For years, many NHS organisations have relied on Commissioning Support Units (CSUs) for operational and IT support services, right through from infrastructure and service desk support to digital systems and procurement.
Now, as the NHS moves towards a more streamlined operating model, that structure is changing. CSUs are being closed in an attempt to simplify the broader NHS landscape while giving ICBs more control over how services are supported across their regions.
The good news is that the change is creating new opportunities for more flexible, locally focused IT support models that better reflect the needs of individual organisations. But alongside that greater control comes an important question: what will this mean for the future of IT support within ICBs?
More control, more responsibility
One of the biggest changes facing ICBs is the loss of access to the large-scale administrative, IT and specialist support services historically delivered through CSUs. While ICBs will have greater freedom to shape their own digital strategies, they will also carry more responsibility for how systems are supported, secured and maintained. And that pressure couldn’t come at a more challenging time.
In March 2025, NHS England informed ICBs that they needed to reduce their running and programme costs by 50% as part of wider efficiency targets. It’s not surprising, therefore, to learn that more than 97% of NHS trust, ICB, and general practice leaders say the financial challenge for 2026/27 will be just as difficult – if not more so – than the previous year. Right now, ICBs are being asked to rethink their IT support models while operating with tighter budgets and fewer resources.
An opportunity for ICBs
Despite the challenges, the transition away from CSU-led support also creates opportunities. ICBs can rethink what effective IT support should look like, and ensure their support works for them.
Some organisations may choose to build more capability internally. However, with more trusts and ICBs expecting workforce reductions across 2026/27, hiring new, dedicated staff to manage IT in-house isn’t always an option.
This is leading ICBs to explore alternative support models that provide specialist expertise without the long-term overheads of expanding internal teams. For many ICBs, this creates an opportunity to move towards more proactive, secure, and efficient solutions like managed IT support arrangements.
Supporting the Post-CSU transition
The CSU changes are definitely creating uncertainty around day-to-day IT support, Microsoft 365 management, cybersecurity and ongoing infrastructure oversight. But it doesn’t have to be complex.
PSTG helps NHS organisations move away from older, now defunct support models towards a more modern approach. From managed Microsoft 365 services through to ongoing infrastructure and security support, we help ensure that IT systems remain secure, supported, and properly maintained. We do this without adding to the pressures and uncertainty already being experienced by NHS teams.
As NHS structures continue to evolve, having the right technology partner in place can help ICBs manage the transition with greater confidence and stability, knowing their systems are supported.