New structure could herald a profound shift in the way the NHS is led
24 May 2018
NHS Improvement and NHS England have published a board paper setting out how the two organisations will work together to provide more joined-up, effective leadership. Proposals include:
- a new NHS Executive Group, co-chaired by the two CEOs and comprising membership of all national directors and regional directors from the two organisations
- the creation of seven integrated (ie spanning both NHSI/NHSE) regional directors
- the regional teams will decide when and how to intervene in systems, providers or CCGs in their region, or - where required - make the relevant recommendations to the national NHS executive group.
Responding, the chief executive of NHS Providers, Chris Hopson, said:
“This could herald a profound shift in the way the NHS is led at a national and regional level, with important implications for trusts and their leaders.
“Trusts would welcome less duplication and better co-ordination between NHS Improvement and NHS England and a single, aligned, leadership for the NHS.
Trusts would welcome less duplication and better co-ordination between NHS Improvement and NHS England.
“They will also welcome NHS Improvement’s intention to shift its primary focus from regulation to improvement support, recognising there is potential tension between the two roles.
“The creation of seven integrated regional teams with wider responsibilities and greater power offers significant opportunities too.
“And hopefully there will be efficiencies and cost savings which could divert into front line care.
“We also welcome the proposal to create a new NHS Assembly which will be the forum that oversees and co-designs the proposed upcoming NHS 10 Year Plan, an important step in ensuring frontline engagement.
“But there are some big risks to manage here too.
“This must be a genuine joint venture of two equal partners. Trusts have been asked to carry significantly more financial and operational risk than they believe is appropriate and this would have been a lot worse without NHSI’s voice in the setting of the provider task. The single joint finance director, for example, must be committed to setting financial and operational performance requirements that providers can actually deliver.
The single joint finance director must be committed to setting financial and operational performance requirements that providers can actually deliver.
“And while regional directors will be better placed to offer trusts support, there is also more potential for unwelcome interference.
“There is also the risk, by bringing these organisations closer together, of creating an unmanageable monolith.
“Success will depend, in large part, on following through on the commitment to devolving power to the regional directors who, in turn, must have the expertise and credibility to work well with trust leaders.
“It will also require a realistic planning, finance and performance framework, and a genuine commitment to involve frontline leaders in developing the detail of future plans.”