- This book describes the trend towards more diverse and devolved forms of purchasing and combinations of purchaser organisations within health authorities in the NHS. It presents a multi-dimensional profile of each of the current models of purchaser organisation. Trends and policy developments are discussed in relation to the likelihood that they will give rise to purchaser organisations which are sustainable, accountable, have the right mix of skills, minimise conflicts of interest and can successfully undertake the main tasks of NHS purchasing. A range of potential future options is discussed, and assessed in relation to the requirements for NHS purchasing. The less radical options do relatively little to address directly the particular weaknesses of current arrangements, while more radical options have the potential to do so, but would require strong external regulation.