There is a growing expectation that commissioning support staff face further rounds of redundancies driven by cuts to the NHS management budget, HSJ has learned.

HSJ understands some CSUs are anticipating their funding will be cut by up to 20 per cent by 2015-16. This is driven by a reduction in the NHS administration budget revealed in the government’s July comprehensive spending review.

CSU leaders expect it to mean CCGs’ running cost allowance will drop to between £20 and £22 per head of population, from the current £25. CCGs’ running cost budgets are CSUs’ main funding source, so leaders expect the reduction to translate to a 10 to 20 per cent cut to their budgets in two years.

It is understood there is currently significant variation in the ratio of income to staff between different CSUs.

Several senior figures in the sector told HSJ they were looking carefully at their staffing levels and forming judgments about the future shape and size of departments.

One CSU leader told HSJ that they are not expecting to have to make staff redundant, but only because their unit had never been fully permanently staffed.

Minutes of NHS England’s commissioning support committee, considered by the organisation’s board this month, identified that CSUs would need to “rightsize” to ensure they are sustainable in future. The term is commonly understood to mean changing staff numbers.

The commissioning support committee report said: “Members [of the committee] agreed that in order for CSUs to remain competitive in a future market, it is important that NHS England supports their development and rightsizing in order to mitigate potential financial risks in future.

“Members supported the work to assess the scale of rightsizing and to identify options for sourcing the funding.”

NHS England estimated the government’s reorganisation of NHS commissioning had involved 10,000 redundancies between summer 2010 and April this year.

There are currently around 9,000 full time equivalent staff in CSUs.

An NHS England spokeswoman said: “It is important that CSUs have the right staffing and skill mix to remain competitive in the future and we support the need for CSUs to explore ways to find efficiencies in their cost base.”

She said no decisions had been made about how future redundancies would be funded.

CSU leaders confirmed to HSJ that NHS England had not committed to any funding for redundancy settlements.