TY - JOUR T1 - Outcome-based commissioning: has its time come? JF - British Journal of General Practice JO - Br J Gen Pract SP - e219 LP - e221 DO - 10.3399/bjgp16X684193 VL - 66 IS - 644 AU - Tim Ballard AU - Nicholas Hicks AU - David Paynton Y1 - 2016/03/01 UR - http://bjgp.org/content/66/644/e219.abstract N2 - A 2014 Commonwealth Fund study of 11 developed countries’ healthcare systems rated the UK’s as the best.1 The NHS, with general practice at its heart, is not just a health service, but also an integral part of the fabric of British society. Sixty-seven years after its foundation, the principles and values on which the NHS were founded remain as relevant, important, and as cherished by the British public as they were in 1948. For example, in 2013, a large Ipsos Mori poll2 found that the NHS is Britain’s most popular institution, ranking ahead of the monarchy, the army, and the GB Olympic team. Indeed, when asked what made them proud to be British,3 72% declared the NHS to be ‘a symbol of what is great about Britain and we must do everything we can to maintain it’.GPs, as providers of 90% of NHS care, are central to NHS provision. In England following the Health and Social Care Act (2012) and the creation of clinical commissioning groups (CCGs) in 2013, GPs have become responsible for more than 70% of the NHS commissioning budget. Recent moves by NHS England are increasing the involvement of CCGs in the commissioning of primary care. This brings with it even greater opportunities for GPs and CCGs to orchestrate the delivery of care. Being at the centre of both the delivery and commissioning of care gives general practice unique opportunities and great responsibilities to shape the future of the NHS. How should GPs and CCGs make the most of these opportunities … and responsibilities?A good place to start is to be clear about the purpose of a healthcare system. In a seminal paper in the NEJM Michael Porter of the Harvard Business School wrote: ‘In any field, improving performance and accountability depends … ER -