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Exclusive: CCGs doubt CSUs' ability to innovate

Many clinical commissioning groups doubt whether their support service providers can work in an innovative way, or are well led, a survey has found.

The survey, conducted by NHS Clinical Commissioners and seen exclusively by HSJ, was completed by 90 CCGs in January (see attached report).

It found that on average CCGs planned to spend £9.43 per head of their population on an NHS commissioning support unit, compared to £13.29 on in house CCG management.

On average just 30p per head of population was planned to be spent with non NHS suppliers.

Only 8 per cent of respondents said they were “very confident” that CSU leaders could “deliver commissioning support in a new and innovative way”, or help NHS commissioners work differently from how the NHS has worked in the past. A further 43 per cent were “quite confident”.

Only a quarter of CCGs were very confident CSUs had the “right calibre of leadership”, with just over half “quite confident”.

More than half of CCGs said that business intelligence services would be among the first they would procure, potentially from providers other than their current NHS support unit.

One senior CSU figure suggested to HSJ this was because it is one of the few support services the private sector had already begun to provide.

He added that the lack of confidence in CSU leaders suggested a lack of faith in NHS commissioners generally, as many CCG and CSU staff had worked together until recently in primary care trusts.

Four of the CCGs which responded said they would be using a CSU from outside their region as their main provider. These included a CCG in the north which planned to use Hertfordshire and Essex CSU, and another in the midlands and east region using South West CSU.

Nearly half CCGs surveyed said they would procure services outside NHS England’s recommended timeframe of April 2013 to September 2014. NHS Clinical Commissioner’s report on the survey said this could be evidence of poor planning by CCGs or dissatisfaction with CSUs.

NHS Clinical Commissioners chair Charles Alessi said: “It must be as easy to change your commissioning support as it is to remain engaged with the incumbent CSU.  

“CCGs are being faced with real problems and some intractable issues and they need the best commissioning support to achieve this, and this is why we feel choice of commissioning support, within and without the NHS family, is so important.”

Readers' comments (3)

  • It is evidence of dissatisfaction with the local CSU. If they were up to the job we would be happy to continue using them. As they are not we are looking for an alternative. Charles Alessi just let me know when that will happen.

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  • So... 51% are very or quite confident in CSU leadership, and more than three quarters are very or quite confident in the calibre of leadership.

    The HSJ spin above "only 8%, only a quarter" is doing a disservice to the survey evidence.

    That is not to say the CSUs havent got a long way to go - they have. As a CSU customer I am painfully aware of that, but also, despite Charles Alessi's naive comments, the cost and disruption of changing service provider is huge - just as big as the transaction and transition costs in changing healthcare services.

    Switch horses when you need to for strategic advantage, but dont kid yourself that moving service provider is an easy-come-easy-go arrangement. You need to be more invested in each other's success than that.

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  • It would be interesting to survey CSUs on their confidence in the CCGs they are there to serve!

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