Jim Easton, DoH director of improvement and efficiency, said around 40% of the £15-20bn saving required by 2014 will come from cutting manager numbers and pay freezes across the NHS.

Improving hospital performance and ‘massive’ reductions in NHS estates and pathology services will make up a further 40%, said Mr Easton.

The final 20% must come from ‘deep service change’ for which GP commissioners will be responsible, he said. The estimate seems to contradict earlier warnings from DoH advisers that commissioners would have to generate the full £20bn saving.

Mr Easton, speaking at the NHS Innovation Expo conference in London, predicted that most consortia would have to buy in support from a group of between 10 and 30 ‘commissioning support agencies.’

These independent agencies will be staffed by ‘the best’ ex-PCT staff, said Mr Easton.

‘There could be as few as ten large commissioning support agencies – the best of PCT staff doing the heavy lifting in terms of things like procurement and contracting,’ he said.  

He predicted around 20% of consortia ‘will commission more effectively than PCTs ever did,’ but the rest would need substantial support.

Mr Easton is leading the DoH Quality, Innovation Productivity and Prevention programme (QIPP), which aims to help the NHS achieve £20bn in efficiency savings by 2014.