This publication sets out guidelines for those commissioning health and social services for people with physical and/or sensory impairments between the ages of 16 and 65. It starts by identifying what are the general aims of commissioning activities directed at this group of people before moving on to address the different stages of the commissioning process: planning; service development; the contracting process; and looking at how a service performs. A checklist is given at the end which highlights the things which need to happen to create responsive, flexible and accessible services. The examples highlighted in the document are all based on current developments although most of them are not actually accounts of existing practices.