National support and backing

Local leaders want aircover from the centre to make difficult decisions, take calculated risks and to see through a significant transformation process over several years. IHOs will only succeed as a model in an environment where local leaders feel able to radically transform the way they operate. Once an IHO host provider has been designated, the DHSC and NHS England must sustain support for local leaders to deliver what will inevitably be a complex, multi-year transformation. This will require political and policy stability.

Those involved in the previous vanguard programme expressed frustration that earlier attempts were derailed, in part due to shifting government priorities. They described a centre that became less willing to make difficult decisions and a failure to provide local leaders with the backing they needed to implement the plans that had taken considerable time and resource to develop. 

As Lord Darzi stated in his review: ‘Constant reorganisations are costly and distracting. They stop the NHS structures from focusing on their primary responsibility to raise the quality and efficiency of care in providers.’