Published: 10/01/2001, Volume 112, No. 5787 Page 4 5

The Department of Health is set to take a back seat in running the NHS, reducing the amount of guidance it issues and handing the reins to the 28 strategic health authority chief executives taking up post from this week.

NHS chief executive Nigel Crisp said the DoH was 'serious about changing the way we manage the NHS', and that by devolving responsibility to the fledgling SHAs politicians and civil servants would from now on take a more arm's-length approach.

But he added: 'Things are being set out clearly now, but it will be 18 months to two years before the new ways of working are embedded.'

With a budget of about£4m each, the new SHA chief executives are starting to appoint their teams of directors, initially from a group of staff who have been ringfenced regionally.

These top teams will start to take over the key planning processes, such as working on the service and financial frameworks, by the end of February.

Mr Crisp pointed out: 'The top teams are being appointed on the basis of current legislation and so the team needs to be the same as those of the current HAs initially, but subject to legislation they will then be able to change.'

He told HSJ that a key role for the SHAs will be to facilitate local health networks - which will also mean changes in relationships and ways of working for acute trusts as well as other parts of the NHS.

This week, the newly appointed chief executives get together for the first time at an induction meeting in London with Mr Crisp and the four regional directors of health and social care. This will be followed by further induction work over the coming weeks in a major development programme to match that already set up for primary care under Barbara Hakin.

The chief executives and their teams will bring their franchise plans to their boards at the beginning of April when they will be formally appointed.

The franchise plans will form the basis of the development of health services for local communities, but will also constitute the formal contracts between SHAs and the DoH.

'The plan will have the support and input of the regions and will require close working with the primary care trust boards - the input of PCTs is crucial, ' Mr Crisp explained. 'The PCT people have a unique perspective, but the level of input will vary depending on local circumstances.'

Mr Crisp said that of the 400-plus responses to the Shifting the Balance of Power in the NHS consultation exercise, there was broad support for the aim of empowerment and no reservations about the direction of travel.

The main concern highlighted was the pace of change, with reservations also about the management experience of PCTs, as well as some local worries about how certain functions such as public health would fit in.

But stressing the need for much more local autonomy and creativity rather than departmental edicts, Mr Crisp said: 'We will set the framework and the principles and then most of the practical arrangements will be decided locally.'