Policy Research Unit
Policy Research Unit
Our publications
Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed?
27 February 2017
Review of the Quality and Outcomes Framework in England
8 February 2017

This report reviews the evidence of effectiveness of Quality and Outcomes Framework (QOF) in the context of a changing policy landscape

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Improving GP recruitment and retention needs a long-term strategy
4 November 2016

This report is an evidence synthesis on GP recruitment, retention and re-employment. 

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Alliance contracting, prime contracting and outcome based contracting: What can the NHS learn from elsewhere?
25 October 2016

This report summarises the findings of a literature review of the available evidence concerning the characteristics of these new contractual models and their implementation in other sectors. 

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PRUComm Research Review August 2016
11 September 2016

This is the fourth annual review of our research and provides a brief overview of our current research activities.

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Public Health and Obesity in England – the New Infrastructure Examined
15 July 2016

The PHOENIX project aims to examine the impact of structural changes to the health and care system in England on the functioning of the public health system, and on the approaches taken to improving the public’s health.

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Interrogating institutional change: Actors' attitudes to competition and cooperation in commissioning health services in England
17 June 2016
Engaging GPs in commissioning: Realist evaluation of the early experiences of Clinical Commissioning Groups in the English NHS
17 June 2016
Commissioning through competition and cooperation
17 June 2016

This is a final report of our project investigating how commissioners in local health systems managed the interplay of competition and cooperation in their local health economies, looking at acute and community health services.

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Understanding primary care co-commissioning: Uptake, scope of activity and process of change
20 April 2016

This report presents early findings from the third phase of a longitudinal study following the development of CCGs since their inception in 2011. The over-arching aim of this phase of the project is to explore the significant changes to the work of CCGs as they took varying levels of new responsibility for commissioning primary care services from April 2015.

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Exploring the GP ‘added value’ in commissioning: What works, in what circumstances, and how?
13 October 2015

In this study we explored the potential added value that clinicians, specifically GPs, bring to the commissioning process in interviews, and followed this up with observations of commissioners at work. Our research used ‘Realist Evaluation’ (Pawson & Tilley, 1997) which involves: seeking out participants ‘programme theories’ as to how a particular policy or programme will bring about the desired outcomes; exploring the extent to which these programme theories ‘work’ in the real world; and examining in detail the mechanisms and contexts which underpin them. 

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Public Health and Obesity in England – the New Infrastructure Examined
5 October 2015

The PHOENIX project aims to examine the impact of structural changes to the health and care system in England on the functioning of the public health system, and on the approaches taken to improving the public’s health.

Read more>>

Eighth National GP Worklife Survey report
1 October 2015

Since 1998, The University of Manchester has undertaken regular surveys of the perceptions of GPs in England about their working lives. These surveys provide important independent evidence for the Department of Health, which contributes to informing policy around GP retention and recruitment.

The results of the 8th National GP Worklife Survey are published today. The survey was undertaken in the spring and summer of 2015 and responses were received from over 2,600 GPs.

The respondents reported the lowest levels of job satisfaction since before the introduction of their new contract in 2004, the highest levels of stress since the start of the survey series, and an increase since three years ago in the proportion of GPs intending to quit direct patient care within the next five years.

The survey was carried out by the Manchester Centre for Health Economics in the Institute of Population Health, on behalf of the Policy Research Unit in Commissioning and the Health Care System (PRUComm), and the report is available here (PDF 784KB).

PRUComm Research Review August 2015
28 September 2015

Over the last year PRUComm’s research activities have continued to expand culminating in a new phase of work examining co-commissioning of primary care by CGGs and NHS England and additional short research projects on primary care to include new projects on the public health system in England and research on competition and collaboration. We have also continued our research on aspects of the functioning of the health care system with work on contracting and competition and also continued to examine the developing public health system. This is our third annual review of research and provides a brief overview of our current research activities.

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Study on the use of contractual mechanisms in commissioning: Final report
3 August 2015

This three year project aimed to investigate how commissioners negotiated, specified, monitored and managed contractual mechanisms to improve services and allocate financial risk in their local health economies, looking at both acute services and community health care.


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The Role Of Local Authorities In Health Issues: A Policy Document Analysis
12 March 2015

Prior to the passing of the Health and Social Care Act 2012 the Communities and Local Government (CLG) Select Committee conducted an investigation into the proposed changes to the Public Health System in England. The Committee considered 40 written submissions and heard oral evidence from 26 expert witnesses. Their report, which included complete transcripts of both oral and written submissions, provided a rich and informed data on which to base an analysis of the proposed new public health system. This report analyses the main themes that emerged from the evidence submissions and forms part of our preliminary work for PRUComm’s PHOENIX project examining the development of the new public health system. 

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Moving Services out of hospital: Joining up General Practice and community services?
16 January 2015

Closer collaboration between primary care and community health services is a clear objective of the most recent NHS reforms. Currently, there is much emphasis on integrating healthcare services and in particular, moving care closer to home and out of the acute care setting by utilising Community Services and Primary Care.
This report summarises the findings of a rapid review undertaken by PRUComm of the available evidence of what factors should be taken into account in planning for the closer working of primary and community health/care services in order to increase the scope of
services provided outside of hospitals.


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GP payment schemes review
16 January 2015

We conducted a review of the literature on primary care physician (Eg family doctor, general practitioner or other generalist working in a community setting) payment, methods and their impacts on physician behaviour. A comprehensive search of databases identified a large number of studies, of which thirty six were included in the final review. Although we were interested in looking at a wide range of outcomes, the majority of the evidence related to activity volume, referrals, supplier-induced demand, patient pre selection and prevention.

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Commissioning through Competition and Cooperation
16 January 2015

A wide ranging set of reforms is being introduced into the English NHS. The reforms are designed to increase the market-like behaviour of providers of care with a view to improving efficiency, quality and responsiveness of services (DH, 2005; Health and Social Care Act, 2012; ‘HSCA 2012’) and they span the New Labour government and current Coalition government regimes. The idea behind these reforms is that competition between a wider range of providers will produce the desired results such as improved quality and greater efficiency.

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PRUComm Research Review July 2014
22 July 2014

Over the last year PRUComm’s research activities have expanded to include new projects on the public health system in England and research on competition and collaboration. We have also continued our
research on the progress of Clinical Commissioning Groups and undertaking responsive research for the Department of Health. This is our second annual review of research and provides a brief overview of our current research activities.

Download full report (pdf)