Barriers to change
Get well soon, Reimagining place-based health, The Place-Based Health Commission Report, identifies three interrelated challenges that are holding back a shift toward placed- based health commissioning:
· The Evidence Paradox: NHS agencies are reluctant to invest (particularly in prevention) as they don’t have clear evidence of effectiveness. However without experimentation that evidence cannot be generated.
· Poorly Aligned Incentives: Different institutions work to different sets of organisational and financial incentives which drives them to work in isolation from each other.
· Rigid regulation: inflexible forms of national regulation can prevent local change and innovation (this point is also made by Locality).
To move toward place based commissioning for health these challenges must be tackled.