The New NHS in England: Exploring the implications of decision making by Clinical Commissioning Groups and their effect on the selection of private providers

This work explores the commissioning arrangements in the NHS after the adoption of Clinical Commissioning Groups (CCGs). The thesis aims to explore how these new commissioning arrangements have affected the decision making process and why commissioners select the providers that they do. This data is then used to see whether or not the service is being subjected to privatisation as was feared with the introduction of the Health and Social Care Act (2012). This work will begin by exploring definitions of privatisation and marketisation before embarking on a description of the shape of the private sector in the NHS. This is followed by the development of an internal/external pressure conceptual framework, adapted from the work of Pettigrew et al. (1992) to understand the pressures that commissioners may face in the selection of providers. The research was underpinned by symbolic interactionism and studied the work of two CCGs, using example services to explore their decision making processes. The thesis explores the themes that emerged from the data by using the internal/external pressure conceptual framework and then discusses to what extent privatisation has occurred in the NHS using the earlier definitions. The research concludes that the ability of the commissioners to freely select providers is severely limited and that as such, the selection of private providers is clustered in specific services.