• NHS Improvement executive team names revealed
  • The new organisation, replacing Monitor and the TDA, will today set out how it plans to work
  • Announces new ‘improvement faculty’ and networks for clinical leaders
  • No competition and cooperation director in top team

NHS Improvement has appointed its executive director team, HSJ can reveal. 

NHS Improvement is being formed by joining the NHS Trust Development Authority and Monitor.

Bob Alexander, currently NHS TDA interim deputy chief executive, will be one of two deputy chief executives of NHS Improvement, and will also be its director of resources.

He has previously held finance director roles at the TDA, Department of Health, and strategic health authorities.

Stephen Hay, currently Monitor interim deputy chief, will be a second NHS Improvement deputy chief, and its director of regulation. He has been a director at Monitor since 2014.

Its other national director posts will also be filled by appointees from Monitor and the TDA’s boards. The full list of directors is:

  • Executive director of resources/deputy chief executive – Bob Alexander, currently TDA deputy chief
  • Executive director of regulation/deputy chief executive – Stephen Hay, currently Monitor deputy chief
  • Executive medical director – Kathy McLean, currently TDA medical director
  • Executive director of nursing – Ruth May, currently Monitor nursing director
  • Executive director of improvement – Adam Sewell-Jones, currently Monitor provider sustainability director
  • Executive director of strategy – Adrian Masters, currently Monitor strategy director
  • Executive director of corporate affairs – Helen Buckingham, currently Monitor chief of staff
  • Executive regional managing director (North) – Lyn Simpson, currently regional director, TDA
  • Executive regional managing director (Midlands and East) – Dale Bywater, currently regional director, TDA
  • Executive regional managing directors for the south and London are yet to be appointed

These are the posts which will report to chief executive Jim Mackey, who was appointed in the autumn. There will be no executive director of cooperation and competition reporting to Mr Mackey, as there is in Monitor, although NHS Improvement will carry out the cooperation and competition functions it will inherit from Monitor.

NHS Improvement is today due to publish an overview document on how it will work. It will announce the creation of a “faculty” to support clinical leadership and improvement in NHS providers, with the involvement of surgeon and former minister Lord Darzi, international improvement expert Don Berwick, UCLPartners managing director Sir David Fish and Sir John Burn, a leading clinical geneticist and NHS England non-executive director.

The new national body will say it will work closely with other arm’s length-bodies, at both national and regional levels; and that it will favour supporting providers over regulatory intervention.

Mr Mackey said in a statement: “NHS Improvement will stand shoulder-to-shoulder with the service, whether that is in getting a grip on the financial situation or providing stability and offering support as our NHS seeks to change and improve to meet the needs of its patients.

“Clinical expertise will be at the heart of our work. That’s why we’re setting up an Improvement Faculty to advise and lead the creation of an ‘Improvement Movement’ across the NHS… We’ll also be establishing networks of clinical leaders across the service to work alongside our medical and nursing directors.”

What it means

The first thing many will notice about the line-up of NHS Improvement’s first executive directors is their familiarity.

All of its national board executive posts have been appointed directly from its two regulatory parents, Monitor and the TDA.

The aspirational name given to the new regulator, and some of the rhetoric about NHS Improvement (Jeremy Hunt has said “safety and quality will be at the heart of the new organisation’s remit”), had led some to believe its top team would receive a more substantial overhaul.

Most of those shaping the new organisation would like it to develop a day to day approach which supports improvement in the NHS, leaving behind regulators’ more traditional interventionist and punitive methods. They believe the job can theoretically be done better, and in a different way, than it has been in recent years.

There are some early indications of a potential shift in style: In particular, NHS Improvement appears to be talking and listening more to NHS providers instead of only handing out orders.

Despite the will for change, though, it won’t abandon the normal business of regulation and performance management overnight. The familiarity of its execs reflects this continuity, as well as the fact it is covered by the law on employment transfers.

NHS Improvement has a massive financial mess to address in the NHS provider sector, and is under huge political pressure to make this situation look a lot better, quickly. This might mean more use of some of the old ways of financial management – not less – at least until the immediate crisis subsides.

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