• NHSE and I to move to single finance and operational regime
  • Will be a single chief finance officer, nursing officer and medical director
  • At present planning, oversight and intervention is split between the commissioner and provider sides 

NHS England and NHS Improvement are moving to a single “financial and operational planning and performance” regime under a shared chief finance officer, they are announcing today

The organisations were due to discuss at a joint board meeting this afternoon the next steps in their attempts to work closer together.

A board paper reveals there will be a shared appointment for several top executive posts:

  • A chief finance officer leading “the integrated financial and operational planning and performance oversight process”. This is contrary to previous expectations that the CFO role would have to remain split because of conflicting responsibilities. However, it means national management of finance and activity – an area of conflicting messages under the separate regimes that have operated in recent years – will be brought under a single director. Paul Baumann and Elizabeth O’Mahony are CFOs at NHSE and NHSI respectively.
  • An “NHS nursing director/chief nursing officer for England”. The current CNO and NHSE nursing director Jane Cummings announced today she would retire this year; while Ruth May is NHSI nursing director.
  • An “NHS medical director”. Kathy McLean is currently medical director and chief operating officer for NHSI while Steve Powis is NHSE medical director.
  • A national director for transformation and corporate development. Emily Lawson currently holds a similar role at NHSE.

Other national directors in both organisations “will take on responsibility for a number of ‘do once’ functions supporting both organisations, with shared governance and oversight”.

NHSI is also creating several new national director roles: chief provider strategy officer; chief people officer; chief improvement officer (improving quality, access and efficiency); and chief commercial officer (estates, procurement and backoffice).

It is not yet clear which current national director roles are being scrapped.

On timing, the paper says “the most senior roles (at a minimum, roles reporting to the two CEOs)” will be decided by September and the next level during the autumn. “We are aiming for all changes to be made by the end of this financial year,” it says.

One of the aims of the joint work is to “reduce administrative costs for redeployment into frontline patient care”. However, it is understood that the number of posts which will be taken out, the scale of any redundancies, is not yet known and is likely to become clear in coming months.

Single planning and performance regime

The board paper says: “We will align all our core processes so that both our internal management and our interactions with the system are conducted once, with clear accountabilities at national, regional and system level.

“This will include establishing a single financial and operational planning process for the health system; a single performance management process and alignment of regulatory interventions.”

At present, commissioner planning, performance and intervention is overseen by NHSE and provider by NHSI.

The paper says the organisations will “establish a single version of the truth in reporting and sharing information about the system”.

It says that recent consultancy work for NHSI on how it should work “identified significant opportunities to refresh the approach to monitoring and managing performance through a greater focus on understanding what improves performance, joint problem solving (not simply upwards assurance) and using data and analysis to identify risks at an earlier stage”.

This “will now feed into a single programme of work between NHS England and NHS Improvement to design our future joint approach to planning and performance, including the interface between regional teams and local health systems [sustainability and transformation partnerships and integrated care systems], trusts and CCGs.”

NHS to return to single finance and performance regime under national finance chief