How important is it that commissioning support services are set up along commercial lines? According to NHS Commissioning Board plans exclusively obtained by HSJ, it appears to be very important indeed. 

One of the documents declares: “This is about building new businesses, not new organisational forms”. The word “businesses” is underlined.

This is a stiff test for many emergent CSSs – mostly staffed by former primary care trust staff who had no desire to work in a commercial organisation. The unforgiving nature of the assessment process contrasts sharply with the “developmental journey” approach to authorising commissioning groups.

Failure for CSSs in some regions seems certain, creating a ready-made market for those passing muster.

Plunging into a fully competitive market – if that happens – seems hasty given some CCGs would prefer to source support services from NHS organisations, and the uncertainty still surrounding the reforms.

It must also be asked whether a support services market would be set up in this way unless the main objective was to minimise redundancy costs.

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