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Scaling up networked care

How can commissioners help single specialty networks to grow?

The commissioning process can be critical to network expansion. Commissioners can be enablers to extending single specialty networks in the first four categories of the toolkit.

We found that providers and commissioners were not always aligned in their definition of how the networked care model operates.

Where differences in understanding exist, there is a risk that the benefits of networked care may not be understood and commissioners may therefore not support network expansion.

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How can commissioners help single specialty networks to grow?

Commissioners and providers were all in agreement as to the importance of collaboration and relationship building when planning and

delivering networks across a wider geography:

  • Strong commissioner relationships are considered key by networked care providers in expanding numerically.
  • Informed commissioner support is considered to be critical in helping to find sustainable networked solutions, share best practice and enable faster expansion of networked care.

“It is of critical importance that we have the explicit support of the commissioners for any expansion of our network.”

Providers favoured multi-year contracts to incentivise service delivery.

How can commissioners help single specialty networks to grow? imageThere was consensus that single specialty services should be commissioned centrally or have one host commissioner for the network. It is easier to build a long term relationship with one commissioner, who is then able to gain a better understanding of the specialty, the network model and the benefits of expansion.

When expanding geographically providers considered differences in STP commissioning priorities and processes to be more challenging. Differing commissioning rules, payment structures and performance targets, particularly when crossing national borders, add complexity.



  • Aligning understanding of networks between providers and commissioners is critical to successful expansion and can be achieved through collaborative working.
  • Commissioner support is critical to enable growth of networks, but sustainability solutions for systems need to be provider led.
  • Multi-year contracts that allow headroom for networked care providers to stabilise challenged services will help network growth.
  • A networked model will benefit from having a single commissioner who understands the model and the benefits that expansion can offer other STPs.