NHS England’s new chief executive today used his first speech in the role to promise rapid progress on integrating care, to offer hope to small hospitals, and to dub past pay reforms a “missed opportunity”.

Simon Stevens

Simon Stevens at Consett Medical Centre in County Durham. April 1, 2014

Simon Stevens, who joins from international health insurance giant UnitedHealth and was previously health adviser to Tony Blair, told an audience in Newcastle that he would spend several months talking to people before setting out detailed plans.

However, Mr Stevens added that there was a “consensus on many of the big things that need to change” and pointed to several priorities.

Indicating a possible focus on changing staff pay and conditions, he identified some past “pay reforms” as a “missed opportunity” and suggested “redesigned jobs, and pay systems that work” should not be seen as an unattainable goal.

Mr Stevens – highlighting what he saw as incorrect “received wisdom” in the health service – said it was possible to have “viable local hospitals that don’t all have to be huge – partly because of different choices about where and how doctors are trained”.

He emphasised service and commissioning integration and said the NHS and local government should “this year” begin testing new ways of “blending health and social care for people with high needs” that “don’t need structural re-organisation”.

“There are many current initiatives to build on, plus some international approaches that we should now try,” Mr Stevens said.

In apparent reference to the idea of merging health and care budgets – something previously floated by shadow health secretary Andy Burnham and others – he cautioned that, “no-one should pretend just combining two financially leaky buckets will magically create a watertight funding solution”.

The incoming chief executive suggested it would be a waste of time to focus on merging CCGs but indicated that empowering some CCGs, and pushing joint commissioning with NHS England, were likely. He said: “We should also be expanding the commissioning impact that high performing [CCGs] can have – and certainly not wasting time on yet another drawn out debate about whether there are too many or too few of them…

“Let’s test new commissioning approaches – including in some geographies and for some services bringing together primary, community, and specialist care.”

Mr Stevens criticised “vain contests” between national NHS organisations, saying they needed to work together, “because the national leadership of the NHS has to be more than the sum of its parts”.

He was appointed in the autumn, ahead of the retirement last week of Sir David Nicholson.