Checkpoint 2 takes out more CSSs

Three NHS commissioning support services have been scrapped after failing the latest ‘checkpoint’ review by the NHS Commissioning Board.

The two CSSs that were proposed to serve West Mercia and Devon and Cornwall, and the proposed national NHS Communications and Engagement Service, failed on two or three of the Checkpoint 2 domains, which focused on business plans and customer focus.

Strategic health authority clusters will now work with primary care trusts, clinical commissioning groups, and CSSs to develop alternative plans for West Mercia and Peninsula.

Meanwhile, an ‘alternative business model’ will be developed for communications. This may mirror the plans drawn up for other ‘at scale’ services, including some data warehousing and analysis.

These will be provided by some CSSs on behalf of others; although the NHS CB has stressed that this will not necessarily do away with the need for local staff.

A further nine CSSs have been told they have issues that require “rapid management”, while the remainder are being allowed to proceed with only “medium to low” issues to address. Another round of checkpoint reviews will take place in August.

CSSs have become an increasingly important part of the latest round of NHS reforms, although they are not mentioned anywhere in the ‘Liberating the NHS’ white paper or the Health and Social Care Bill.

They are intended to provide a range of support services to CCGs, which will be extremely ‘light’ organisations, and which will have just £25 per head of registered population to spend on ‘back office’, infrastructure and support services.

However, a number of CCG leaders have complained that their primary care trust clusters are forcing them to accept the CSS offer, when they would prefer to buy services from the private sector.

The issue has emerged as key aspect of how much ‘autonomy’ CCGs will have to make their own decisions. Dame Barbara Hakin, who has been leading on their development for the NHS CB, told an NHS Alliance / NAPC conference recently that this was one reason for Checkpoint 2’s focus on customer issues.

She warned that the checkpoint would see more CSSs fail. The NHS CB will host CSSs until 2015-16, at which point they are meant to become stand-alone organisations.

The BMA is concerned that many will move into the private sector, privatising key aspects of the commissioning process.

The remaining CSSs are: South Yorkshire, Staffordshire, North West London, Arden, North Yorkshire and Humber, Kent and Medway, Merseyside, Cheshire, Warrington and Wirral, Norfolk and Waveney, North East, Central and East London, West Yorkshire, Best West, and CSS South.

The remaining CSSs with issues to manage are: Greater East Midlands, Greater Manchester, Cumbria and Lancashire, Birmingham and Black Country, Essex, South London, Surrey and Sussex, Central Southern, and Hertfordshire.