Scott Rebecca J, Mathie Elspeth, Newman Hannah J H, Almack Kathryn, Brady Louca-Mai
Library and Computing Services, University of Hertfordshire, London, UK.
Health and Social Care Inclusion, Centre for Research in Public Health and Community Care, University of Hertfordshire, London, UK.
Health Expect. 2024 Jun;27(3):e14053. doi: 10.1111/hex.14053.
This exploratory literature review seeks to examine the literature around commissioning processes in the co-production of health and care services, focusing on two questions: How do health and care commissioning processes facilitate and/or pose barriers to co-production in service design and delivery? What are the contextual factors that influence these processes?
A systematic search of three databases (Medline, Public Health and Social Policy and Practice) and a search platform (Web of Science) was conducted for the period 2008-2023. A total of 2675 records were retrieved. After deduplication, 1925 were screened at title and abstract level. Forty-seven reports from 42 United Kingdom and Ireland studies were included in the review. A thematic synthesis of included studies was conducted in relation to the research questions.
The review identified one overarching theme across the synthesised literature: the complexity of the commissioning landscape. Three interconnected subthemes illuminate the contextual factors that influence this landscape: commissioners as leaders of co-production; navigating relationships and the collective voice.
Commissioning processes were commonly a barrier to the co-production of health and care services. Though co-production was an aspiration for many commissioners, the political and economic environment and service pressures meant that it was often not fully realised. More flexible funding models, longer-term pilot projects, an increased emphasis in social value across the health and care system and building capacity for strong leadership in commissioning is needed.
Patients and the public did not contribute to this review as it was a small piece of work following on from a completed project, with no budget for public involvement.
本探索性文献综述旨在研究围绕健康与护理服务联合生产中的委托流程的文献，重点关注两个问题：健康与护理委托流程如何促进和/或阻碍服务设计与交付中的联合生产？影响这些流程的背景因素有哪些？
对2008年至2023年期间的三个数据库（Medline、公共卫生与社会政策及实践）和一个搜索平台（科学网）进行了系统检索。共检索到2675条记录。去重后，对1925条记录进行了标题和摘要层面的筛选。纳入综述的有来自英国和爱尔兰42项研究的47份报告。针对研究问题对纳入研究进行了主题综合分析。
综述在综合文献中确定了一个总体主题：委托格局的复杂性。三个相互关联的子主题阐明了影响这一格局的背景因素：委托方作为联合生产的领导者；处理关系与集体声音。
委托流程通常是健康与护理服务联合生产的障碍。尽管联合生产是许多委托方的愿望，但政治和经济环境以及服务压力意味着它往往无法完全实现。需要更灵活的资金模式、长期试点项目、在整个健康与护理系统中更加强调社会价值以及培养委托方面强大领导力的能力。
患者和公众未参与本综述，因为这是一项在已完成项目之后开展的小工作，没有用于公众参与的预算。
