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Commissioning is essentially the planning and purchasing of services to meet the needs of the population. One of the reasons the NHS was established was because of the gross disparity of services across the country and between different client groups. The introduction of the internal market by the Conservatives in the 1980s led to the separation of purchasing from provision. While the name for ‘buying services’ changes, there was a planning function for many years before ‘commissioning’ was established as a concept under the Labour government. Some services are commissioned nationally, others at a regional level and some more locally, depending on the scarcity of the diseases and the highly specialised nature of the services. 

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The timelines show the extraordinary state of flux that purchasing or commissioning organisations have experienced over the last few decades.  We have had Clinical Commissioning Groups, Primary care Trusts, Primary Care Groups and GP-fundholders (to name but a few) each with slightly different functions, sizes and geographical reach.  Over the course of the next Parliament, we may find we need to add another body. If we do, the chances are, it may have been tried before.

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