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CSU private partnerships 'essential' for QIPP

Partnerships between commissioning support units and the private sector will have an “essential” role in driving integrated care to enable the NHS to meet its efficiency challenge, HSJ has been told.

In an exclusive interview, Bob Ricketts, the NHS Commissioning Board’s director of commissioning support strategy and market development, and Andrew Kenworthy, its interim director of the CSU transition programme, agreed that CSUs were “essential” to the NHS’s ability to deliver on the quality, innovation, productivity and prevention programme.

Mr Ricketts said: “Commissioners are not going to deliver the QIPP challenge unless they commission differently.

“You want to create an integrated care pathway where there’s a focus on prevention, using the right mix of community and acute services, so you need to get the incentives right for that.

“You probably want five or nine year contracts – as part of that you probably want gain share and pain share, all the risk stuff. It makes sense to grow support services and get them to focus on that much more demanding, sophisticated commissioning for transformation. That’s the big agenda.”

Mr Ricketts said he foresaw several markets in commissioning support services developing over the coming years, with different markets around functions like communications and human resources “as opposed to the rather more sophisticated approach in place around commissioning for outcomes, commissioning care pathways”.

The markets would be different for each commissioning support “service line” – CSU functions were divided into seven service lines earlier in the assurance process, and are currently categorised into 30 types. There could be different procurement frameworks or industry standards for each service line.

He said a strategy for developing markets for excellent commissioning support services would be published in six months.

Mr Kenworthy was unable to give any detail on how CSU data management and integration centres would be funded. The centres will be run by some CSUs to process and link data from the health and social care sectors and feed it up to the NHS Information Centre – but there is widespread concern in among CSUs over how they will be paid for.

Readers' comments (6)

  • I'm sorry but these people seem to be getting more and more detatched from the every day reality that most of us commissioners and providers are trying to cope with.

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  • "as part of that you probably want gain share and pain share, all the risk stuff."

    That's fine. Until people realise that the independent sector view is that dealing with "all the risk stuff" has a cost attached to it.

    If the risk proves to be higher than forecast, be ready for the sort of back tracking we've seen today with West Coast Main Line, but if it goes the other way (and indepdent sector "wins big") be ready for PFI-esque criticism.

    In the meantime "all the risk stuff" doesn't sound too threatening does it?

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  • I cannot imagine any pain being shared by the private sectoor, Causing pain seems the most likely option,
    Existing NHS providers will bear the pain from what is coming. No doubt as idependent GPs & their CCGs will prosper.

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  • "as part of that you probably want gain share and pain share, all the risk stuff."

    Agree with above comments; the private sector will gain share and the NHS will risk share aka hold all the risk as it has done in all market failures to date.

    I don't see how Ricketts gets from “Commissioners are not going to deliver the QIPP challenge unless they commission differently" to the need for competition between commissioners. Bizarre!

    However if he wants competition the answer as Roy Lilley has pointed out is for CCGs to merge asap so CSUs are squeezed out but this will require some bottle on the part of relatively new and inexperienced board members. Have they the guts or the competence?

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  • The still emerging problem is the very marked shift in negotiating power towards the acute providers. They have attracted many of the best finance and quality staff from the PCTs and are running rings around the new CCGs. Watch as the referrals go up, the acutes desperately squeezing more and more from their control of most of the system and the new CSUs also gaming the resulting confusion to push for a bigger slice of the running costs. QIPP is a fiction in most places. Few real improvements have been made and the 'successes' claimed in the last year have just been shuffling paper around to give the appearance of savings. The wheels are coming off I am afraid and it's going to get very bloody quite soon.

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  • "CSU private partnerships 'essential' for QIPP"

    You mean essential for the maintainance of the lifestyle to which management consultants/McKinsey/PA Consulting have become accustomed............

    Bob Ricketts: now there's a brain of such magnitude we should hang on his every word. It would be considered libellous if I said what I really thought, having had dealings in the past.

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