Policy Research Unit
Policy Research Unit
Our publications
Impact of removing indicators from the Quality and Outcomes Framework (QOF)
4 July 2018

The project aimed to analyse the effect of indicator removal in a large, nationally-representative cohort of patients whose care quality has been consistently recorded over time. The research provides intelligence on the likely patient impacts of changing existing incentives. This is key to understanding the risks of change, but also what the change in practice activity has been as a consequence of removing incentives.

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Numbers of GPs who want out within 5 years at all-time high, finds survey
31 May 2018

The number of GPs who say they are likely to quit direct patient care within five years rose to 39% in 2017 from 35% in 2015, according to a new survey carried out by University of Manchester researchers.

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Understanding primary care co-commissioning: Uptake, scope of activity and process of change. Final Report (March 2018)
21 March 2018

This report presents the findings from a study following the development of Clinical Commissioning Groups (CCGs) in England. This is the third phase of the project, which aims to understand the ways in which CCGs are responding to their new primary care co-commissioning responsibilities from April 2015. The study provides detailed evidence about the experiences of CCGs as they took on delegated responsibility for primary care commissioning.  

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Next Steps in Commissioning through Competition and Cooperation (2016-2017)
4 March 2018

The aims of this stage of the field work remained the same as those of the initial study. The project aimed to investigate 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 (CHS).

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Primary care co-commissioning: challenges faced by clinical commissioning groups in England
8 January 2018

From April 2015, the responsibility for commissioning primary care services was delegated from NHS England to Clinical Commissioning Groups (CCGs). Two years on, how have CCGs responded to their new responsibilities and what challenges do they face?

Read our debate and analysis paper published in the British Journal of General Practice >>

How are CCGs managing conflicts of interest under primary care co-commissioning in England? A qualitative analysis
13 November 2017

From April 2015, NHS England (NHSE) started to devolve responsibility for commissioning primary care services to clinical commissioning groups (CCGs). The aim of this paper is to explore how CCGs are managing potential conflicts of interest associated with groups of GPs commissioning themselves or their practices to provide services.

Read the BMJ open article and our blog>>

Commissioning through competition and cooperation in the English NHS under the Health and Social Care Act 2012
16 October 2017

The Health and Social Care Act 2012 (‘HSCA 2012’) introduced a new, statutory, form of regulation of competition into the National Health Service (NHS), while at the same time recognising that cooperation was necessary. NHS England’s policy document, The Five Year Forward View (‘5YFV’) of 2014 placed less emphasis on competition without altering the legislation. We explored how commissioners and providers understand the complex regulatory framework, and how they behave in relation to competition and cooperation.

Read the BMJ open article>>

PRUComm Research Review 2017
15 August 2017

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

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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.

Read more>>

Understanding primary care co-commissioning: Uptake, scope of activity and process of change. Interim report
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>>