Large CCGs will be forced to bear the costs of external commissioning support if they want to achieve economies of scale, a DH director has said.

Dame Barbara Hakin, Managing Director of Commissioning Development at the DH, rubbished the view that large CCGs will be able to keep commissioning support in-house, under the health reforms.

"It is my view looking at the running costs is that even the biggest CCG will have to have some level of external commissioning support if it is to obtain economies of scale," said Dame Hakin in a webinar hosted by the NHS Institute for Innovation and Improvement.

Indicative funding allocations for CCGs are thought to be on course to be published this January.

She also described the bill's rule that commissioning support should not come from the NHS unless housed within a CCG as "unreasonable".

"NHS staff should be able to form social enterprises while working in independent companies," she said.

"The National Commissioning Board is considering a proposal allowing it to 'host' Commissioning Support Units for the first two to three years of their lives to allow them to become established."

She warned of 'conflicting priorities' for commissioning GPs splitting their time between clinical and managerial duties, advocating the simplicity being one or the other.