NHS England Announces Commissioning Support Framework – Winners and Losers

At the end of last week, NHS England announced the successful bidders for the commissioning support services framework. This gives clinical commissioners a range of options for support services of various types.

“In February 2014, NHS England invited organisations to come forward that were capable of bringing together end-to-end support services, such as back-office finance and HR, GP IT services, contracting, engagement and business intelligence.”

So some of what these organisations will do falls in our procurement commissioning space, without a doubt. Up until now, much of this work has been carried out by CSUs (commissioning support units), formed from staff who used to carry out similar work in the old strategic health authorities. The CSUs basically had to bid to get on this framework in order to have any sort of future.

There are three Lots to the framework. Lot 1 (end to end commissioning support); Lot 2A (medicines management) and Lot 2b (supporting Continuing Healthcare and Individual Funding Requests). Lot 1 looks like the big one.

Looking at the list of successful bidders, the first interesting point is that it has not been the bloodbath for the CSUs that some expected. There are some losers - the North-West and Yorkshire & Humber CSUs have now got very uncertain futures, missing out on the major Lot 1 list. Mergers or assimilation into their CCG clients is likely here.

But most existing CSUs are represented; 5 are on all 3 lots. They are the newly merged South, South West & Central Southern CSU; Midlands & Lancs; North East London; North of England; and Greater East Midlands & Arden.

And there are only three private-sector organisations; all of them have a place in Lot 1, two of them in Lot 2 and none in Lot 3. MBED are in Lot 1 only – a consortium of Mouchel, BDO, Engine and Dr Foster. Capita (no surprises there) makes it into Lots 1 and 2; as does Optum. That organisation is part of the huge US-based but increasingly global United Healthcare Group – until recently, the employer of Simon Stevens, now CEO of NHS England. (Move along there, nothing to see here ... )

Two local authorities, NHS Shared Business Services and a one further private bidder were invited to tender in August but did not make it through. What is perhaps surprising is the lack of any of the consulting / BPO firms (except Capita). Some thought that the likes of McKinsey and PWC were likely to be big players in this market. Perhaps they see more to be gained in working for the CCGs in different roles; or perhaps they proved too expensive in the context of this competition.

And bear in mind that the CCGs are not mandated to use this framework. They could choose to look elsewhere for the support they need, or indeed insource and do it themselves; some are already doing that. Equally, if they do use the framework, one assumes they will have to run “mini-competitions" to choose between the providers on the list, so there is no guarantee that the organisations on the framework will have a successful future. But it is a lot better to be on the list than not!

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