Commissioning 2

We believe the best commissioning happens when it’s co-produced – planned and delivered together with local partners and communities. We see our role as one of support, not just direction, bringing people together, sharing what works and helping you build on your strengths.

Halving administrative costs and exploring clustering or mergers can release resources for care – but only if governance, assurance and leadership capacity are redesigned, not simply reduced. This article proposes a practical approach to productivity that protects safety, quality and continuity while simplifying how systems work.

The Medium-Term Planning Framework (MTPF) for 2026/27–2028/29 marks a deliberate move away from short-term cycles towards multi-year, integrated planning across finance, quality, activity, and workforce. Coupled with the Neighbourhood Health Service direction, it empowers local systems to assume wider responsibilities for specialised commissioning, service redesign, and performance delivery while retaining national consistency through trajectories and oversight. This paper sets out what boards and system leaders must do now to translate the framework into credible, paced change.

Digital infrastructure must move beyond point solutions. The Medium Term Planning Framework's (MTPF) call to ‘do digital differently’, together with new investment, can deliver access, coordination and workload relief – if systems design for interoperability, clinical safety and digital inclusion from the outset.

Neighbourhood Health is a cornerstone of the 10-Year Health Plan, aiming to move care closer to home, strengthen community models, and embed digital-first pathways. The NHS Medium-Term Planning Framework (MTPF) provides multi-year discipline to support this ambition. This piece aims to share insights and practical considerations to help members interpret national ambitions and apply them regionally.

Delivering neighbourhood health at pace requires alignment between NHS bodies, local government and VCSE partners, supported by interoperable data and flexible estates. Co – production with lived experience ensures services reflect local needs and sustain trust, while multi – year certainty enables staged build – out of hubs, contracts and teams.