More than half of PCTs used private firms or consultants to help commission services in 2008/9, a GP newspaper investigation has found.
In addition, a fifth of PCTs use private companies to develop, write or improve their strategic plans, the investigation shows.
Data obtained from 64 PCTs under the Freedom of Information Act show that they paid an average of £284,329 each to private firms in 2008/9. PCTs used an average of four firms each to provide advice or support.
Fourteen PCTs admitted a private firm was paid to write, develop or improve their annual or long-term strategic plans.
Some PCTs paid private firms huge sums for help. Birmingham East and North PCT paid data supplier Dr Foster more than £990,000 as part of a plan to cut health inequalities.
GP newspaper also found that two SHAs - NHS East of England and NHS North West - employed firms on behalf of PCTs to help develop their strategic plans.
In addition, PCTs are spending tens of thousands of pounds preparing themselves for the scrutiny of the DoH's World Class Commissioning (WCC) panel. Five PCTs and one SHA - NHS North West - paid private firms to conduct mock interviews to prepare board members for their WCC assessments.
The revelations come as a Royal College of Nursing investigation found the NHS spends £350 million a year on management consultants, a third of the total spending on QOF.
Dr David Jenner, practice-based commissioning lead at the NHS Alliance, said it may be effective for smaller PCTs to outsource highly-skilled work but PCTs should 'be able to write their own plans'.
'At a time like this we need co-operation, without paying for all the additional costs involved in the private sector, like their advertising,' he added.
PCT Network director David Stout said the findings were not surprising, because PCTs were encouraged to use private sector support. He warned that boards 'cannot outsource responsibility for strategy' even if they had external help to write it.
Dr Jenner said if a company's contribution to a PCT's strategy was not clear, it could be seen by the public as a deception.
- 22% of PCTs use a private firm to develop their annual plans
- 52% of PCTs use private companies to assist with commissioning services
- £284,329: Average cost for PCTs that used private firms to help with commissioning in 2008/9
- £350 million: Amount spent on management consultants each year by the NHS (Source: Royal College of Nursing)