Anglia Commissioning Support Unit will not continue as a standalone organisation following complaints from its customers over costs and the quality of its services.
It is thought likely it will either to be taken over by or merged with another CSU. Anglia has been supplying support services to clinical commissioning groups in Norfolk, Norwich, Great Yarmouth and Waveney, and is the first CSU to be axed since Surrey and Sussex failed in April.
Its demise brings the number of CSUs still running down to 17. Sources close to the CSU development programme believe further “consolidation” is likely.
Jonathon Fagge, chief executive of Norwich CCG, wrote in his blog on Saturday: “Our Anglia CSU is to become part of a larger CSU (assuming one of the other providers in the market is sufficiently interested in the opportunity). Words like ‘partner’, ‘merger’ and ‘takeover’ are being used interchangeably.”
Mr Fagge said that by April his and neighbouring CCGs would have a different provider of support services, although many of those services would still be delivered by staff currently working for Anglia CSU in Norwich.
“There’s a long history to this, and no shortage of opinions of how we got here, what’s wrong, and who’s to blame,” he wrote. “But for CCGs in Norfolk the issues are relatively simple: it’s too expensive, its delivery is inconsistent, and there is no confidence that it can deliver high quality services that are good value for money without radical change.”
Mr Fagge went on to say that while there were some “very high quality individuals” in Anglia CSU, “but not enough of them to pull the organisation into recovery.”
He listed the following three “red lines” for future commissioning support providers.
- Operating efficiencies - “the total service package needs to cost less”;
- Local delivery - “many of the services need to be delivered within the local system”;
- Local relationship - “we don’t want to do business with you via Skype to London, Cardiff, or Manchester”.
Mr Fagge said three to four months of discussions would now follow.
Anglia CSU is known to have been one of the main areas of focus for NHS England’s business development unit in recent months.
The organisation never recruited a permanent managing director, and NHS England brought in Caroline Mitchell to run it on an interim basis last spring.
CSU transition programme director Andrew Kenworthy told HSJ at the time that Norfolk and Waveney offered good services, but “recruiting folk in that part of the world is quite challenging, because it’s not geographically as accessible as other parts of the country.”
That followed an attempt to test the level of interest among private sector firms to run the unit. The idea of CCGs taking ownership of Anglia CSU was floated last summer.
A joint statement issued by the CSU, the Norfolk and Waveney CCGs, and NHS England said: “Like all new organisations, there have been some challenges within the CSU, but the CSU has also delivered some high quality work. The CSU in its present form, one of the smallest in the country, always needed to find a partner for it to be sustainable into the future.
“The work that the project team (consisting of the CCGs, with the support of the business development unit and the CSU) are about to embark upon will involve running a transparent process to select a CSU which will ultimately take on the responsibility for delivery of support services for the local CCGs, delivering some services locally in Norfolk and Waveney.
“This is all about looking to the future - ensuing that there is a greater scale and resilience for these services but crucially a focus on local customer needs.”