The idea that commissioning support units will be little more than an outsourced data handling and contract processing resource for clinical commissioning groups is being replaced by a more expansive vision.

Bob Ricketts, the NHS Commissioning Board’s director of commissioning support strategy and market development, states fully established CSUs will be “barely recognisable” from their initial form.

Mr Ricketts was also, of course, the man behind transforming community services – the policy launched by the last government which is having a more profound effect on the nature of NHS provision than anything yet dreamt up by the coalition.

‘It seems the commissioning board will be able to exert considerable influence through the CSU “market” for the foreseeable future’

Some CSUs will become increasingly important. Already the sector is on course to employ 8,000 staff, compared to 5,000 within CCGs. With support services all due to be retendered by the end of the next financial year, capacity and capability will be concentrated in fewer than 20 organisations.

They are likely to be joined by a small number of the larger CCGs whose in-house expertise is developed enough to become available and attractive to other commissioning groups.

Access to expertise

The successful providers of commissioning support services will be active in working for CCGs on “transformative” strategies. They will help the commissioners plan integrated services and influence service reconfiguration.

Nor will their client base be restricted to CCGs – already councils are seeking help in delivering public health services, while providers will also want access to CSU expertise.

Successful CSUs will form joint ventures with private sector players, but many will also act together in a networked fashion to provide stiff competition to the traditional consultancies and outsources looking to build market share.

Finally, with Mr Ricketts saying the “externalisation” of support services can wait, it seems the commissioning board will be able to exert considerable influence through the CSU “market” for the foreseeable future.

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