Ethnicity and Commissioning

Addressing ethnicity throughout the commissioning or service improvement cycle

Commissioning can be described as “the set of linked activities required to assess the healthcare needs of a population, specify the services required to meet those needs within a strategic framework, secure those services, monitor and evaluate the outcomes”. UK government policy emphasises the proactive and strategic nature of commissioning, which should involve both transformational (reshaping the configuration of services) as well as transactional (custodianship of the budget, contract monitoring) elements.

Provider organisations also undertake their own service improvement cycles, responding to evolving clinical guidelines and professional standards, as well as internal performance monitoring, patient satisfaction feedback and clinical audit.

There are many versions of these cycles, but most include the elements represented in the diagram below:Commissioning cycle

Both NHS commissioning and providing organisations could do much more to embed attention to addressing ethnic diversity and inequality into such transformational work.

The EEiC project has produced a range of resources that can support attention to ethnicity throughout the commissioning or service improvement cycle:

We also found that organisational cultures and structures frequently fail to support a focus on addressing inequity, including ethnic inequalities, within healthcare commissioning. There is a need for stronger leadership and more effective framing of the issues to encourage action in this area.  Resources that can support work in this area can be found here:

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