Recommendation 128

Commissioner access to experience and resources

Commissioners must have access to the wide range of experience and resources necessary to undertake a highly complex and technical task, including specialist clinical advice and procurement expertise.

Commissioning support services have been developed to provide commissioners with the range of capacity and expertise required to commission effectively.

Commissioning comprises some activities for which the statutory commissioning body must retain ultimate responsibility, but there is also a range of key support functions which the statutory body not only does not have to undertake itself, but for which it may be more effective and efficient to secure externally. These are known as ‘commissioning support services’. Commissioning support services typically include:

  • Health Needs Assessment
  • business intelligence
  • support for redesign
  • communications and public and patient engagement
  • procurement and market management (agreeing contracts)
  • provider management (monitoring contracts)

Provision of commissioning support services is currently dominated by 19 commissioning support units, created from primary care trusts and hosted by NHS England and the NHS Business Services Authority until 2016.

NHS England will prioritise the further development of the expertise and resources required in its Commissioning Support Services Strategy, and in underpinning products such as quality standards, continuity of service, and procurement vehicles.


NHS England is introducing a Lead Provider Framework agreement for commissioning support services to ensure that clinical commissioning groups and other commissioners have a choice of the best and most efficient commissioning support suppliers. For further information on the Framework see recommendation 127.