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CSU independence plan put on hold

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NHS England has paused a project that would enable its commissioning support units to become independent in just over two years.

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CSUs are hosted by NHS England and made £808m in 2013-14 by selling support services to clinical commissioning groups, local authorities and NHS England itself.

Guidance on how they could become autonomous was expected to be released last month, with a further, more detailed instalment due in November.

These documents were expected to chart a clear path on how the support units could become independent entities by the end of 2016.

But NHS England’s director of commissioning support services and market development Bob Ricketts confirmed to LGC’s sister title Health Service Journal that nothing will now be released until after the beginning of 2015.

Other well connected sources said they expect no further word on autonomy until after next year’s general election.

CSUs were expected to become independent of NHS England by the end of 2016.

In February NHS England set out four possible long-term options for autonomous CSUs ranging from joint venture private companies to a customer controlled social enterprises.   

The commissioning body’s decision to not publish any further guidance this year does not change its policy or the timeframe, HSJ understands.

However, senior figures in the sector indicated privately their doubts that they will have time to consider the options, formulate business cases and go out to consultation by the end of 2016 if no further details are released until next May.

The general election could also throw the future of CSUs into doubt, as a Labour led government could halt the autonomy project all together.

Labour’s shadow health secretary Andy Burnham has indicated that he does not want to see CSUs floated off in the private sector.

HSJ has learned CSU leaders were informed of the decision to pause the work on autonomy last month in a letter by Ian Dodge, the NHS England director for commissioning strategy.

The letter said the commissioning would support CSUs pushing ahead with autonomy through the voluntary “early explorer” programme.

CSUs are currently bidding for accreditation to NHS England’s procurement framework for commissioning support services, which reached the invitation to tender stage last month.

This, rather than the organisational form, is CSUs’ most urgent area of focus, as NHS England has made it clear that CSUs will have no future unless their bid is successful.

Although the decision to pause the autonomy project was widely welcomed by CSU leaders, some also expressed disappointment at the ongoing uncertainty for the sector.

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