A realistic evaluation of practice-based commissioning

The tendency of governments to recycle policy from previous periods presents analysts with the opportunity of assessing their likelihood of success in new time periods. This article presents a theoretical and empirical contribution toward this goal. Its theoretical contribution utilises the work of Pawson and Archer by exploring how context from previous and current periods can be compared and separated from generic policy mechanisms that underpin reforms in order to be able to show how outcomes from the past might be reproduced or transformed in current policy. Its empirical contribution applies this framework to the case of GP fundholding from the 1990s and practice-based commissioning of the 2000s, to show how the latter policy both addresses the difficulties of its predecessor but also makes significant errors that jeopardise its potential for success.