Commissioning Support Units (CSUs)
Last Updated: March, 2019

Commissioning Support Units are a product of the  2012 Health and Social Care Act . They were set up and originally run by  NHS England  to advise  Clinical Commissioning Groups  (which are supposed to be headed by GPs) on how to spend their budget.

There are 19 CSUs, employing approximately 9-thousand staff with a budget of £21-million to £62-million.

In 2014 a group of five companies comprising multinational health care companies and management consultants including -  UnitedHealth ,  McKinsey , KPMG, Capita EY and  PwC  - formed what they called the Commissioning Support Industry Group (CSIG). The purpose of this group was to bid for the Commissioning Support Unit contracts. The groups secret meetings were chaired by UnitedHealth (the previous employer of  Simon Stevens ).

NHS England set up a lead provider framework for commissioning support services. This was drawn up by the CSIG.

Clinical Support Units were put out to competitive tender in 2016, with the intention of taking them off the NHS books.

Bob Ricketts, director of commissioning support strategy at NHS England, said that there was a lot of interest from commercial providers to take over the running of CSUs.

William Laing of 'Laing and Buisson' (the health care analyst) said:

I can imagine private equity groups are keen on running [CSUs], and I can see that the NHS is probably keen on them being taken over. The government couldn't have made it clearer that CSUs are going to become independent entities by 2016.

The privatisation of CSUs means that private companies have significant influence in how the NHS budget is spent. Therefore we are entering a situation where the private sector is buying private care from itself using the NHS budget. Which might be looked at as step in the direction of  Accountable Care Organisations .