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an Economist Intelligence Unit business healthcare

Commissioning briefs

Case studies: Renal replacement services; Ultra orphan drugs

Commissioning briefs can be thought of as "due diligence” for commissioners who are deciding whether to invest in or disinvest from particular services, drugs, diagnostics and devices.  They address all the issues – cover all the bases – required for commissioning in a rational, transparent and evidence-based way.  Commissioning briefs are independent yet robust, allowing commissioners and clinicians to more quickly decide a course of action, set policy and make commissioning and other allocation decisions.

Commissioning briefs contain:

  • Plain language executive summary and conclusions
  • Description of the service or technology, its alternatives, and its role in the clinical pathway
  • Effectiveness and safety analyses of the service or technology, compared with alternatives
  • Cost-effectiveness information
  • Critique of key claims cited by proponents and opponents
  • Summary of relevant clinical guidelines, including NICE, SIGN and Royal Colleges
  • Judgements including a policy recommendation if required

Commissioning briefs are used for:

  • Speeding up negotiations between commissioners, clinicians and other stakeholders
  • Developing policy and making allocation decisions, including exceptional funding policy
  • Understanding and implementing NICE technology appraisals
  • Examining drugs, devices, interventional procedures, diagnostics, service packages and clinical policies
  • Stress testing business cases for new drugs, devices, procedures and diagnostics
  • Forecasting the impact of emerging technologies
  • Assisting with specialist commissioning of high cost, low volume technologies and services
  • Resolving difficult or controversial policy debates


“The work done on PAVR with Bazian brought together commissioners, clinicians and academics to ensure that the commissioning of this new, innovative procedure will be based on sound evidence.  This will benefit future NHS patients, and has demonstrated that we can introduce new technologies through a robust research-led approach.  It also provided a model for introducing innovations to the NHS in the future through a collaborative process based on World Class Commissioning.”
Kate Caston, Director of East Midlands Specialised Commissioning