The NHS England top team is to be shaken up amid a string of departures of less senior directors from the organisation.

Under a raft of changes, its director of policy post, which Bill McCarthy is leaving in coming weeks, is to be replaced by a director of commissioning strategy. The post holder will report directly to chief executive Simon Stevens.

The commissioning development directorate, of which Rosamond Roughton is interim director, is to be abolished, most of its functions transferred to the operations directorate and the post renamed director of commissioning operations.

Dame Barbara Hakin, currently the interim director of operations will become its permanent director.

The remaining functions from the commissioning development directorate will be transferred to the commissioning strategy directorate.

Ms Roughton will join the operations directorate and remain part of the NHS England national director team.

A new post of director of specialised commissioning is to be created, which some hope will appeal to a senior leader working in hospitals.

The changes follow a review of the structure, initiated by Mr Stevens and reported by HSJ last month.

They come as a large number of directors at lower levels in the organisation are opting to leave.

Those who have left very recently or are leaving shortly include regional director for the South of England John Bewick; director of intelligence Chris Outram; director of NHS commissioning (corporate) Ann Sutton; and at least two area team directors. Director of financial control Sheenagh Powell is retiring.

Several other directors are also understood to be leaving, following large numbers of other departures over the past two months. None of the changes were a result of people being made redundant by NHS England.

HSJ understands that NHS England is not seeking to make immediate substantive replacements of area team directors.

This is because the next phase of NHS England’s review of structure and functions will consider the future and functions of its 27 area teams, potentially affecting its director roles.

The review is also examining whether there is any duplication of roles at national level, HSJ understands.

An NHS England spokesman said: “We are one year into the creation of a new organisation. “This is a natural moment for some people to think about doing different things.

“We have some great and important jobs to offer for the next phase in the organisation’s lifecycle and we hope to see talented people stepping forward.”