Thanks for the Petunias

A guide to developing and commissioning non-traditional providers to support the self management of people with long term conditions.


Non-traditional providers (such as voluntary organisations, community groups and social enterprises) are important additions to routinely commissioned services. They are often deeply embedded in the communities they serve and can provide more ‘tailor made solutions’ for the needs of people with long term conditions (LTCs) identified through the collaborative care planning process.

Engaging with non-traditional providers in an effective way can lead to:

  • Better outcomes for people with LTCs (social and clinical)
  • More cost effective use of NHS resources (and social care)
  • Widening of the local provider base

This guide is an important product of the national Year of Care Programme. Year of Care is a successful programme, originally piloted in three diverse health communities in 2007/10.

What This Guide Offers:

This guide has two aims:

  1. Firstly to make routine consultations between clinicians and people with LTCs truly collaborative, through care-planning
  2. Then to ensure the local services that people need to support the actions they want to take to improve their health and well being outcomes, are available via commissioning

This guide is the outcome of the second work stream, to capture the outputs of care planning, and develop community based services to support self management.

Whilst the Year of Care pilot sites wished to develop the role of non-traditional providers they encountered a number of challenges for systematically commissioning such services. This guide offers a potential organisational model that addresses the numerous barriers that were raised. It also gives ideas as to how this could work on a practical level.

A key element in the guide is ‘commissioning for sustainability’, ensuring it becomes embedded in the local health economy, rather than becoming another well intentioned pilot that is cut when funding streams become tight.

This is not a definitive guide to commissioning, but an exploration of a possible organisational model that can be adapted according to local circumstance, resources and need. I hope that you find this guide helpful as you work towards effectively commissioning non-traditional providers to support people in your locality to manage their long term conditions.

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