Abstract copyright UK Data Service and data collection copyright owner.

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 qualityto discover how PCTs/LHBs and the disparate groups within them manage and negotiate the demands of governance mechanisms on organisational capacityto assess which governance mechanisms have most (and least) 'bite' and influence on service quality, and whyto discover whether these governance arrangements permit 'bottom-up' innovation and encourage clinical and managerial commitment to qualityto interpret the findings in the light of between-country differences (England and Wales) and changes in the NHS since 1991The 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).

One-stage stratified or systematic random sample

Purposive selection/case studies

Face-to-face interview

Compilation or synthesis of existing material