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Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed?

Gadsby, E.W., Peckham, S., Coleman, A., Bramwell, D., Perkins, N, Jenkins, L.M. (2017) Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed? BMC Public Health, 17 . pp. 1-11. E-ISSN 1471-2458. (doi:10.1186/s12889-017-4122-1) (KAR id:60523)

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http://dx.doi.org/10.1186/s12889-017-4122-1

Abstract

Background: The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reforms have altered public health commissioning.

Methods: We conducted multi-methods research over 33 months, incorporating national surveys of Directors of Public Health and local council elected members at two time-points, and in-depth case studies in five purposively selected geographical areas.

Results: Public health commissioning responsibilities have changed and become more fragmented, being split amongst a range of different organisations, most of which were newly created in 2013. There is much change in the way public health commissioning is done, in who is doing it, and in what is commissioned, since the reforms. There is wider consultation on decisions in the local council setting than in the NHS, and elected members now have a strong influence on public health prioritisation. There is more (and different) scrutiny being applied to public health contracts, and most councils have embarked on wide-ranging changes to the health improvement services they commission.

processes, with consequences for what health improvement services are ultimately commissioned. Time (and further research) will tell if any of these changes lead to improved population health outcomes and reduced health inequalities, but many of the opportunities brought about by the reforms are threatened by the continued flux in the system.

Item Type: Article
DOI/Identification number: 10.1186/s12889-017-4122-1
Uncontrolled keywords: Health sector reform, Public health commissioning, Health improvement, Local govern
Subjects: H Social Sciences > HM Sociology
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Stephen Peckham
Date Deposited: 23 Feb 2017 14:19 UTC
Last Modified: 06 Feb 2020 04:15 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/60523 (The current URI for this page, for reference purposes)
Gadsby, E.W.: https://orcid.org/0000-0002-4151-5911
Peckham, S.: https://orcid.org/0000-0002-7002-2614
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