London’s central commissioning support body has insisted it is responding to concerns about its cost.

HSJ last month reported Commissioning Support for London’s chief executive Rhona McLeod was on “extended leave” seven months after it was founded.

Clearly when we look forward to next year and beyond we have to be realistic that the investment situation for the NHS has changed

This followed concerns among the primary care trusts which fund the organisation that it was costing too much for what it was providing.

NHS Harrow chief executive Sarah Crowther, who has stepped in as the commissioning body’s executive chair, told HSJ the NHS financial situation had declined since the organisation’s business case was agreed.

She said: “Clearly when we look forward to next year and beyond we have to be realistic that the investment situation for the NHS has changed. We are having to think about future proofing the organisation.

“The context which we work in is changing and flexible. We need to make sure we are flexible in the way we respond. We need to think about the contracts our funders are working within and we need to be sensitive to that. How do we help them do the job they need to do in a very cost effective way?”

Commissioning Support for London comprises seven predecessor organisations, including Healthcare for London, which is leading service reform, and the London Health Observatory.

Ms Crowther said their management had now been merged and it was now consulting with staff on changing their roles to fit into the new structure.

This did not involve redundancies but people changing jobs, she said.

It is prioritising programmes that can help PCTs as investment is cut. In particular it is developing a claims management service.

Ms Crowther said: “CSL can be part of the solution to the financial situation rather than the problem. It is clearly about helping PCTs challenge their acute provider contracts and get some robust discussions in place. Many have traditionally struggled to get their contracts to stick.”

She said services such as claims management, which at present some PCTs buy from private companies for large amounts of money, could be provided within the NHS.