Ministers promise to provide for "appropriate oversight arrangements and safeguards", but there is no immediate detail on how the complex web of intelligence and surveillance commissioners and parliamentary oversight might be strengthened.
Related: The Guardian view on care workers: undervalued, underpaid | Editorial Yet care providers have a point when they ask how they are supposed to make ends meet on the rates they are paid by council commissioners.
Related: Mental health charities can help people where the NHS cannot "To improve access to MBCT we need a combination of top-down action, such as getting commissioners and senior managers on board, and bottom-up action... pro-active mindfulness teachers and trainers setting up high quality local services and encouraging GPs to refer patients who would benefit from MBCT treatment," he says.
"Ultimately we are looking to build up a solid foundation of expertise among commissioners so they commissioning can be done expertly and consistently," she says.
Michie points to examples of best practice such as the strategic projects team at NHS Midlands and East, which helps commissioners to work more effectively through collaboration: "One of the challenges commissioners have is that they're unlikely to have the skill sets they need in one organisation but can as a team," she says.
According to EU protocol, the proposal from the investigating team will now go to a college of EU commissioners for a final decision next month.
A spokesman for Almunia told the Guardian that after discussions with the UK authorities, he would "propose to the college of commissioners to take a positive decision and in principle the decision should be taken during this mandate of the commission in October".
"I think that's the kind of smart stuff that commissioners can do where investment now can pay big dividends in the future in terms of efficiency and effectiveness of the supply side".
The commissioners were most persuaded by the recent independent Cochrane review of the evidence for the two drugs, which said Lucentis was not superior.
Shorter contracts with tight budgets from commissioners are also placing pressure on cash flow and working capital at the frontline.
The communities secretary, Eric Pickles, has sent commissioners to run almost all aspects of the council for four years.
