Commissioning support units are likely to have to pay the NHS Commissioning Board less than the 50p per head for hosting services that it first proposed.
Barbara Hakin, national director of commissioning development, has told CSUs that the charge will cover the costs of the CSU transition team at the NHS CB, including its work to set up CSUs as independent bodies.
It will also cover the costs of providing infrastructure services to the 23 proposed CSUs, including payroll, estates, IT and legal services.
Hakin said that the NHS CB is setting up a series of working groups, covering areas that include informatics and human resources, to work on how hosting arrangements between the NHS CB and CSUs will work.
The authority has also awarded a contract to consultancy firm PriceWaterhouseCoopers to explore and appraise “externalisation options” for CSUs.
Although the units are being hosted by the NHS CB initially, it has always said that it expects them to become independent organisations by 2015, and for them to operate in a market for support services.
This has prompted concern from the BMA and other organisations that CSUs could move into the private sector, leading to a ‘privatisation’ of significant elements of commissioning.
However, many clinical commissioning groups have indicated that they would like to use the private sector for IT support and specialist information services.
The NHS CB expects to give CSUs a licence to operate by the autumn. The licences will define the relationship between CSUs and the NHS CB, including the freedoms and delegated powers granted to each unit.
Hakin said CSUs with a higher risk profile would have greater levels of intervention that those with a lower level of risk.
She said CSUs would have governance arrangements equivalent to a board including individuals who could act in a ‘non-executive’ type role.
However, these arrangements cannot legally be called a board, as the CSUs are not yet organisations but part of the NHS CB and its governance arrangements.
The NHS CB said further announcements on CSU managing directors are expected in early September, but where there are strong interim arrangements substantive appointments may not be made until later in the year.
So far 16 managing directors have been appointed after only nine appointments were made in the first round of recruitment http://www.ehi.co.uk/news/primary-care/7897/14-csss-left-without-managing-directors.
The NHS CB is also looking to add to its own, permanent staff. It announced last week that it was looking for 19 senior directors on salaries of more than £100,000 each.
These include four posts dealing with information and data: a chief analyst on a salary of £125,000; a director of intelligence on £132,500; a director of open information on £105,000; and a director of insight on £102,000.
• Commissioning support units were initially called commissioning support organisations and then commissioning support services. The NHS CB has said they should now be known as CSUs, in order to distinguish them from the wider commissioning support services market place.