Leading market figures now believe it is unlikely commissioning support units will enter long-term partnerships with private sector firms before 2014.

CSUs were originally expected to begin forging deals with the private sector in spring 2012, after policy guidance from the NHS Commissioning Board encouraged them to enter into “commercial partnerships”. However, neither NHS nor private sector bosses now expect that to happen this financial year, and some believe it will be the end of 2013-14 before partnerships are formed.

The board will host the 23 CSUs from October and has committed to developing the sector until the end of 2013-14. The CSUs are intended to become independent by 2016.

Commercial partnerships would be long-standing business collaborations between CSUs and private or voluntary sector organisations.

They could take the form of manpower deals, enabling CSUs to bring in extra staff when needed, or deals to supply technical products or specialist skills not widely available in the NHS.

HSJ has learned that although CSUs can bring in consultancy firms to do one-off pieces of work, there is now an understanding that none should enter into long term agreements with private firms before the commissioning board takes over as host. This is because any long term deals signed now could tie the board’s hands over the next 18 months as it works to develop CSUs.

Commissioning support sources said the commissioning board has given a clear indication to this effect, to the frustration of some of the more advanced CSUs.

Delays to the appointment of many CSU managing directors have also prevented units from entering discussions with private firms.

The commissioning board, meanwhile, is understood to be primarily focused on ensuring CSUs are financially sustainable and on developing the market for commissioning support services.

There has also been a cooling of interest in the private sector. A series of meetings between private sector suppliers and CSUs, set up as part of a “learning network” for the sector, has tailed off in recent months.

One senior private sector source said that potential CSU partners were keeping an open mind as to how much commissioning support business would be available to them. “The policy is running its course”, the source said, adding that the initial plan for an open market in CSUs was only “an opening offer”.

Another well placed private sector figure said: “CSUs should work with the private sector because they need to learn a new set of commercial skills”. However at present, CSUs were most concerned with “trying to balance the books” and ensuring they had a level of staffing that was both affordable and sufficient to properly serve clinical commissioning groups.