Strengthening the Commissioning Capacity of Primary Health Networks: A Framework and Strategies for Development

Primary Health Networks (PHNs) play a pivotal role in improving the efficiency, effectiveness, and equity of primary health care in Australia. As regional commissioners, PHNs assess community health needs, design service models, and contract providers to deliver integrated, locally responsive health and social care. However, variability in commissioning practices and the absence of a nationally informed model for developing commissioning capability continue to limit consistency, sustainability, and system impact. This Perspectives article synthesises organisational capacity‑building theory alongside recent empirical evidence from research conducted across multiple PHNs to articulate a conceptual framework for strengthening commissioning capability at national, regional, and organisational levels. The framework addresses a gap in current practice by outlining the system enablers, governance mechanisms, and workforce development strategies required to support effective and sustainable commissioning. It highlights the interconnected roles of the PHN Cooperative, the Commonwealth Department of Health, State-funded health services, and individual PHNs in fostering a coordinated and learning‑oriented commissioning environment. By articulating these system and organisational requirements, the article offers a conceptual contribution intended to guide policy alignment, collaborative practice, and capability development across Australia's PHN network.