Primary care trusts in the NHS Tees cluster are planning to form a commissioning support organisation with others in the North East, which could extend across the whole of the region and even move into Yorkshire.

The PCTs – Hartlepool, Stockton-on-Tees, Middlesbrough, Redcar and Cleveland – must have got early wind of the news, revealed by HSJ last week, that the commissioning support end point expected in Westminster, and in Quarry House, is about 30 organisations.

The expectation means the average provider will work for clinical commissioning groups covering a population of about 1.7 million – but NHS Tees has a collective population of only about 560,000. The whole of the North East’s population is about 2.6 million.

PCT joint working in the North East region has been more advanced than in others – trusts began to cluster some years ago and have quickly started sharing more services.

Over in Yorkshire and the Humber, commissioning support discussion is focusing on a three way split: South Yorkshire, North Yorkshire and the Humber and West Yorkshire. That would result in population coverage of around 1.8 million – satisfyingly close to that magic 1.7 million figure.

Commissioning support organisations will be the main recipients of staff from PCTs and will fill in the gaps in planning and contracting in the new NHS as required. If they are allowed to take a lead – and this will depend on the character of the NHS Commissioning Board and clinical commissioning groups – support organisations with a population of 1.8 million (let alone 2.6 million) will be a powerful force.