Consequences of how third sector organisations are commissioned in the NHS and local authorities in England: a mixed-methods study.
COVID-19
CROSS-SECTIONAL STUDIES
PATIENT AND PUBLIC INVOLVEMENT
PERSUASIVE COMMUNICATION
POLICY
SOCIALISED MEDICINE
STATE MEDICINE
VOLUNTARY ORGANISATIONS
Journal
Health and social care delivery research
ISSN: 2755-0079
Titre abrégé: Health Soc Care Deliv Res
Pays: England
ID NLM: 9918470788706676
Informations de publication
Date de publication:
Oct 2024
Oct 2024
Historique:
medline:
4
10
2024
pubmed:
4
10
2024
entrez:
4
10
2024
Statut:
ppublish
Résumé
As a matter of policy, voluntary, community and social enterprises contribute substantially to the English health and care system. Few studies explain how the National Health Service and local authorities commission them, what outputs result, what contexts influence these outcomes and what differentiates this kind of commissioning. To explain how voluntary, community and social enterprises are commissioned, the consequences, what barriers both parties face and what absorptive capacities they need. Observational mixed-methods realist analysis: exploratory scoping, cross-sectional analysis of National Health Service Clinical Commissioning Group spending on voluntary, community and social enterprises, systematic comparison of case studies, action learning. Social prescribing, learning disability support and end-of-life care were tracers. Maximum-variety sample of six English local health and care economies, 2019-23. Commissioning staff; voluntary, community and social enterprise members. None; observational study. How the consequences of commissioning compared with the original aims of the commissioners and the voluntary, community and social enterprises: predominantly qualitative (non-measurable) outcomes. Data sources were: 189 interviews, 58 policy and position papers, 37 items of rapportage, 692,659 Clinical Commissioning Group invoices, 102 Freedom of Information enquiries, 131 survey responses, 18 local project group meetings, 4 national action learning set meetings. Data collected in England during 2019-23. Two modes of commissioning operated in parallel. Commodified commissioning relied on creating a principal-agent relationship between commissioner and the voluntary, community and social enterprises, on formal competitive selection ('procurement') of providers. Collaborative commissioning relied on 'embedded' interorganisational relationships, mutual recognition of resource dependencies, a negotiated division of labour between organisations, and control through persuasion. Commissioners and voluntary, community and social enterprises often worked around the procurement regulations. Both modes were present everywhere but the balance depended inter alia on the number and size of voluntary, community and social enterprises in each locality, their past commissioning experience, the character of the tracer activity, and the level of deprivation and the geographic dispersal of the populations served. The COVID-19 pandemic produced a shift towards collaborative commissioning. Voluntary, community and social enterprises were not always funded at the full cost of their activity. Integrated Care System formation temporarily disrupted local co-commissioning networks but offered a longer-term prospect of greater voluntary, community and social enterprise influence on co-commissioning. To develop absorptive capacity, commissioners needed stronger managerial and communication capabilities, and voluntary, community and social enterprises needed greater capability to evidence what outcomes their proposals would deliver. Published data quality limited the spending profile accuracy, which did not include local authority commissioning. Case studies did not cover London, and focused on three tracer activities. Absorptive capacity survey was not a random sample. The two modes of commissioning sometimes conflicted. Workarounds arose from organisations' embeddedness and collaboration, which the procurement regulations often disrupted. Commissioning activity at below its full cost appears unsustainable. Spending profiles of local authority commissioning; analysis of commissioning in London and of activities besides the present tracers. Analysis of absorptive capacity and its consequences, adjusting the concept for application to voluntary, community and social enterprises. Comparison with other health systems' commissioning of voluntary, community and social enterprises. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128107) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 39. See the NIHR Funding and Awards website for further award information. National Health Service commissioners and local councils often buy health and care services from voluntary, community and social enterprises. This study aimed to explore how commissioners and voluntary, community and social enterprises worked together and where improvements could be made. We talked to commissioners and voluntary, community and social enterprises in six areas across England and focused on services for learning disabilities, social prescribing and end-of-life care. We analysed National Health Service financial accounts to see how much the National Health Service was spending on services provided by voluntary, community and social enterprises. We surveyed how commissioners and voluntary, community and social enterprises were using information and knowledge to make decisions. We organised events bringing together commissioners and voluntary, community and social enterprises to share knowledge and experience. We found there were two ways commissioners bought services from voluntary, community and social enterprises. One was commodified (a buying-and-selling model), the other collaborative (based on working together). Both were happening at the same time in all the areas of the study, but usually one of them was more present than the other. We saw a general move towards collaboration, but some areas were further along with this than others. Various things helped commissioners and voluntary, community and social enterprises collaborate, such as: paying voluntary, community and social enterprises enough for their services; having people and networks that encouraged others to work with voluntary, community and social enterprises; and including voluntary, community and social enterprises in making decisions about health and care. Commissioners and voluntary, community and social enterprises might therefore lean further towards working together to see how collaborative commissioning can be further developed; how to make contract prices cover voluntary, community and social enterprises’ costs; how to enable longer-term contracts; and how to enable less hurried, more considered ways of renewing contracts (e.g. by putting draft contract specifications out to pre-tender consultation). The new Integrated Care Systems in local areas could encourage all this to happen, but pressures elsewhere in the health and care sector might make it more difficult.
Sections du résumé
Background
UNASSIGNED
As a matter of policy, voluntary, community and social enterprises contribute substantially to the English health and care system. Few studies explain how the National Health Service and local authorities commission them, what outputs result, what contexts influence these outcomes and what differentiates this kind of commissioning.
Objectives
UNASSIGNED
To explain how voluntary, community and social enterprises are commissioned, the consequences, what barriers both parties face and what absorptive capacities they need.
Design
UNASSIGNED
Observational mixed-methods realist analysis: exploratory scoping, cross-sectional analysis of National Health Service Clinical Commissioning Group spending on voluntary, community and social enterprises, systematic comparison of case studies, action learning. Social prescribing, learning disability support and end-of-life care were tracers.
Setting
UNASSIGNED
Maximum-variety sample of six English local health and care economies, 2019-23.
Participants
UNASSIGNED
Commissioning staff; voluntary, community and social enterprise members.
Interventions
UNASSIGNED
None; observational study.
Main outcome measures
UNASSIGNED
How the consequences of commissioning compared with the original aims of the commissioners and the voluntary, community and social enterprises: predominantly qualitative (non-measurable) outcomes.
Data sources
UNASSIGNED
Data sources were: 189 interviews, 58 policy and position papers, 37 items of rapportage, 692,659 Clinical Commissioning Group invoices, 102 Freedom of Information enquiries, 131 survey responses, 18 local project group meetings, 4 national action learning set meetings. Data collected in England during 2019-23.
Results
UNASSIGNED
Two modes of commissioning operated in parallel. Commodified commissioning relied on creating a principal-agent relationship between commissioner and the voluntary, community and social enterprises, on formal competitive selection ('procurement') of providers. Collaborative commissioning relied on 'embedded' interorganisational relationships, mutual recognition of resource dependencies, a negotiated division of labour between organisations, and control through persuasion. Commissioners and voluntary, community and social enterprises often worked around the procurement regulations. Both modes were present everywhere but the balance depended inter alia on the number and size of voluntary, community and social enterprises in each locality, their past commissioning experience, the character of the tracer activity, and the level of deprivation and the geographic dispersal of the populations served. The COVID-19 pandemic produced a shift towards collaborative commissioning. Voluntary, community and social enterprises were not always funded at the full cost of their activity. Integrated Care System formation temporarily disrupted local co-commissioning networks but offered a longer-term prospect of greater voluntary, community and social enterprise influence on co-commissioning. To develop absorptive capacity, commissioners needed stronger managerial and communication capabilities, and voluntary, community and social enterprises needed greater capability to evidence what outcomes their proposals would deliver.
Limitations
UNASSIGNED
Published data quality limited the spending profile accuracy, which did not include local authority commissioning. Case studies did not cover London, and focused on three tracer activities. Absorptive capacity survey was not a random sample.
Conclusions
UNASSIGNED
The two modes of commissioning sometimes conflicted. Workarounds arose from organisations' embeddedness and collaboration, which the procurement regulations often disrupted. Commissioning activity at below its full cost appears unsustainable.
Future work
UNASSIGNED
Spending profiles of local authority commissioning; analysis of commissioning in London and of activities besides the present tracers. Analysis of absorptive capacity and its consequences, adjusting the concept for application to voluntary, community and social enterprises. Comparison with other health systems' commissioning of voluntary, community and social enterprises.
Funding
UNASSIGNED
This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128107) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 39. See the NIHR Funding and Awards website for further award information.
National Health Service commissioners and local councils often buy health and care services from voluntary, community and social enterprises. This study aimed to explore how commissioners and voluntary, community and social enterprises worked together and where improvements could be made. We talked to commissioners and voluntary, community and social enterprises in six areas across England and focused on services for learning disabilities, social prescribing and end-of-life care. We analysed National Health Service financial accounts to see how much the National Health Service was spending on services provided by voluntary, community and social enterprises. We surveyed how commissioners and voluntary, community and social enterprises were using information and knowledge to make decisions. We organised events bringing together commissioners and voluntary, community and social enterprises to share knowledge and experience. We found there were two ways commissioners bought services from voluntary, community and social enterprises. One was commodified (a buying-and-selling model), the other collaborative (based on working together). Both were happening at the same time in all the areas of the study, but usually one of them was more present than the other. We saw a general move towards collaboration, but some areas were further along with this than others. Various things helped commissioners and voluntary, community and social enterprises collaborate, such as: paying voluntary, community and social enterprises enough for their services; having people and networks that encouraged others to work with voluntary, community and social enterprises; and including voluntary, community and social enterprises in making decisions about health and care. Commissioners and voluntary, community and social enterprises might therefore lean further towards working together to see how collaborative commissioning can be further developed; how to make contract prices cover voluntary, community and social enterprises’ costs; how to enable longer-term contracts; and how to enable less hurried, more considered ways of renewing contracts (e.g. by putting draft contract specifications out to pre-tender consultation). The new Integrated Care Systems in local areas could encourage all this to happen, but pressures elsewhere in the health and care sector might make it more difficult.
Autres résumés
Type: plain-language-summary
(eng)
National Health Service commissioners and local councils often buy health and care services from voluntary, community and social enterprises. This study aimed to explore how commissioners and voluntary, community and social enterprises worked together and where improvements could be made. We talked to commissioners and voluntary, community and social enterprises in six areas across England and focused on services for learning disabilities, social prescribing and end-of-life care. We analysed National Health Service financial accounts to see how much the National Health Service was spending on services provided by voluntary, community and social enterprises. We surveyed how commissioners and voluntary, community and social enterprises were using information and knowledge to make decisions. We organised events bringing together commissioners and voluntary, community and social enterprises to share knowledge and experience. We found there were two ways commissioners bought services from voluntary, community and social enterprises. One was commodified (a buying-and-selling model), the other collaborative (based on working together). Both were happening at the same time in all the areas of the study, but usually one of them was more present than the other. We saw a general move towards collaboration, but some areas were further along with this than others. Various things helped commissioners and voluntary, community and social enterprises collaborate, such as: paying voluntary, community and social enterprises enough for their services; having people and networks that encouraged others to work with voluntary, community and social enterprises; and including voluntary, community and social enterprises in making decisions about health and care. Commissioners and voluntary, community and social enterprises might therefore lean further towards working together to see how collaborative commissioning can be further developed; how to make contract prices cover voluntary, community and social enterprises’ costs; how to enable longer-term contracts; and how to enable less hurried, more considered ways of renewing contracts (e.g. by putting draft contract specifications out to pre-tender consultation). The new Integrated Care Systems in local areas could encourage all this to happen, but pressures elsewhere in the health and care sector might make it more difficult.
Types de publication
Journal Article
Observational Study
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-180Références
Gadsby EW, Peckham S, Coleman A, Bramwell D, Perkins N, Jenkins LM. Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed? BMC Publ Health 2017;17:1–11.
World Health Organization. Health for All by the Year 2000. Geneva: WHO; 1985.
Organisation for Economic Co-operation and Development. Health at a Glance: Europe 2022: State of Health in the EU Cycle. Paris: OECD; 2022.
Office for National Statistics. Healthcare Expenditure, UK Health Accounts Provisional Estimates: 2021. London: ONS; 2022.
Exworthy M. A review of recent structural changes to District Health Authorities as purchasing organisations. Environ Planning C: Govt Pol 1993;11:279–89.
Exworthy M, Peckham S. The contribution of coterminosity to joint purchasing in health and social care. Health Place 1998;4:233–43.
Allen P, Osipovič D, Shepherd E, Coleman A, Perkins N, Garnett E, Williams L. Commissioning through competition and cooperation in the English NHS under the Health and Social Care Act 2012: evidence from a qualitative study of four clinical commissioning groups. BMJ Open 2017;7:e011745.
Checkland K, Allen P, Coleman A, Segar J, McDermott I, Harrison S, et al. Accountable to whom, for what? An exploration of the early development of Clinical Commissioning Groups in the English NHS. BMJ Open 2013;3:e003769. https://doi.org/10.1136/bmjopen-2013-003769
McDermott I, Allen P, Moran V, Coleman A, Checkland K, Peckham S. Context: Commissioning in the English NHS. In: Allen P, Checkland K, Peckham S, Moran V, editors. Commissioning Healthcare in England. Bristol: Policy Press; 2020. pp. 15–34.
Allen P, Checkland K, Moran V, Peckham S. Commissioning Healthcare in England Evidence. Bristol: Policy and Practice Policy Press; 2020.
NHS England. Five Year Forward View. London: NHS England; 2014.
House of Commons Committee of Public Accounts. Introducing Integrated Care Systems. London: House of Commons; 2023.
Sanderson M, Allen P, Osipvic D, Petsoulas C, Lau Y-S, Boiko O, et al. The Developing Architecture of System Management: Integrated Care Systems and Sustainability and Transformation Partnerships. 2022. URL: https://prucomm.ac.uk/integrated-care-systems-final-report-published.html (accessed 27 February 2023).
Ferlie E, Lynn LE Jr, Pollitt C. The Oxford Handbook of Public Management. Oxford: Oxford University Press; 2005.
Miller R, Rees J. Mental health commissioning: master or subject of change? Ment Health Rev J 2014;19:145–55.
Osborne DE, Gaebler T. Reinventing Government: How the Entrepreneurial Spirit Is Transforming the Public Sector. Wokingham: Addison-Wesley; 1992.
Callaghan G, Exworthy M, Hudson B, Powell M. Prospects for collaboration in primary care: relationships between social services and the new PCGs. J Interprof Care 2000;14:19–26.
Checkland K, Harrison S, Snow S, Mcdermott I, Coleman A. Commissioning in the English National Health Service: what’s the problem? J Soc Pol 2012;41:533–50.
Body A. The commissioner’s perspective: The lived realities of commissioning children’s preventative services in England and the role of discretion. Volunt Sect Rev 2019;10:253–71.
Macmillan R. The Third Sector Delivering Public Services: An Evidence Review. Birmingham: Third Sector Research Centre; 2010.
Martikke S, Moxham C. Public sector commissioning: experiences of voluntary organizations delivering health and social services. Int J Publ Admin 2010;33:790–9.
Bovaird T, Dickinson H, Allen K. Commissioning across Government: Review of Evidence. Birmingham: Third Sector Research Centre, 2012.
Sheaff R, Charles N, Mahon A, Chambers N, Morando V, Exworthy M, et al. NHS commissioning practice and health system governance: a mixed-methods realistic evaluation. Health Serv Deliv Res 2015;3:1–184. https://doi.org/10.3310/hsdr03100
The Cabinet Office. Partnerships in Public Services: An Action Plan for Third Sector Involvement. London: The Stationery Office; 2006.
JSNA Blackpool. SNA Blackpool Joint Strategic Needs Assessment. Blackpool: NHS Blackpool CCG and Blackpool Council, 2021.
Cohen MD, March JG, Olsen JP. A garbage can model of organizational choice. Admin Sci Quart 1972;17:1–25.
Granovetter M. Economic action and social structure: the problem of embeddedness. AJS 1983;41:481–510.
Baker G, Gibbons R, Murphy KJ. Relational contracts and the theory of the firm. Quart J Econ 2002;117:39–84.
Gibbons R, Henderson R. Relational contracts and organizational capabilities. Organ Sci 2012;23:1350–64.
Macneil IR. Contracts: adjustment of long-term relations under classical, neo-classical and relational contract law. Northw Univ Law Rev 1978;72:854–905.
Allen P. A socio-legal and economic analysis of contracting in the NHS internal market using a case study of contracting for district nursing. Soc Sci Med (1982) 2002;54:255–66.
Porter A, Mays N, Shaw S, Rosen R, Smith J. Commissioning healthcare for people with long term conditions: the persistence of relational contracting in England’s NHS quasi-market. BMC Health Serv Res 2013;13:52.
Mannion R, Smith P. Trust and Reputation in Community Care: Theory and Evidence. In: Anand P, McGuire A, editors. Changes in Health Care: Reflections on the NHS Internal Market. London: Palgrave Macmillan; 1997. pp. 141–61.
Musekiwa E, Needham C. Co-commissioning at the Micro-Level: Personalised Budgets in Health and Social Care. In: Loeffler E, Bovaird T, editors. The Palgrave Handbook of Co-Production of Public Services and Outcomes. Berlin: Springer; 2021. pp. 249–63.
Bovaird T, Loeffler E. We’re All in This Together: Harnessing User and Community Co-production of Public Outcomes. Birmingham: Institute of Local Government Studies, University of Birmingham; 2013.
Macmillan R, Paine AE. The third sector in a strategically selective landscape – the case of commissioning public services. J Soc Pol 2021;50:606–26.
Loeffler E, Bovaird T. Co-commissioning of public services and outcomes in the UK: bringing co-production into the strategic commissioning cycle. Publ Money Manag 2019;39:241–52.
Newbigging K, Mohan J, Rees J, Harlock J, Davis A. Contribution of the voluntary sector to mental health crisis care in England: protocol for a multimethod study. BMJ Open 2020;7:e019238.
NHS England. Next Steps Towards Primary Care Co-commissioning. London: NHS England; 2014.
Petsoulas C, Allen P, Checkland K, Coleman A, Segar J, Peckham S, Mcdermott I. Views of NHS commissioners on commissioning support provision: evidence from a qualitative study examining the early development of clinical commissioning groups in England. BMJ Open 2014;4:e005970.
HM Government. Civil Society Strategy: Building a Future That Works for Everyone. London: HM Government; 2018.
Exworthy M, Powell M, Mohan J. The NHS: quasi-market, quasi-hierarchy and quasi-network? Publ Money Manag 1999;19:15–22.
Petsoulas C, Allen P, Hughes D, Vincent-Jones P, Roberts J. The use of standard contracts in the English National Health Service: a case study analysis. Soc Sci Med (1982) 2011;73:185–92. https://doi.org/10.1016/j.socscimed.2011.05.021
Vincent-Jones P. The new public contracting: public versus private ordering? Indiana J Glob Legal Stud 2007;14:259–78.
Sheaff R, Schofield J. Inter-organizational Networks in Healthcare: Program Networks, Care Networks and Integrated Care. In: Ferlie E, Pedersen A, Montgomery K, editors. Oxford Handbook of Health Care Management. Oxford: Oxford University Press; 2016. pp. 434–58.
Bishop S, Waring J. Becoming hybrid: The negotiated order on the front line of public–private partnerships. Hum Relat 2016;69:1937–58. https://doi.org/10.1177/0018726716630389
Coupet J, McWilliams A. Integrating organizational economics and resource dependence theory to explain the persistence of quasi markets. Admin Sci 2017;7:29.
Baumol WJ. Contestable markets: an uprising in the theory of industry structure. Am Econ Rev 1982;72:1–15.
Krajewski M. Commodifying and Embedding Services of General Interests in Transnational Contexts: The Example of Healthcare Liberalisation in the EU and the WTO. In: Joerges, C, Falke, J, editors. Karl Polanyi, Globalisation and the Potential of Law in Transnational Markets. 2010; pp. 330–58.
Mazanderani F, Locock L, Powell J. Biographical value: towards a conceptualisation of the commodification of illness narratives in contemporary healthcare. Soc Health Illness 2013;35:891–905. https://doi.org/10.1111/1467-9566.12001
McClean S, Moore R. Money, commodification and complementary health care: theorising personalised medicine within depersonalised systems of exchange. Soc Theory Health 2013;11:194–214.
Stoeckle JD. From service to commodity: corporization, competition, commodification, and customer culture transforms health care. Croat Med J 2000;41:141–3.
Osipovič D, Allen P, Sanderson M, Moran V, Checkland K. The regulation of competition and procurement in the National Health Service 2015–2018: enduring hierarchical control and the limits of juridification. Health Econ Policy Law 2020;15:308–24. https://doi.org/10.1017/S1744133119000240
Noort BAC, Ahaus K, van der Vaart T, Chambers N, Sheaff R. How healthcare systems shape a purchaser’s strategies and actions when managing chronic care. Health Policy 2020;124:628–38. https://doi.org/10.1016/j.healthpol.2020.03.009
Chambers N, Sheaff R, Mahon A, Byng R, Mannion R, Charles N, et al. The practice of commissioning healthcare from a private provider: learning from an in-depth case study. BMC Health Serv Res 2013;13:S4. https://doi.org/10.1186/1472-6963-13-S1-S4
Albalate D, Bel G, Reeves E. Government choice between contract termination and contract expiration in re-municipalization: a case of historical recurrence? Int Rev Admin Sci 2021;87:461–79.
Checkland K, Coleman A, Mcdermott I, Peckham S. Clinically led commissioning: past, present and future? In: Exworthy M, Mannion R, Powell M, editors. Dismantling the NHS? London: Policy Press; 2016. pp. 149–70.
Sheaff R, Marshall M, Rogers A, Roland M, Sibbald B, Pickard S. Governmentality by network in English primary healthcare. Soc Policy Admin 2004;38:89–103. https://doi.org/10.1111/j.1467-9515.2004.00378.x
Lipsky M. Street-Level Bureaucracy. New York: Russell Sage Foundation; 2010.
Gale N, Dowswell G, Greenfield S, Marshall T. Street-level diplomacy? Communicative and adaptive work at the front line of implementing public health policies in primary care. Soc Sci Med (1982) 2017;177:9–18.
Bossert T. Analyzing the decentralization of health systems in developing countries: decision space, innovation and performance. Soc Sci Med (1982) 1998;47:1513–27. https://doi.org/10.1016/S0277-9536(98)00234-2
Exworthy M, Frosini F. Room for manoeuvre?: Explaining local autonomy in the English National Health Service. Health Policy 2008;86:204–12. https://doi.org/10.1016/j.healthpol.2007.10.008
Exworthy M, Frosini F, Jones L, Peckam S, Powell M, Greener I, et al. Decentralisation and Performance: Autonomy and Incentives in Local Health Economies. Southampton: NCCSDO; 2010.
Exworthy M, Frosini F, Jones L. Are NHS foundation trusts able and willing to exercise autonomy? ‘You can take a horse to water…’. J Health Serv Res Policy 2011;16:232–7. https://doi.org/10.1258/jhsrp.2011.010077
Ferlie E, Addicott R, Exworthy M, Fitzgerald L. Networks in Health Care: A Comparative Study of Their Management Impact and Performance. London: HSDR; 2010.
Flynn R, Pickard S, Williams G. Contracts and the quasi-market in community health services. J Soc Policy 1995;24:529–50. https://doi.org/10.1017/S0047279400025423
Sheaff R, Morando V, Chambers N, Exworthy M, Mahon A, Byng R, et al. Managerial workarounds in three European DRG systems. J Health Organ Manag 2020;34:295–311. https://doi.org/10.1108/JHOM-10-2019-0295
Egholm L, Kaspersen LB. A Processual-Relational Approach to Civil Society. In: Egholm L, Kaspersen LB, editors. Civil Society: Between Concepts and Empirical Grounds. New York: Routledge; 2020. pp. 3–30.
Salamon LM, Anheier HK. Defining the Nonprofit Sector: A Cross-National Analysis. Manchester: Manchester University Press; 1997.
Hall MH, Reed PB. Shifting the burden: how much can government download to the non-profit sector? Can Publ Admin 1998;41:1–20.
Baines S, Bull M, Woolrych R. A more entrepreneurial mindset? Engaging third sector suppliers to the NHS. Soc Enterpr J 2010;6:49–58.
Birchall J, Simmons R. What motivates members to participate in co-operative and mutual businesses? Ann Publ Cooper Econ 2004;75:465–95. https://doi.org/10.1111/j.1467-8292.2004.00259.x
Rose-Ackerman S. Altruism, ideological entrepreneurs and the non-profit firm. VOLUNTAS: Int J Volunt Nonprof Organ 1997;8:120–34. https://doi.org/10.1007/BF02354190
Billis D. Towards a Theory of Hybrid Organizations. In: Billis D, editor. Hybrid Organizations and the Third Sector: Challenges for Practice, Theory and Policy. Basingstoke: Palgrave Macmillan; 2010. pp. 46–69.
Allen P, Bartlett W, Zamora B, Turner S. New forms of provider in the English National Health Service. Ann Public Coop Econ 2011;82:77–95.
Gintis H, Bowles S. The Distribution of Wealth and the Viability of the Democratic Firm. In: Pagano U, Rowthorn B, editors. Democracy and Efficiency in the Economic Enterprise. New York: Routledge; 2002. pp. 96–111.
Alcock P. A strategic unity: defining the third sector in the UK. Voluntary Sector Review 2010; 1:5–24.
Gorsky M, Mohan J, Willis T. Mutualism and Health Care. Manchester: Manchester University Press; 2006.
Rees J, Miller R, Buckingham H. Commission incomplete: exploring the new model for purchasing public services from the third sector. J Soc Pol 2017;46:175–94.
Kendall J. The mainstreaming of the third sector into public policy in England in the late 1990s: whys and wherefores. Policy Pol 2000;28:541–62.
The Home Office. On Relations between Government and the Voluntary and Community Sector in England. London: HMSO; 1998.
Macmillan R. Decoupling the State and the Third Sector? The ‘Big Society’ as a Spontaneous Order. Birmingham: Third Sector Research Centre; 2013.
Cabinet Office. Civil Society Strategy: Building a Future that Works for Everyone. London: Cabinet Office, 2018.
Baker L, Jochum V, Garforth H, Usher R. Big Local Relationships and Public Agencies. London: Local Trust; 2022.
Macmillan R; Sheffield Hallam University. A surprising turn of events: episodes towards a renaissance of civil society infrastructure in England. People Place Policy Online 2021;15:57–71.
National Council for Voluntary Organisations. UK Civil Society Almanac. London: National Council for Voluntary Organisations; 2022.
Tussell. UK Public Procurement through VCSEs, 2016–2020. London: Tussell; 2021.
Curry N, Mundle C, Sheil F, Weaks L. The Voluntary and Community Sector in Health Implications of the Proposed NHS Reforms. London: Kings Fund; 2011.
Miller R. Third sector organisations: unique or simply other qualified providers? J Publ Ment Health 2013;12:103–13.
Dayson C. Social prescribing ‘plus’: a model of asset-based collaborative innovation? People Place Policy 2017;11:90–104.
Bull D, Bagwell S, Weston A, Joy I. Untapped Potential: Bringing the Voluntary Sector Strengths to Health and Care Transformation. Report commissioned by the Richmond Group of Charities and its partners for the Doing the Right Thing project. London: NPC; 2016.
Dayson C, Wells P. Voluntary and community sector policy under the coalition government. People Place Policy Online 2013;7:91–9.
Perspective Economics. The Role of Voluntary, Community, and Social Enterprise (VCSE) Organisations in Public Procurement. Belfast: Perspective Economics; 2022.
Sheaff R, Halliday J, Exworthy M, Gibson A, Clark J, Asthana S, et al. Diverse Healthcare Providers: Behaviour in Response to Commissioners, Patients and Innovations. London: Department of Health and Social Care; 2018.
National Audit Office. Developing New Care Models Through NHS Vanguards. London: NAO; 2018.
Mazzei M, Teasdale S, Calò F, Roy MJ. Co-production and the third sector: conceptualising different approaches to service user involvement. Publ Manag Rev 2020;22:1265–83.
Arvidson M, Kara H. Valuing Third Sector Achievements in a Service Delivery Context: Evaluations and Social Value. In: Rees J, Mullins D, editors. The Third Sector Delivering Public Services: Developments, Innovations and Challenges. Bristol: Policy Press; 2016. pp. 149–66.
Garnett E, Baeza J, Trenholm S, Gulliford M, Green J. Social enterprises and public health improvement in England: a qualitative case study. Public Health 2018;161:99–105. https://doi.org/10.1016/j.puhe.2018.04.019
Courpasson D, Clegg S. Dissolving the iron cages? Tocqueville, Michels, bureaucracy and the perpetuation of elite power. Organization 2006;13:319–43.
Storey J, Basterretxea I, Salaman G. Managing and resisting ‘degeneration’ in employee-owned businesses: a comparative study of two large retailers in Spain and the United Kingdom. Organization 2014;21:626–44.
DiMaggio PJ, Powell WW. The iron cage revisited: institutional isomorphism and collective rationality in organizational fields. Am Soc Rev 1983;48:147–60.
Milbourne L, Cushman M. Complying, transforming or resisting in the new austerity? Realigning social welfare and independent action among English voluntary organisations. J Soc Policy 2015;44:463–85.
Rees J, Taylor R, Damm C. Opening the ‘black box’: organisational adaptation and resistance to institutional isomorphism in a prime-led employment services programme. Public Policy Admin 2022;39:106–24.
Shore C, Wright S. Governing by numbers: audit culture, rankings and the new world order. Soc Anthropol 2015;23:22–8.
Benson A. ‘The Devil That Has Come amongst Us’: The Impact of Commissioning and Procurement Practices NCIA Inquiry into the Future of Voluntary Services. London: NCIA; 2014.
Carmel E, Harlock J. Instituting the ’third sector’as a governable terrain: partnership, procurement and performance in the UK. Policy Politics 2008;36:155–71.
Evans B, Richmond T, Shields J. Structuring neoliberal governance: the nonprofit sector, emerging new modes of control and the marketisation of service delivery. Policy Soc 2005;24:73–97.
Skelcher C, Smith SR. Theorizing hybridity: institutional logics, complex organizations, and actor identities: the case of nonprofits. Public Admin 2015;93:433–48.
Fox D. Policy commercializing nonprofits in health: the history of a paradox from the 19th century to the ACA. Milbank Q 2015;93:179–210. https://doi.org/10.1111/1468-0009.12109
Davis K. Credit union governance and survival of the cooperative form. J Finan Services Res 2001;19:197.
Paine AE, Hill M. The Engagement of Volunteers in Third Sector Organisations Delivering Public Services. In: Rees J, Mullins D, editors. The Third Sector Delivering Public Services. Bristol: Policy Press; 2016. pp. 127–48.
Veronesi G, Kirkpatrick I, Altanlar A, Sarto F. Corporatization, administrative intensity, and the performance of public sector organizations. J Public Adm Res Theory 2022;33:701–15.
Bevir M, Waring J. Decentring Health Policy: Learning from British Experiences in Healthcare Governance. London: Routledge; 2017.
Klijn E-H. Governing networks in the hollow state contracting out, process management or a combination of the two? Public Manag Rev 2002;4:149–65.
Koppenjan J, Mandell M, Keast R, Brown K. The Role of Context in Hybrid Governance Arrangements. Presented at the Fifth Transatlantic Dialogue, Washington DC.
Rhodes RAW. The new governance: governing without government. Pol Stud 1996;44:652–67. https://doi.org/10.1111/j.1467-9248.1996.tb01747.x
Sheaff R, Chambers N, Charles N, Exworthy M, Mahon A, Byng R, Mannion R. How managed a market? Modes of commissioning in England and Germany. BMC Health Serv Res 2013;13:S8. https://doi.org/10.1186/1472-6963-13-S1-S8
Wells S, Tamir O, Gray J, Naidoo D, Bekhit M, Goldmann D. Are quality improvement collaboratives effective? A systematic review. BMJ Qual Saf 2018;27:226–40.
Sheaff R. Healthcare access and mobility between the UK and other European Union stat. Health Policy 1997;42:239–53.
Herepath A, Kitchener M, Waring J. A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study. Health Serv Deliv Res 2015;3:1–242.
Feng W, Fox AM. What’s the hold up? The FDA’s delayed implementation of menu-labeling policy. Admin Soc 2022;54:1045–88.
Checkland K. National service frameworks and UK general practitioners: street-level bureaucrats at work? Soc Health Illness 2004;26:951–75. https://doi.org/10.1111/j.0141-9889.2004.00424.x
Kim AY, Choi WS. Considerations on the implementation of the telemedicine system encountered with stakeholders’ resistance in COVID-19 pandemic. Telemed J e-Health 2021;27:475–80.
Owen DL, Swift TA, Humphrey C, Bowerman M. The new social audits: accountability, managerial capture or the agenda of social champions? Eur Account Rev 2010;9:81–98.
Touati N, Roberge D, Denis JL, Cazale L, Pineault R, Tremblay D. Clinical leaders at the forefront of change in health-care systems: advantages and issues: lessons learned from the evaluation of an integrated oncological services network. Health Serv Manage Res 2006;19:105–22.
Wagner WE. Administrative law, filter failure, and information capture. Duke LJ 2009;59:1321.
Pawson R, Tilley N. Realistic Evaluation. London: SAGE Publications Ltd; 1997.
Sayer A. Method in Social Science: A Realist Approach. London: Psychology Press; 1992.
Wildavsky AB. Speaking Truth to Power. Piscataway, NJ: Transaction Publishers; 1989.
Dalkin SM, Greenhalgh J, Jones D, Cunningham B, Lhussier M. What’s in a mechanism? Development of a key concept in realist evaluation. Implement Sci 2015;10:49. https://doi.org/10.1186/s13012-015-0237-x
Greenhalgh J, Manzano A. Understanding ‘context’ in realist evaluation and synthesis. Int J Soc Res Methodol 2021; 25:583–95.
Sheaff R, Doran N, Harris M, Lang I, Medina-Lara A, Fornasiero M, et al. Categories of context in realist evaluation. Evaluation 2021;27:184–209.
The RAMESES II Project. What Realists Mean by Context; or, Why Nothing Works Everywhere or for Everyone. Oxford: The Rameses II Project, 2017. URL: https://www.ramesesproject.org/media/RAMESES_II_Context.pdf (accessed 27 February 2023).
The RAMESES II Project. What Is a Mechanism? What Is a Programme Mechanism? Oxford: The Rameses II Project, 2017. URL: http://ramesesproject.org/media/RAMESES_II_What_is_a_mechanism.pdf (accessed 27 February 2023).
Lane PJ, Lubatkin M. Relative absorptive capacity and interorganizational learning. Strateg Manage J 1998;19:461–77.
Newton J, Graham J, McLoughlin K, Moore A. Receptivity to change in a general medical practice. Br J Manage 2003;14:143–53.
Van Den Bosch FA, Volberda HW, De Boer M. Coevolution of firm absorptive capacity and knowledge environment: organizational forms and combinative capabilities. Organ Sci 1999;10:551–68.
Flatten TC, Greve GI, Brettel M. Absorptive capacity and firm performance in SMEs: the mediating influence of strategic alliances. Eur Manag Rev 2011;8:137–52.
Harvey G, Skelcher C, Spencer E, Jas P, Walshe K. Absorptive capacity in a non-market environment. Public Manag Rev 2010;12:77–97. https://doi.org/10.1080/14719030902817923
Cohen WM, Levinthal DA. Absorptive capacity: a new perspective on learning and innovation. Admin Sci Quart 1990;35:128–52.
Currie G, Croft C, Chen Y, Kiefer T, Staniszewska S, Lilford R. The capacity of health service commissioners to use evidence: a case study. Health Serv Deliv Res 2018;6:1–158.
Moynihan DP, Hawes DP. Responsiveness to reform values: the influence of the environment on performance information use. Public Admin Rev 2012;72:S95–105.
Van den Hooff B, Huysman M. Managing knowledge sharing: emergent and engineering approaches. Inform Manag 2009;46:1–8.
Finkelstein S, Mooney AC. Not the usual suspects: how to use board process to make boards better. Acad Manag Persp 2003;17:101–13.
Moynihan DP, Landuyt N. How do public organizations learn? Bridging cultural and structural perspectives. Public Admin Rev 2009; 69:1097–105.
Van Ees H, van der Laan G, Postma TJ. Effective board behavior in the Netherlands. Eur Manag J 2008;26:84–93.
Jansen JJ, Van Den Bosch FA, Volberda HW. Managing potential and realized absorptive capacity: how do organizational antecedents matter? Acad Manage J 2005;48:999–1015.
Faraj S, Sproull L. Coordinating expertise in software development teams. Manage Sci 2000;46:1554–68.
Lane PJ, Salk JE, Lyles MA. Absorptive capacity, learning, and performance in international joint ventures. Strateg Manage J 2001; 22:1139–61.
Flatten TC, Engelen A, Zahra SA, Brettel M. A measure of absorptive capacity: scale development and validation. Eur Manag J 2011;29:98–116. https://doi.org/10.1016/j.emj.2010.11.002
Hardwick R, Anderson R, Cooper C. How do third sector organisations use research and other knowledge? A systematic scoping review. Implement Sci 2015;10:84.
Pfeffer J, Salancik GR. The External Control of Organizations: A Resource Dependence Perspective. Stanford, CA: Stanford University Press; 2003.
Hillman AJ, Shropshire C, Cannella Jr AA. Organizational predictors of women on corporate boards. Acad Manage J 2007;50:941–52.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101.
Gibson A. CCG Spend on VCSEs, 2018/19: Data and Analysis. GitHub; 2023. URL: https://github.com/AlexGibsonPlymouth/3SC (accessed 24 June 2024).
HM Treasury. Guidance for Publishing Spend over £25,000. London: HM Treasury, 2013.
Care Quality Commission. Using CQC Data (with Links to the CQC Active and Deactivated Locations Directories). London: Care Quality Commission, 2022.
NHS Digital. NHS Payments to General Practice: England, 2018/19. London: NHS Digital; 2019.
NHS England. Clinical Commissioning Groups’ Accounts (2016–17). London: NHS Digital; 2018.
Clifford D. Voluntary sector organisations working at the neighbourhood level in England: patterns by local area deprivation. Environ Plan A: Econ Space 2012;44:1148–64.
Halliday J, Asthana S, Hewson P, Gibson A. Playing with fire: limitations of the big society for an emergency service. Publ Policy Admin 2013;28:290–305.
Gioia DA, Corley KG, Hamilton AL. Seeking qualitative rigor in inductive research: notes on the Gioia methodology. Organ Res Method 2013;16:15–31.
Mintzberg H. Power in and around Organizations. Englewood Cliffs, NJ: Prentice Hall; 1983.
Mintzberg H. Power and organization life cycles. Acad Manag Rev 1984;9:207–24.
Revans RW. What is action learning? J Manage Dev 1982;1:64–75.
Revans R. ABC of Action Learning. London: Routledge; 2017.
Burawoy M. The extended case method. Soc Theory 1998;16:4–33.
Popper KR. Conjectures and Refutations. London: Routledge Kegan Paul; 1963.
Rasmussen J. Human error and the problem of causality in analysis of accidents. Philos Trans R Soc London Ser B 1990;327:449–60; discussion 460.
De Jong BA, Elfring T. How does trust affect the performance of ongoing teams? The mediating role of reflexivity, monitoring, and effort. Acad Manage J 2010;53:535–49.
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 2013;13:117. https://doi.org/10.1186/1471-2288-13-117
Srivastava A, Thomson SB. Framework analysis: a qualitative methodology for applied policy research. J Admin Govern 2009;4:72–9.
Payne G, Williams M. Generalization in qualitative research. Sociology 2005; 39:295–314.
Sanderson M, Allen P, Osipovič D. The regulation of competition in the National Health Service (NHS): what difference has the Health and Social Care Act 2012 made? Health Econ Policy Law 2016;12:1–19.
Mannion R, Davies HTO. Payment for performance in health care. BMJ 2008;336:306–8. https://doi.org/10.1136/bmj.39463.454815.94
Bergman M, Lane J-E. Public policy in a principal–agent framework. J Theor Pol 1990;2:339–52.
Harker R. NHS Funding Allocations: Clinical Commissioning Groups. London: House of Commons; 2019.
Brien P. Local Government Finances. London: House of Commons; 2022.
Department for Levelling Up, Housing and Communities. Revenue Outturn (RO) 2020–21 Final: Social Care and Public Health (RO3) Data. London: Department for Levelling Up, Housing and Communities; 2021.
National Audit Office. Financial Sustainability of Local Authorities Visualisation: Update. London: NAO; 2021.
Corry D. Where Are England’s Charities. London: Think NPC; 2020.
Marmot M. Health equity in England: the Marmot review 10 years on. BMJ 2020;368:m693.
Whitty C. Health in Coastal Communities. London: Department of Health and Social Care; 2021.
Marmot M, Allen J. COVID-19: exposing and amplifying inequalities. J Epidemiol Community Health 2020;74:681–2.
Bambra C, Riordan R, Ford J, Matthews F. The COVID-19 pandemic and health inequalities. J Epidemiol Commun Health 2020;74:964–8.
The Strategy Unit. Making the Case for Integrating Physical and Mental Health Services in England. London: NHS Midlands and Lancashire Commissioning Support Unit; 2018.
Goddard M, Mannion R, Smith PC. Assessing the performance of NHS Hospital Trusts: the role of ‘hard’ and ‘soft’ information. Health Policy 1999;48:119–34.
Ettelt S, Mays N, Allen P. The multiple purposes of policy piloting and their consequences: three examples from national health and social care policy in England. J Soc Pol 2015;44:319–37.
Exworthy M. Localism in the NHS quasi-market. Environ Planning C: Govt Pol 1998;16:449–62. https://doi.org/10.1068/c160449
Davies HT, Nutley SM. What Works? Evidence-Based Policy and Practice in Public Services. London: Policy Press; 2000.
GOV.UK. Cases in the UK. Coronavirus in the UK. 2023. URL: https://coronavirus.data.gov.uk/details/cases (accessed 13 March 2023).
De Bono DS, Greenfield D, Travaglia JF, Long JC, Black D, Johnson J, et al. Nurses’ workarounds in acute healthcare settings: a scoping review. BMC Health Serv Res 2013;13:175.
Halbesleben JRB, Wakefield DS, Wakefield BJ. Work-arounds in health care settings: literature review and research agenda. Health Care Manage Rev 2008;33:2–12. https://doi.org/10.1097/01.HMR.0000304495.95522.ca
Lalley C, Malloch K. Workarounds: the hidden pathway to excellence. Nurse Leader 2010;8:29–32. https://doi.org/10.1016/j.mnl.2010.05.009
Tummers L, Bekkers V. Policy implementation, street-level bureaucracy, and the importance of discretion. Public Manag Rev 2014;16:527–47.
Ferlie E, Addicott R. Determinants of Performance in Cancer Networks: A Process Evaluation. London: NCCSDO; 2004.
Provan K, Kenis P. Modes of network governance: structure, management, and effectiveness. J Public Adm Res Theory 2008;18:229–52.
Kirkpatrick I, Altanlar A, Veronesi G. Hybrid professional managers in healthcare: an expanding or thwarted occupational interest? Public Manag Rev 2022;25:859–78. https://doi.org/10.1080/14719037.2021.1996777
Allen P, Osipovič D, Shepherd E, Coleman A, Perkins N, Garnett E. Commissioning through Competition and Cooperation. Manchester: Policy Research Unit on Commissioning and the Healthcare System; 2016.
King D, Chan O, Coule T, Dahill D, Mainard-Sardon J, Martin A, et al. Respond, Recover, Reset: Two Years On. Nottingham: Nottingham Trent University, Centre for People, Work and Organisational Practice; 2022.
Baylis A, Chikwira L, Robertson R, Tiratelli L. Dying Well at Home: Commissioning Quality End-of-Life Care. London: Kings Fund; 2023.
North DC. Institutions, transaction costs and economic growth. Econ Inquiry 1987;25:419–28.
North DC. Institutions, transaction costs and productivity in the long run. Econ History 1993;1993:9309004.
Valentinov V. The transaction cost theory of the nonprofit firm: beyond opportunism. Nonprofit Volunt Sector Quart 2008;37:5–18.
Gnyawali DR, Ryan-Charleton T. Nuances in the interplay of competition and cooperation: towards a theory of coopetition. J Manage 2018;44:2511–34. https://doi.org/10.1177/0149206318788945
Chiapello E, Fairclough N. Understanding the new management ideology: a transdisciplinary contribution from critical discourse analysis and new sociology of capitalism. Discourse Soc 2002;13:185–208.
Fairclough N. Discourse analysis in organization studies: the case for critical realism. Organ Stud 2005;26:915–39. https://doi.org/10.1177/0170840605054610
Frumkin P, Galaskiewicz J. Institutional isomorphism and public sector organizations. J Public Adm Res Theory 2004;14:283–307. https://doi.org/10.1093/jopart/muh028
Paton C. The changing political economy of the NHS. Public Finan Manag 2006;6:539.
DiMaggio PJ, Anheier HK. The sociology of nonprofit organizations and sectors. Ann Rev Soc 1990;16:137–59. https://doi.org/10.1146/annurev.so.16.080190.001033
Sheaff R, Ellis-Paine A, Exworthy M, Hardwick R, Smith CQ. Commodification and healthcare in the third sector in England: from gift to commodity – and back? Public Money Manag 2023;44:298–307. https://doi.org/10.1080/09540962.2023.2244350
World Health Organization. Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978.
Murphy M, Irwin A, Maher M. Winners and Losers? The Social Marketisation of Civil Society. Maynooth: Maynooth University & Community Work Ireland; 2020.
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med 2014;89:1245–51.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007;19:349–57. https://doi.org/10.1093/intqhc/mzm042
Rahal C. The keys to unlocking public payments data. Kyklos 2018;71:310–37. https://doi.org/10.1111/kykl.12171
Rahal C, Mohan J. The role of the third sector in public health service provision: evidence from 25,338 heterogeneous procurement datasets. SocArXiv 2022; https://doi.org/10.31235/osf.io/t4x52
Goodair B, Reeves A. Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013–20: an observational study of NHS privatisation. Lancet Public Health 2022;7:e638–46. https://doi.org/10.1016/S2468-2667(22)00133-5
Virgin. Introducing HCRG Care Group. London: Virgin, 2021. URL: www.virgin.com/about-virgin/virgin-group/news/introducing-hcrg-care-group (accessed 24 June 2024).
Twenty20Capital. How We Work. London, Twenty20 Capital, 2021.
Dayson C, Eadson W, Sanderson E, Wilson I. Greater Manchester State of the Voluntary Sector 013. Sheffield: Centre for Regional Economic and Social Research Hallam University, 2013.
City Health Care Partnership. Accounts for City Health Care Partnership, Year Ending 31 March 2019, Hull: City Health Care Partnership. 2019.
Marie Stopes International. Accounts for Marie Stopes International, Year Ending 31 December 2018. London: MSI Reproductive Choices; 2019.
Mannion R, Smith P. Trust and Reputation in Community Care: Theory and Evidence. In: McGuire A, Anand P, editors. Changing Health Care, Reflections on the NHS Internal Market. Basingstoke: Macmillan; 2007. pp. 141–61.
Plickert G, Cote RR, Wellman B. It’s not who you know, it’s how you know them: who exchanges what with whom? Soc Netw 2007;29:405–29. https://doi.org/10.1016/j.socnet.2007.01.007
Thomson AM, Perry JL. Collaboration processes: inside the black box. Public Admin Rev 2006;66:20–32.