Private companies and charities are set to be encouraged to work with NHS commissioning support units rather than sell directly to clinical commissioning groups, LGC’s sister title Health Service Journal has learned.
A draft NHS Commissioning Board report recommends NHS commissioning support units – which have been set up by primary care trust staff to provide back-office support and data services to the new CCGs – be allowed to enter into contracts of up to five years with CCGs.
It is hoped the move would stabilise the market and give CSUs the security to form partnership deals with private and third sector providers.
It will mean CSUs are unlikely to face outside competition to provide to CCGs for the next three years. Final plans will be made public in June.
Although the overall number of CSUs has fallen from 23 to 19 since last summer, there is a widespread expectation that there will be further mergers and takeovers between now and the first round of CSU contracting, expected in summer 2014.
Bob Ricketts, the NHS Commissioning Board’s director of commissioning support strategy, told HSJ: “Enabling successful CSUs to secure longer-term contracts with commissioners should reduce the risk of market failure, and the costs and potential disruption of continuing market churn.”
Meanwhile, HSJ reported that struggling commissioning support units will be given just three months to improve their business practices or face intervention by the NHS Commissioning Board.
The board has found that all 19 of the units currently being established would be viable until the end of 2013-14, based on service level agreements they have signed with clinical commissioning groups.
However, its assessment also identified a set of CSUs that needed urgently to improve their business practices.
Some will be given just three months to improve before the board intervenes. Its available options would include replacing the top team, arranging takeover by another CSU, or bringing in an outside organisation to manage some functions. Improvement targets will focus on CSUs’ capacity to function as independent, standalone businesses.
CSUs with less pressing issues will be given a year to show improvement.
The exercise, carried out by accountancy firm RSM Tenon, also raised questions about the capacity of some CSUs to continue to deliver 5% surpluses and 4% savings programmes beyond 2013-14.
CSU transition programme director Andrew Kenworthy would say only that there were a “handful of stonking CSUs”, but that others had fared less well.
“These are organisations which compete with each other and in the commercial market,” he told HSJ. “Sharing information about whether we have huge confidence in them or whether they’re in a higher level of risk has an impact on customer confidence and in their ability to compete.”
This means that CCGs have less information to base their choices on. Mr Kenworthy said the decision to be less open was in the interests of supporting the CSUs as they develop.