Page comments I agree there are a lot of Commissioned services out there doing excellent work but unfortunately I have also seen those service which cause concern, and do not (not competent to)  take on complex cases.
I have seen commissioner divide a service in two separate providers; city and county, one being NHS and the other being vol. sector. As a result one getting a better service than the other.
I agree with both dr gerada and yourselves. There are some organisations that take on more than they handle which reiterates your point of too many services being commissioned without thorough investigation. 
We know there are bad practices out there; private, voluntary and NHS but I am pleased to say i feel these are out numbered by the excellent ones.
Thu, 28 Jun 2012 06:07:17 +0100 Matt Beecroft In my experience voluntary agencies do not have the infrastructure to employ medical staff and rely on medics on a sessional basis. Complex cases and prescribing require medics with experience of working with service users and with a position within the team to ensure safe clinical governance. I agree the way forward is for NHS voluntary sector partnerships. Lets work together, using our expertise in the areas we do best and put service users first. Wed, 27 Jun 2012 22:30:39 +0100 Andy B