Primary Care-Led Commissioning in England and Wales: the Changing Complexity of Governance for Quality, 1991-2005

UKDA study number:5721

Principal Investigators

Abbott, S.
Procter, S.
City University. St Bartholomew School of Nursing and Midwifery. Public Health and Primary Care Unit

Data Collector

Iacovou, N.

Sponsor

Economic and Social Research Council

Distributed by

UK Data Archive, University of Essex, Colchester.

November 2007

Bibliographic Citation

All works which use or refer to these materials should acknowledge these sources by means of bibliographic citation. To ensure that such source attributions are captured for bibliographic indexes, citations must appear in footnotes or in the reference section of publications. The bibliographic citation for this data collection is:

Abbott, S. and Procter, S., Primary Care-Led Commissioning in England and Wales: the Changing Complexity of Governance for Quality, 1991-2005 [computer file]. Colchester, Essex: UK Data Archive [distributor], November 2007. SN: 5721.

Acknowledgement

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Copyright:
S.J. Abbott, S. Procter and N. Iacovou

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5721 . Primary Care-Led Commissioning in England and Wales: the Changing Complexity of Governance for Quality, 1991-2005

Depositor:

Abbott, S. , City University. St Bartholomew School of Nursing and Midwifery. Public Health and Primary Care Unit

Principal Investigators:

Abbott, S. , City University. St Bartholomew School of Nursing and Midwifery. Public Health and Primary Care Unit

Procter, S. , City University. St Bartholomew School of Nursing and Midwifery. Public Health and Primary Care Unit

Data Collector:

Iacovou, N.

Sponsor:

Economic and Social Research Council
Grant Number: RES-000-22-1198 (Public Services: Quality, Performance and Delivery programme.)

Other Acknowledgements:

Richard Smith was also responsible for data collection.

Abstract:

This research project explored primary care-led commissioning (PCLC) in the National Health Service (NHS) in England and in Wales, and aimed to set these in the context of NHS changes since 1991. PCLC is understood here to mean the process of arranging the whole range of health care services (acute, community, primary), either by providing services directly or by commissioning them from other providers.

The study had five key objectives:

• to explore the extent to which the complexity and bureaucratic nature of governance processes enable Primary Care Trusts (PCTs) in England and Local Health Boards (LHBs) in Wales to pursue strategic and clinical objectives relating to service quality
• to discover how PCTs/LHBs and the disparate groups within them manage and negotiate the demands of governance mechanisms on organisational capacity
• to assess which governance mechanisms have most (and least) 'bite' and influence on service quality, and why
• to discover whether these governance arrangements permit 'bottom-up' innovation and encourage clinical and managerial commitment to quality
• to interpret the findings in the light of between-country differences (England and Wales) and changes in the NHS since 1991

The study used qualitative methodology to construct three case studies (two in England, one in Wales), using in-depth, semi-structured interviews conducted with PCT members in England and LHB members in Wales. Documentary analysis was also conducted of board meeting papers published on the web (ten in England and five in Wales). The resulting data collection includes 48 interview transcripts and 3 board meeting minutes documents (these also include grid analyses of other documents).

Further information about the project, including documents, may be found on the ESRC Primary Care-Led Commissioning in England and Wales award web page.

Main Topics:

Topics covered in the interviews include: commissioning; changes in the NHS and performance targets; administrative structures of PCTs and LHBs; effects of commissioning on the roles of general practitioners and other health care professionals; the role of Patient and Public Involvement (PPI) in health care commissioning. For further details, see the Data List (link in the Documentation table below).

Coverage:

Time Period Covered: The interview data include respondents' reflections on NHS arrangements from 1991 onwards, but the major focus is the present (2005-2006). Documentary analysis focuses on documents from 2005 only.
Dates of Fieldwork: July 2005 - May 2006
Country: England and Wales
Spatial Units: No spatial unit
Observation Units: Individuals; Groups
Kind of Data: Textual data; Individual (micro) level; Semi-structured interview transcripts; Minutes of meetings (includes grid analyses of documents).

Universe Sampled:

Location of Units of Observation: National
Population: Board members of PCTs in England and LHBs in Wales, interviewed during 2005-2006, and associated board meeting minutes/documents.

Methodology:

Time Dimensions: Cross-sectional (one-time) study
Sampling Procedures: One-stage stratified or systematic random sample; Purposive selection/case studies
Number of Units: 48 interview transcripts; 3 meeting minutes documents.
Method of Data Collection: Face-to-face interview; Compilation or synthesis of existing material
Weighting: Not applicable.

Language(s) of Written Materials:

Study Description: English
Study Documentation: English

Access:

Access Conditions: The depositor has specified that registration is required. Available to all registered users. The depositor may be informed about usage.
Availability: ESDS Qualidata, UK Data Archive
Contact: Help desk: qualidata@esds.ac.uk

Date of First Release:

6 November 2007

Copyright:

S.J. Abbott, S. Procter and N. Iacovou

File last updated:

24 January 2008