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This briefing paper looks at the development of commissioning arrangements in the NHS in England up to April 2013. It is intended as historical background to Commons Briefing Paper CBP 7206, The structure of the NHS in England (see also Library Standard Note SN06749, The reformed health service, and commissioning arrangements in England).

According to the Department of Health, commissioning is “the process of ensuring that the health and care services provided effectively meet the needs of the population. It is a complex process with responsibilities ranging from assessing population needs, prioritising health outcomes, procuring products and services, and managing service providers.”

While commissioning in the NHS is a relatively recent development, elements of the commissioning function have been present, in one form or another, since the inception of the service in 1948.

Since 1991 commissioning has taken place in the context of the “purchaser / provider split”, whereby part of the NHS is responsible for contracting with NHS (and independent-sector) providers for the supplying of services for patients.

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