The commissioning framework for health and wellbeing, published in March 2007, aims to shift the focus from treating people when they are sick towards prevention and keeping them healthy and independent. This framework builds on the White Paper 'Our health, our care, our say', which presented a clear commitment to give people more choice and control over services they receive, to deliver services closer to where people live and to tackle inequalities.

The focus is on people - not just people who are ill but everybody, and the need to look further than just physical health problems, to promote wellbeing, which includes social care, housing and all the other elements that build a sustainable community. The aim of the commissioning framework for health and wellbeing is to help commissioners to do this by showing how they can provide personalised services, promote health and wellbeing, proactively prevent ill health, and work in partnership to reduce health inequalities by focusing on outcomes for children and adults.

Key issues are:

• Giving individuals more choice and control over their own care.
• The new duty for NHS and local government to provide a joint strategic needs assessment, which requires those who plan services to deliver care that reflects the needs of their local communities.
• Wider use of flexibilities around Practice-based Commissioning.
• Redesigning local health services based on people's needs, and convenience.

The framework identifies eight elements of more effective commissioning:

Putting people at the centre of commissioning

This involves giving people greater choice and control over services and treatments (including self care), and access to good information and advice to support these choices. Mechanisms will be developed to help the public get involved in shaping these services, with advocacy to support groups who find it hard to express views.

Understanding the needs of populations and individuals

Joint strategic needs assessment by councils, PCTs and practice-based commissioners will help them to better understand the needs of individuals, by using recognised assessment and care planning process appropriately, and mitigating risks to health and wellbeing of individuals.

Sharing and using information more effectively

In order to make effective decisions for individuals and groups, we need to use and share information in an effective way. This includes clarifying what information can be shared under what circumstances, joining up the IT systems of front line practitioners and encouraging individuals and communities to be co-producers of information.

Assuring high quality providers for all services

Commissioners should develop effective, strong partnerships with providers and engage them in needs assessments. Procurement should be transparent and fair. Commissioning will be focused on outcomes, leading to more innovative provision, tailored to the needs of individuals and supplied by a wider range of providers.

Recognising the interdependence between work, health and wellbeing

Commissioners can facilitate collaborative approaches with business to improve advice and support for individuals. Additionally, all providers of NHS care will be incentivised to support and promote the health and wellbeing of their employees.

Developing incentives for commissioning for health and wellbeing

Bringing together local partners using Local Area Agreements will help to promote health, wellbeing and independence, by using contracts, pooling budgets and using the flexibilities of direct payments and practice-based commissioning.

Making it happen - local accountability

The Department of Health and the Department for Communities and Local Government will develop a single health and social care vision and outcomes framework, including a set of outcomes metrics aligned with the framework.

Making it happen - capability and leadership

The Department of Health and other national stakeholders will provide support to all local commissioners to address their capability gaps, where these organisations can add real value. this support will be tailored to different types of commissioners - PCTs, practice-based commissioners and local authorities.

The framework sets out a vision, a framework and practical proposals for the commissioning of health, care and wellbeing from 2008/09. The document was a consultation document; the outcome of which is awaited.

website link: Commissioning Framework for Health & Wellbeing

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