When the new services are up and running it is essential you continually reflect on their impact, successes and failures, so you can set the tone for future commissioning and highlight areas of services in need of redesign or replacement. This is not a ‘do once’ activity - it should be repeated for each commissioning cycle and any findings can be fed back into the commissioning process to influence ‘Step 3: local needs assessment', ‘Step 4: prioritisation’ and ‘Step 6: commissioning plans'.

Make sure the local monitoring arrangements you set up include data collection and time for providers and commissioners to reflect so it can be fed into the development priorities for the next commissioning round.

You will also need to monitor demand against services through feedback on the effectiveness of the services at improving outcomes. You’ll need to identify unmet need (where people are asking for services not currently commissioned), and evaluate levels of demand for services that are not well used, or are ineffective in improving outcomes.

This process of reflecting on and evaluating services usually benefits from the involvement of key stakeholders through network groups or specific monitoring and evaluation groups.

Done well, this final step will help ensure the service that is commissioned is one that is both high quality and sustainable.