Fourteen out of eighteen commissioning support units are planning redundancies in order to cut costs, an NHS England board paper has revealed.

CSUs, which were set up to provide IT and other support services to clinical commissioning groups, have struggled to find their feet since they were created.

EHI has reported a number of CSU mergers and shut downs over the past year, and NHS England is now working on a new guidance “to support CSUs to move to more autonomous forms.”

The Department of Health initially estimated that between 25 and 35 CSUs could be set up. But the number of independent CSUs has steadily fallen as several of the organisations have merged or set up joint collaborations.

A paper  being presented to NHS England’s board meeting this week, say that CSU committee which oversees the development and assurance of the units has put in place a cost reduction programme “to support CSUs to reduce their costs and strengthen their competitiveness and long term viability”.

“14 of 18 CSUs are planning a mixture of compulsory and voluntary redundancies, two CSUs are planning voluntary redundancies only, and two CSUs (North Yorkshire and North of England) are not planning to make any redundancies,” says the paper.

One of the reasons for the mergers and collaborations is NHS England’s Lead Provider Framework, which was first announced in October last year.

The framework will allow CCGs to purchase commissioning support services on a 'call-off' basis. Up to 15 organisations are expected to be on it, including CSUs, charities and private companies.

This could lead to even more mergers. EHI reported in November last year that North West London, South London and Kent and Medway CSUs were exploring a three-way partnership to secure a place on the framework.

Central Midlands CSU and Staffordshire and Lancashire CSU are also in talks regarding a merger to enable them to be named as a ‘lead provider’ organisation.

EHI reported last week that Central Eastern CSU has decided to close down in October this year. Earlier this year, Greater Manchester and Cheshire and Merseyside Commissioning Support Units announced they are planning a merger.

Should the planned mergers and shut-downs go ahead; the total number of CSUs will be down to 15 by the end of the year.