Another CSU on the brink of extinction

NHS Anglia Commissioning Support Unit is looking at options for merging with another CSU.

The CSU, which provides IT and other support services to clinical commissioning groups in Norfolk, Norwich, Great Yarmouth and Waveney, has decided it cannot operate on its own.

A spokesperson from NHS Anglia CSU told EHI that the decision had been made to look for options to collaborate with another CSU.

“This summer, Ernst and Young worked with Norfolk’s clinical commissioning group customers to look at future options for the structure of NHS Anglia CSU,” said the spokesperson.

“This exercise concluded that the preferred option is for NHS Anglia CSU to work more closely with another CSU. This solution has been put forward for a number of reasons, primarily that Anglia is one of the smallest CSUs in the country.”

Jonathon Fagge, chief executive of NHS Norwich CCG, wrote in his blog last weekend that CCGs have been unhappy with the service delivered by the support body.

“For CCGs in Norfolk the issues are relatively simple: it’s too expensive, its delivery is inconsistent, and there is no confidence that it can deliver high quality services that are good value for money without radical change,” he says.

The CSU spokesperson agreed that it needed to provide a more stable service. “It needs to be more resilient to ensure stability of provision and to be able to deliver the improvements in value for money that CCG customers will expect, which requires scale.

“It is not yet known which CSU Anglia will work with, or what the exact nature of the arrangement will be. However, a decision is expected to be made in the next seven to eight weeks.”

The spokesperson added that while the transition is taking pace, the CSU will focus on business as usual.

The creation and development of CSUs has been troubled from the start. The idea of CSUs was not mentioned in the ‘Liberating the NHS’ white paper that brought about the latest round of commissioning reforms.

Instead, it emerged as strategic health authorities and primary care trusts were disbanded and CCGs set up with very small management budgets.

The idea was that CSUs would take over finance, HR, IT and other functions, at least for a period of time, after which they would be ‘externalised’ and CCGs given more choice of provision.

Originally, the Department of Health estimated that between 25 to 35 CSUs would be set up. However, as the 1 April 2012 data for them to become operational came closer, the number fell steadily.

On 1 April, only 19 CSUs were in operation, after West Yorkshire and South Yorkshire and Bassetlaw CSUs merged close to the deadline in March.

EHI reported earlier this year, that another CSU, Surrey and Sussex, would close down after coming to the conclusion that it is “not sustainable as an independent CSU.” The latest news from Anglia will take the total number down to 17.