What we mean by commissioning

The way in which young people’s mental health and wellbeing services are commissioned varies considerably across the UK. This guide has been developed to support commissioning for young people’s mental health services within the context of the English model. However, we hope that many of the suggestions included will also be of use and relevance to those with a commissioning responsibility in other countries and settings.

As a general guide, we have found the following definition from the Commissioning Support Programme helpful in terms of describing the purpose of commissioning for young people:

“The process for deciding how to use the total resource available for children, young people and their parents and carers in order to improve outcomes in the most efficient, effective, equitable and sustainable way.”¹.

NHS England emphasises that commissioning is a multi-stage process which includes the following aspects:

“The health-needs assessment for a population, through the clinically based design of patient pathways, to service specification and contract negotiation or procurement, with continuous quality assessment.” ².

Significantly, the Health and Social Care Act (2012) places duties on Clinical Commissioning Groups (CCGs) to incorporate patient and carer perspectives into all stages of the commissioning cycle³. However, there are many reasons why young people may not currently be participating in the commissioning process, including:

• The scale and complexity of the commissioning agenda
• Negative attitudes about young people and their ability to get involved in this agenda
• The timescales involved
• Lack of knowledge and expertise by CCGs in terms of how to engage with young people and support their participation
• Lack of relationships and networks with young people, making recruitment difficult
• Not prioritising participation ⁴

In this guide, we will consider how commissioners can add value at each stage of the commissioning process to ensure that the most appropriate services are procured to address the mental health needs of young people aged 16–25.