Primary care trusts (PCTs) commission health services on behalf of their local population, and are performance managed by strategic health authorities (SHAs). The Department launched a nationally consistent commissioning assurance system in June 2008 to strengthen performance management of PCT commissioning. This system will be managed locally by the SHAs, and will hold PCTs to account for commissioning and reward improved performance against three areas of commissioning—health outcomes, commissioning competencies and board governance. Detailed information about commissioning assurance is provided in the ‘Commissioning Assurance Handbook’. Copies of the handbook have been placed in the Library.