NHS Improving Quality is expected to be substantially cut back and could well be abolished under proposals being considered by a national review of the health service’s improvement organisations, HSJ understands.

The review – led by NHS England deputy chair Ed Smith – was launched in October on the back of the NHS Five Year Forward View. It was a response to the forward view conclusion that “the way in which improvement and clinical engagement happens” in the health service currently can be “fragmented and unfocused”, despite the several hundred million pounds spent on bodies that support this work. Other bodies under consideration by the review of NHS “improvement architecture” include the NHS Leadership Academy, clinical senates and networks, and academic health science networks.


Sources say NHS Improving Quality’s budget for 2015-16 has already been substantially reduced

But several sources close to the review have told HSJ they expect its most substantive recommendation to be to radically scale back, and probably close, the NHS England hosted organisation NHS Improving Quality.

It is understood that if it is abolished, NHS England will look to ensure some NHS Improving Quality staff and expertise are retained in other organisations.

One source said the improvement agency’s budget for 2015-16 had already been substantially reduced, which, although not directly linked to the review, had increased the urgency of the situation and uncertainty for staff.​

Sources said the NHS Leadership Academy had received relatively strong feedback during the review team’s work, and was likely to be retained. It may also take on new work in the “talent management” of very senior leaders in the NHS.

The review may also result in England’s 15 academic health science networks taking on additional responsibilities.

Its findings, which have not yet received final approval, include that AHSNs should in future carry out more work on service improvement. This may be the subject of a subsequent stage of the review, HSJ understands.

The review has also received feedback that the role of the 12 clinical senates hosted by NHS England is very unclear, and that they may not be needed.

However, it is understood NHS England currently intends to retain the senates despite this feedback.

One source close to the review stressed that it was ongoing and recommendations could still be changed.

It was unclear as HSJ published this story how quickly NHS England would approve final recommendations.

Meanwhile, HSJ understands some NHS England staff have been told most of its patient safety functions will be transferred to another organisation, and that safety will in future be the responsibility of a single national organisation.

However, the national commissioning body has said no decision will be confirmed until after the election on which organisation will take on its safety roles or whether a new body will be created to do so.

NHS England chief executive Simon Stevens has sought to give up the functions, with the intention that the organisation can focus on commissioning.

News of the proposed changes comes amid a wider, ongoing internal restructure at NHS England, aimed at reducing costs and making it work better. A consultation was launched in October but the organisation has not yet confirmed its new national structure.

From 1 April, NHS England’s 27 area teams will be replaced by 15 subregional teams, which will work more closely with each other and with its regional teams. This part of NHS England’s restructure is understood to have led to around 300 redundancies to date.