developed over years – for example, more combative approaches to contract negotiation and performance management, and focusing on organisational interests above system needs.