{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T03:43:44Z","timestamp":1793245424306,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"2_suppl","license":[{"start":{"date-parts":[[2012,4,1]],"date-time":"2012-04-01T00:00:00Z","timestamp":1333238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Health Serv Res Policy"],"published-print":{"date-parts":[[2012,4]]},"abstract":"\n Objectives<\/jats:title>\n To investigate the tensions faced in commissioning services for children's speech, language and communication needs and to identify variation in commissioning practice in response to these tensions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Quantitative and qualitative evidence from a review of speech, language and communication services in one English region, focused on three case studies.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The case studies reveal variation in practice in relation to commissioning tensions generated by: low incidence\/high needs cases, blurred boundaries between health and education, multi-agency working, parental voice and service development. The introduction of commissioning and models of practice such as \u2018the commissioning cycle\u2019 has left huge variation between localities in levels and type of provision for these services.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Large variation in commissioning practice is associated with commissioners' adoption of one of three models: a market model, an integrated model and a top-up model.<\/jats:p>\n <\/jats:sec>","DOI":"10.1258\/jhsrp.2012.011121","type":"journal-article","created":{"date-parts":[[2012,5,9]],"date-time":"2012-05-09T10:30:36Z","timestamp":1336559436000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Tensions in Commissioning: Services for Children's Speech, Language and Communication Needs in One English Region"],"prefix":"10.1177","volume":"17","author":[{"given":"Karen","family":"Davies","sequence":"first","affiliation":[{"name":"Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Davies","sequence":"additional","affiliation":[{"name":"School of Education, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,4,1]]},"reference":[{"key":"bibr1-jhsrp.2012.011121","volume-title":"The Bercow Report: A review of services for children and young people (0-19) with speech, language and communication needs.","author":"Bercow J","year":"2008"},{"key":"bibr2-jhsrp.2012.011121","volume-title":"Better Communication: an action plan to improve services for children and young people with speech, language and communication needs.","author":"Department for Children, Schools and Families.","year":"2008"},{"key":"bibr3-jhsrp.2012.011121","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004110"},{"key":"bibr4-jhsrp.2012.011121","volume-title":"Partnership in Public Services.","author":"The Cabinet Office.","year":"2005"},{"key":"bibr5-jhsrp.2012.011121","volume-title":"Support and Aspiration: A new approach to Special Educational Needs and disability. 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