The Department of Health needs to clarify and better communicate significant elements of its reforms, or risk implementation problems, according to a cross-government review.

The 2011-12 Capability Review and Action Plan for the DH was published today by the Cabinet Office. It is compiled by the DH and reviewed by the Cabinet Office and intended to give an honest assessment of its capability.

The overall assessment of leadership, strategy and delivery highlights weaknesses and five out of nine headline areas are rated “amber-red” on a red-amber-green scale. However, the department has maintained performance since the last review in 2009, it says, and is being “against a much tougher climate and an exceptional set of challenges”.

It says the DH is directly affected by the government’s reforms adding: “Functions will change, all jobs in the DH are affected, but about a third will either be moving or will not exist at the end of 2014.

“Our ability to lead and manage the transition and handle risks to delivery will be tested like never before.”

The areas which are rated poorly and require improvement highlight policy uncertainty. It says the department “has made significant progress in setting clear strategies”.

However, it adds: “External stakeholders are unclear as to how and when the new policies will translate into practical change…

“Some issues, such as education and training, are still to be resolved, with uncertain consequences for the overall health landscape. This state of considerable flux is causing concern, as well as limiting stakeholders’ ability to plan for the new paradigm.”

One of the specific requirements is to publish a “system map” with a “short factual account of what each organisation does and how they all fit together”.

The review says the DH is “known for its strengths in delivery” but says: “The pace and scale of change means that organisational and delivery models are being developed as legislation is going through Parliament, and they therefore carry some uncertainty and may be subject to change. That said, the department will need pace, clarity and consistent communication to explain how the new system will work and agility to adapt as necessary.”

It also says there is a “clear challenge… to ensure that [the DH’s] capabilities to plan, resource and prioritise are as robust for public health and social care as they are for the NHS, whilst recognising the implications of different accountabilities in local government.”

The document says work on addressing many of the issues is already underway.

Commenting on the report, a DH spokesman said: “Since the last capability review our skills, resources and capabilities have either improved or stayed the same. This year’s review recognises the department’s strengths: it is agile and responsive, known for its strengths in policy making and delivery as well as its ability to solve complex problems.

“However, the scale of the challenge facing the department has increased substantially - for example, with increasing demand for services and rising public expectations for better quality - so it’s not surprising we found there are areas where we can do better.

“That’s why we have put together a comprehensive action plan that covers all the areas that have been identified as needing improvement.”