The Department of Health has missed its own deadline to publish plans on how it will address a catalogue of corporate failures set out in a government review.

Managers under pressure to meet many DoH-set deadlines and targets have reacted angrily.

The DoH has put back by two months its response to the capability review published by the Cabinet Office in June.

The review slated the DoH's leadership and strategy formation and said it had 'not yet set out a clearly articulated vision for the future'.

The DoH response was that it would 'publish a full action plan' in July. This was signed by NHS chief executive David Nicholson, DoH permanent secretary Hugh Taylor and chief medical officer Sir Liam Donaldson.

But the DoH this week said it needed more time and would publish an outline plan 'shortly' and the full report in September.

Unimpressed

Managers in Partnership chief executive Jon Restell said senior staff would be unimpressed, as they had 'very little slack' on timescales for changes such as reconfiguration.

The delay contrasted with the experience of managers 'pushed extremely hard in the last year in the set-up of new primary care trusts, ambulance trusts and strategic health authorities', he said.

'People in the service will be looking up at the centre and saying 'how much time do they need?''

British Medical Association consultants committee deputy chairman Dr Ian Wilson said the delay was 'alarming' because the response was crucial for the DoH to set out a clear vision for healthcare.

Criticism also came from all political fronts. Dr Howard Stoate, a Labour member of the Commons health select committee, said he was disappointed by the news.

'These are difficult problems that need to be sorted,' he said.

Liberal Democrat committee member Sandra Gidley said health secretary Alan Johnson 'would be in a much better position if he had the response from the DoH now'.

Shadow health secretary Andrew Lansley said: 'The capability review warned that the department lacked an articulate vision and direction for health and social care, but nothing has been done about it.'

More time needed

But NHS Confederation policy director Nigel Edwards called such criticisms a 'cheap shot' at the DoH.

The pace of change, such as the push to devolve power to the front line, poses 'fundamental questions about the nature of the centre and its relationship to the service', he said - and the DoH would need the extra time to address it.

A DoH spokesperson said: 'There will be an outline of the department's development plan available shortly with fuller detail on timetables and deliverables built around the areas for action identified by the capability review report, due in September.

'We have been engaging with staff to help develop the plan.'

The DoH was scored on 10 measures covering leadership, strategy and delivery - but only two measures, both for delivery, indicated positive progress. Attention given to the department's 2,300 staff had not been sufficient, it said, and there was a shortage of skills in supporting ministers.

Portfolio concerns

The delay came to light as worries grew over how portfolios have been split between ministers.

The last NHS Confederation council meeting reported members' concerns over the divisions, particularly responsibility for workforce between health services minister Ben Bradshaw and junior health services minister Ann Keen.

Its report of the meeting also cited Mr Bradshaw's 'huge workload', which includes responsibilities in finance, primary care, commissioning and a non-NHS role as minister for the South West. This could mean 'the new team will have less time to engage with us', the report warned.

Association of Directors of Public Health president Dr Tim Crayford said he was worried public health minister Dawn Primarolo's portfolio, which includes cardiac services, dentistry and reconfigurations, was too large.

Independent Healthcare Advisory Service director Sally Taber said that private sector members were worried about the separation of long-term conditions from social care posing a risk to continuity.

The DoH spokesperson said Mr Bradshaw's first responsibility was to the DoH and the new team was 'working hard, supported by the department, to give every policy the attention and dedication required to drive forward further improvements'.

  • One month after the announcement of Lord Darzi's Next Stage review of the NHS, the DoH said the junior minister had met more than 400 staff as part of a 'nationwide tour' with NHS chief executive David Nicholson.

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