• New NHSE/I common operating model must deliver 20 per cent efficiency saving
  • New model will be overseen by 20 member executive group
  • Despite goodwill on both sides, bringing together the two “very different” organisations will be “very challenging”, boards warned

NHS England and NHS Improvement must cut their costs by 20 per cent through developing a new joint operating model, according to plans discussed by senior figures today.

The paper outlining how system leaders were approaching the development of the new single operating model was presented to a “meeting in common” of leaders from both organisations in Skipton House, London.

The paper, entitled Next steps on delivering a single operating model and shared culture, said: “Following the funding settlement and ambition for the long term plan, we must have a sharper focus on improving productivity and efficiency…

“Both organisations have committed to an overarching set of financial principles, within a 20 per cent shared efficiency envelope, to ensure the corporate, regional and local ‘end to end’ design work delivers the efficiencies required.”

The bodies have a combined annual budget of approximately of £686m - £508m for NHS England and £178m for NHS Improvement.

It added that the new aligned leadership would comprise a 20-member “NHS Executive Group” which “will develop an integrated strategy building from the long term plan for the NHS, as well as a set of clear actions to ensure effective and consistent implementation of these priorities across their teams”.

Many senior board members at the meeting, including outgoing chair Sir Malcolm Grant, spoke warmly about a sense of growing co-operation between the two organisations.

But NHSE national director Emily Lawson, the project’s senior responsible officer, warned that despite goodwill on both sides, “a lot of people [have told us] over the last two months [that NHSE and NHSI are] very different organisations” and it would be “very challenging to bring them together”.

Ms Lawson said the importance of developing a single culture and joint goals had been recognised but warned “shifting behaviours” was very challenging.

The new model is scheduled to be discussed for final approval by both boards at the end of November.

The paper also reaffirmed an ambition for genuine devolution of power to the regional level. The “locus of decision making will be more focused on the regional directors and their teams,” the paper said.

It added: “The regions will manage the performance of local systems, drawing on the expertise and support of the corporate functions to improve services and support local transformation.”

A second paper also discussed at the meeting gave further details on the new leadership structure.

The paper, Governance model for joint working between NHS England and NHS Improvement, confirmed the structure would be co-chaired by two chief executives.

A set of new single national director roles will include: a single NHS medical director; single NHS nursing director/chief nursing officer for England; single chief financial officer, and a single national director for transformation and corporate development.

The paper added: “[Below the national structure there will be] single regional teams bringing together NHSE and NHSI functions in the regions, led by regional directors with a single reporting line to the two chief executives, and with responsibility for the performance of all NHS organisations in their region in relation to quality, finance and operational performance.”