Values-based commissioning (V-BC) is a necessary complement to evidence-based practice (E-BP). By bringing the two together we obtain both the values of those who plan, provide and use services, with the evidence, both good and bad, about what does or does not work. Thus V-BC will demand that the evidence is filtered through a V-BC mesh of relevant values; and this ensures that patients and service users accept more readily what the evidence tells us.

We have seen in the book the challenge of establishing V-BC, especially at a time of austerity. Some will conclude that it is too expensive in time or resources. Others may feel it is valuable but only when we have time; at the moment, it is a luxury that we cannot afford. To these sceptics we say: V-BC will help enormously in ensuring that patients and service users accept the restrictions on services as long as they have been fully involved in making those decisions and the decisions are genuinely based on an analysis of competing values. This will be true for those services which are deemed too expensive or for which there is insufficient positive evidence; but conversely where there is not good evidence, V-BC allows commissioners to buy innovative treatments that accord with patients and service users values.