As the only organisation in Milton Keynes with a full overview of all NHS funded healthcare, NHS Milton Keynes has a responsibility to ensure its commissioning decisions improve the health of and reduce health inequalities in the population of the borough and provide access to safe high quality services. This will require commissioning in a completely different way from the traditional methods, to commissioning entire pathways of care monitored against end-point outcomes and patient/client satisfaction and aligning financial incentives with more prevention and care provided closer to home.