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I left a PCT and ended up in a CSU as part of the reorganisation, I won't stay there because there is nothing attractive about the roles on offer for those who were formerly commissioners. Staff within the service are encouraged to adopt an item of service transactional approach, CSU leadership for the most part fondly imagines it is commercial but actually hasn't got a clue and the customer is still developing and may be struggling to define the approach it wants to see from CSUs.Effective relationship management makes for successful delivery, the current position is a recipe for a perfect storm.

I really don't think that the way PCTs operated was always successful, and the worst of them were quite simply terrible. The good PCTs who worked in partnership with local clinicians made some significant improvements in care for patients. Sometimes PCTs made providers unhappy, I don't recollect any one ever saying to me it was my job to allow our local health economy to be ripped off by poor providers with inflated expectations and poor delivery - so not going to loose any sleep over that.