NHS England has appointed Jonathan Fielden and Arvind Madan to lead its work on specialised services and primary care respectively.

Meanwhile, Cally Palmer, chief executive of the Royal Marsden Foundation Trust, has been appointed national director of cancer services.

Dr Fielden, previously medical director at University College London Hospitals FT, will be director for specialised services. Dr Madan, currently partner and chief executive at London’s Hurley Group GP provider, will be director for primary care.

Jonathan Fielden

Jonathan Fielden will also serve as a deputy medical director in Sir Bruce Keogh’s medical directorate

Both Dr Fielden and Dr Madan will also serve as deputy medical directors to national medical director Sir Bruce Keogh, as part of his medical directorate.

Dr Fielden will be responsible for developing a specialised services strategy for NHS England. This area of commissioning faces a number of major problems, including rapidly rising spending, demands for new expensive treatments - including under the cancer drugs fund - and concerns about its decision making processes.

Dr Madan will lead on primary care commissioning. This includes work on reform and modernisation of the primary care provider model, and developing co-commissioning with clinical commissioning groups. His work with the Hurley Group has been held up as nationally leading - for example, in using technology to enhance access.

The new appointments represent a reorganisation of NHS England’s national structure. The national director for commissioning operations, who is expected to be appointed in the near future, will be responsible primarily for performance, planning and CCG assurance.

Responsibility for direct commissioning will move from the commissioning operations directorate to the medical directorate, under the two new directors.

It is understood that Ros Roughton, currently responsible for direct commissioning, is moving to the medical directorate, and will work alongside Dr Madan.

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