The NHS Commissioning Board has announced exclusively to HSJ that it will appoint all commissioning support service leaders this spring.
The board’s business development unit has also explained that if a CSS plan was found to be unviable it could parachute in a new leadership team or force a takeover by a viable CSS.
It is the first time plans have been detailed for what happens when a CSS fails the assurance process.
Information gathered by HSJ from strategic health authorities this week reveals 25 CSS plans are being developed by primary care trust clusters.
Outline business plans are due to be submitted to the commissioning board on Friday as part of the crucial “checkpoint two” stage of the assurance process, which is designed to root out unviable CSSs.
Business development unit director Joe Rafferty told HSJ the commissioning board would appoint CSS leaders in May and June.
“The one thing characterising CSSs that appear to be getting momentum behind them is clearly identifiable quality leadership,” he said.
CSSs will be hosted at arm’s length by the board until no later than 2016, when they are intended to become “free-standing” organisations.
Mr Rafferty said: “It’s perfectly sensible that the board will want to be comfortable with the people running these organisations. [As] the hosting organisation [they] will still bear the responsibility for any risk associated with these organisations.”
Mr Rafferty said that where a CSS plan was abandoned during the assurance process, existing PCT cluster staff would probably remain in place while a new leadership team could be brought in or drafted in “from a CSS that successfully passed through checkpoint two”.
He revealed the commissioning board is set to launch a leadership assessment process for commissioning support.
This will be open to people not currently in senior CSS posts, and will produce a pool of people who could be brought in where a CSS’s leadership team is found to be lacking.
“We anticipate that the majority of CSSs would pass checkpoint two”, Mr Rafferty said, adding it was likely that all required further help and development. “We will not blink at failing a CSS that isn’t up to scratch,” he added.
Derek Felton, executive director at Ernst and Young, which is working with the DH on commissioning support development, agreed that CSS plans were improving significantly, particularly in terms of tailoring their offer to clinical commissioning group needs.
“We are beginning to see a change in the way CCGs are viewing CSS services,” he added. Leading CCGs are increasingly able to identify the support services they needed to buy in from outside, how much they were able to pay and where CSSs demonstrated they were adding value, he said.
The number of CSSs under development has fallen from 36 at the beginning of 2012. Newly merged CSSs include: Essex; Birmingham, Solihull and the Black Country; and Berkshire, Buckinghamshire, Gloucestershire, Oxfordshire and Swindon.
Meanwhile the Greater East Midlands CSS covers seven PCT clusters, including Bedfordshire and Luton.
Northamptonshire and Milton Keynes cluster chief John Parkes, who is leading on the region’s CSS, said it would build on existing commissioning partnership work in the East Midlands. Operating on a large scale would drive down costs but the CSS would still be responsive to local CCGs, while staff would have more security.
Four PCT cluster areas are not working on a CSS business plan. These are: Cambridgeshire and Peterborough; Suffolk; Bournemouth, Poole and Dorset; and Wiltshire and Bath and North East Somerset.
In these areas CCGs are planning to employ more staff themselves and buy in a small amount of support from outside or neighbouring CCGs.