TY - JOUR T1 - The challenge of commissioning for populations JF - British Journal of General Practice JO - Br J Gen Pract SP - e387 LP - e389 DO - 10.3399/bjgp12X641618 VL - 62 IS - 598 AU - Andrew Lee AU - Fiona Head AU - Chris Packham AU - Mike Robinson Y1 - 2012/05/01 UR - http://bjgp.org/content/62/598/e387.abstract N2 - The health reforms in England have elicited considerable public and professional angst and concern. There has also been a flurry of activity among GP commissioners and health managers trying to set up the clinical commissioning groups as well as simultaneously figure out how to carry out the task of commissioning. In the process, several key issues have surfaced that need to be addressed. First, what is the vision of commissioners and for whom do we commission; do we act primarily in the interests of our patients, our communities, our practices, our local health services, or for ourselves? Secondly, how do we reconcile competing and differing voices in the commissioning forum; what are the values and considerations that underpin our decision-making? The need to articulate this is crucial as it informs the strategic direction of commissioning activities.It was evident from the government's listening exercise on the proposed health system reforms that a wide range and number of different stakeholders want to be engaged in the commissioning of health services.1 Greater involvement by hospital clinicians and nurses, public and patient representatives, as well as potentially local politicians, will now be a part of the reforms. Undoubtedly shared leadership and collaboration in commissioning is important as well as the need for meaningful stakeholder engagement and ‘buy in’ to any service changes. While multi-agency engagement is desired, what is less clear is how it will work in practice.2 Whose voice takes precedence?The journey of any one patient through our health system is complex. So for commissioning to work, the decision-making process needs both to be informed by the separate stakeholders of the system and also to operate corporately with a shared vision and direction. Collaboration across the system is needed to produce a system that serves individual patient needs. However, … ER -