• Led by NHS Milton Keynes.
  • Aimed to ensure effective practice-based commissioning, ensuring it is primary care led, patient-focused and evidence-based.
  • Involved a high degree of collaborative working, with patients having a major input.
  • High level of engagement with the public held real benefits with people being able to see the changes their input and ideas could produce.


This project aimed to make practice-based commissioning effective. GPs and other health professionals worked with patients to bring about measurable improvements in services and embed new approaches more widely across the health system.

The project team began working with the Patients’ Forum and GP practices across Milton Keynes to identify areas to improve such as chronic obstructive pulmonary disease, asthma, cardiovascular disease, terminal care and depression.

Local librarians and the Centre for Evidence Based Medicine at Oxford University held discussions with practices and patients to understand the evidence base for each area of improvement. Patients were consulted again to measure the success of changes after they had been tested.

Individual practices across Milton Keynes led on different clinical areas, sharing their improvements with all of the GP practices involved in the project.


  • Clinical outcomes improved in many areas including smoking cessation, diabetes and weight management.
  • Most GP practices to set up patient participation groups, giving patients a real means of influence.
  • Participants were able to track progress over the three years of the programme and reflect on what worked.
  • The project team felt this level of engagement with the public held real benefits with people being able to see the changes their input and ideas could produce.
  • The collaborative approach leant itself to leading to larger scale changes than would otherwise be possible and allowed the team to demonstrate quantifiable improvements in the quality of care.

Who was involved?

Partners included Milton Keynes Practice Based Commissioning Collaborative, University of Oxford, Department of Primary Health Care and Centre for Evidence Based Medicine, Milton Keynes Patient Forum.

Further reading

Research report

Involving primary care clinicians in quality improvement

April 2012
Research report

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