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AbstractThis research explored how newly forming clinical commissioning groups (CCGs) were beginning to think about their new 'duty' to tackle health inequalities (HIs), as outlined in UK health policy. The concept of 'sensemaking' (Weick 1995) was used to illustrate the influences on CCGs' interpretations of the policy. Three CCGs in the North of England were recruited, and qualitative methods, including interviews, observations and document analysis, were used to collect data, over a period from January 2012 to December 2012. The tangibility of central policy objectives is important in providing clear guidance and direction to organizations trying to tackle large scale policy agendas such as HIs. At a local level, both individual and collective organizational histories and wider relationships were influential on the way CCGs understood the problem of HIs and how they decided to try to tackle the issue locally. The research highlights what influences local level relationships and what factors need to be considered when trying to interpret and implement national policy at a local level.

This timely book is the most comprehensive account yet of recent commissioning practice in the English NHS and its impact on health services and the healthcare system. Drawing on eight years of research, expert researchers in the field analyse crucial aspects of commissioning, including competition and cooperation, the development of Clinical Commissioning Groups and contractual mechanisms. They also consider the influence of recent commissioning reforms on public health infrastructure. For academics and policy makers in health services research and policy, this is a valuable collection of evidence that deepens understanding of how commissioning works