Commissioners are increasingly under pressure to deliver improved services with fewer resources and hard decisions need to be made in the current economic climate. Activists who understand the commissioning process are in a strong position to influence decisions and protect the interests of patients and RCN members. The earlier activists and nurses get involved in these decision-making processes, the more likely it is that they will have a positive influence on behalf of patients and nurses. This publication covers what commissioning is, who leads commissioning and where it takes place, as well as detailing six keys to help activists and nurses in unlocking and understanding the commissioning process. (RCN - publications)