The shadow NHS Commissioning Board chief executive Sir David Nicholson has backed calls for clinical commissioning groups to be allowed greater choice of commissioning support provider.

Speaking at the National Association of Primary Care conference in Birmingham this morning, Sir David said: “The idea of CCGs being able to make choices between clusters is a really good one.”

He told the conference that “historically, NHS management has tended looked up the system for its leadership, rather than outwards”.

“We need over the next 12 months or so to embed that customer focus on existing cluster workers, to enable that to be a reality, so that in 2013 you have the opportunity to look at a [customer focused] NHS which can deliver your needs. That’s the cultural change we intend to make,” Sir David said.

He also told the conference he might reconsider the requirement for CCGs to have a secondary care doctor on their board.

Sir David said: “I’m happy to look at that again. If people think that’s not the right way of doing it, and there’s a way of organising it so we avoid the situation that the individual themselves is never in the room when the important discussions [in which they had a personal interest] are had, I’m very happy to think about ways for making that happen”.

The NAPC, in coalition with the NHS Alliance, has called for the CCGs to be allowed to choose between NHS commissioning support units immediately. Opening the conference, NAPC chairman Johnny Marshall called for a culture change in the Department of Health to allow CCGs to be properly autonomous.

Sir David also emphasised that clinical senates should not be seen as “arms” of the NHS Commissioning Board, “doing our business”. He said: “All we’re saying is we want to ensure that it happens. We’re happy to host them - but they’re there to support you locally.”

He said the principle of CCGs being able to organise themselves was important, “but we have to be realistic about some of the CCGs that people are talking about. We have to think about are we setting them up to fail at the beginning?”

Sir David said reconfigurations, including closing hospital services and providing more care closer to home were “mission critical” for the NHS, and that the failure regime for trusts “will be used”.

The Department of Health will set out PCT allocations a week after the NHS Operating Framework is published on 24 November, Sir David said. The additional document will include “indicative budgets for individual CCGs”, and how running costs would be divided between councils, the board, and CCGs. The document will also give details on the controversial “quality premium”, which will provide financial incentives for good performance in commissioning.