Wednesday, 6 April 2022

What comes after Commissioning?

There has been much talk of late about how 'commissiong' as a practice, as a concept, as a job description (etc) is on the way out... Clinical Commissioning Groups are to be subsumed into Integrated Care Systems (Partnerships? Programmes...?). We have afterall, moved on from Compulsory Competitive Tendering, Best Value, the Purchaser Provider Split, Procurement (along with TQM, BPR, Kaizen etc etc), isn't it time we moved on from Commissioning too...?


But we should be careful not to throw the baby out with the bathwater.

The systems view of commissioning is that it has and should always have been about real outcomes, co-production & co-design, patient/client/user 'centeredness', asset based community development, progressive procurement, whole systems working etc...

So if we move on from commissioning, will we move on from all those features too? I hope not. But what do we call this commissioning 2.0? (Or is it 3.0, or even 5G commissioning?)

I have been mulling on this.

One of my all time favourite movies is The Rainmaker (1956) which tells the story about a mecurial character called Starbuck played by Burt Lancaster. He arrives in a farming town ravaged with drout and aims to convince them that he can make it rain. Unsurprisingly he meets much scepticism and the film is all about whether his charisma can help the town believe in itself and collectively make the rain happen... (There is some romance too, naturally) I won't tell you how it ends (do watch it). Remembering this film led me to small conclusion: when we stop talking about commissioning, perhaps we should talk about

#Gainmaking instead.

And what #gainmakers do, is everything that is needed to bring about lasting & sustainable health gains, or social gains, or economic gains etc The focus is on gains - for people, communities, regions and nations. And just like Burt Lancaster's character, this is a shared and collective effort, mixed with trust, confidence and (Ted Lasso's) belief.