Commissioning Support Units: Their progress so far

Back office function

The Health Service Journal has published this supplement to highlight the successes of Commissioning Support Units (CSUs), and to discuss their next steps, as they “enter a competitive market next year”, where they have to bid to get a place on the lead provider framework. There has been immense change since CSUs were first launched, in 2010. Originally, there were 95, and that figure was reduced to 23 in 2013, and now there are 15 CSUs in England, with 3 further mergers planned for the future.

Making savings


CSUs aim to help CCGs save money

The aim of CSUs is to help clinical commissioning groups (CCGs) save money by improving:

  • performance
  • provider contract management
  • IT innovation and efficiency in the NHS
  • use of data to identify regular service users and allocate resources effectively
  • the management of service reconfigurations.

Case studies

There are several sections to this supplement:

  • CSU success stories – North of England Commissioning Support Unit’s whole systems approach is just one of the success stories. Their approach has enabled collaboration between health and social care providers, to improve the management of winter pressures, such as an increase in respiratory disorders, or falls, so that services have the capacity to cope during challenging times. Other case studies look at the development of a consultancy to help commissioners improve their services, a programme to improve respiratory commissioning, and “using business intelligence to support good commissioning.”

Case studies share some learning from success stories

  • Good practice in providing support after discharge – with people living longer in England, there is the risk that many of the elderly will be lonely and/or suffering from one, or more long-term conditions, and so it is essential that their needs are catered for. This case study looks at how voluntary groups, such as the British Red Cross can work with CCGs and hospitals, to help elderly people settle back in their own home, following hospital discharge, and reduce their chance of readmittance.
  • Improving treatment by sharing data – Asthma is the UK’s most common chronic illness, and therefore, the way services are provided is crucial to improving outcomes for patients and operating more efficiently. Communication channels must be strongly and clearly visible, to facilitate the sharing of patient data, so that commissioners know where best to effectively allocate resources for asthma sufferers. This section looks at some examples of good practice.
  • Integrated care – this section looks at the various options available as primary and secondary care providers work more closely together. “There is a move towards prime contractor models that financially reward all organisations to act in an integrated way.” One case study looks at how integrated care works for small population living far away from the hospital.
  • The transition from primary care trusts to clinical commissioning groups – this discussion addresses “a shift of emphasis from balancing finances [as was the case with primary care trusts] to improving care [which is the focus of clinical commissioning groups].” Previously, benchmarks would include key performance indicators, while now, they are the services that are being delivered to patients, the quality of care, and the clinical outcomes achieved.


This is an important document for everyone delivering health and social care, including commissioners, health and social care professionals, local authorities, and the voluntary sector. It provides clear outlines of the roles of the providers, the CCGs and CSUs, and offers many practical examples of successful working collaborations and effective data sharing.


Involvement and communication are essential to continued success

As a starting point, you could look through the case studies and see which are relevant to your own populations, and see if they can be adapted to improve service delivery in your areas. If you are bidding to be part of the lead provider framework, then this will give you an idea of what is required and what to expect. The important thing to remember is to involve all relevant groups in the discussion and to maintain effective communication channels.


The NHS’s not so little helper: How CSUs are growing (PDF)
Health Service Journal – commissioning supplement
12 September 2014

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Caroline De Brún

Caroline De Brún

Caroline has been a medical librarian in a variety of NHS and academic roles since 1999, working in academic, primary and secondary care settings, service improvement, knowledge management, and on several high profile national projects. She has a PhD in Computing and currently develops resources to support evidence-based cost and quality, including QIPP @lert, a blog highlighting key reports from health care and other sectors related to service improvement and QIPP (Quality, Innovation, Productivity, Prevention). She also delivers training and resources to support evidence identification and appraisal for cost, quality, service improvement, and leadership. She is co-author of the Searching Skills Toolkit, which aims to support health professionals' searching for best quality clinical and non-clinical evidence. Her research interests are health management, commissioning, public health, consumer health information literacy, and knowledge management. She currently works as a Knowledge and Evidence Specialist for Public Health England, and works on the Commissioning Elf in her spare time.

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