This exploratory literature review sought 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. 2675 records were retrieved. After de-duplication, 1925 were screened at title and abstract level. 49 reports from 44 studies were included in the review. These were overwhelmingly from the United Kingdom. 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.
Original languageEnglish
JournalHealth Expectations
Publication statusAccepted/In press - 14 Apr 2024


  • Co-production
  • literature review
  • commissioning
  • health care
  • social care
  • health services


Dive into the research topics of 'Commissioning and co-production in health and care services: An exploratory literature review'. Together they form a unique fingerprint.

Cite this