NHS chief executive David Nicholson has promised that the creation of a new senior team within the Department of Health will deliver a 'different kind of leadership to support local NHS staff'.

The restructuring announced this week includes the creation of three posts: a director general for commissioning and systems management; a director general of finance and performance; and a medical director for the NHS.

The new commissioning and service development role replaces the existing DoH commissioning post, which Duncan Selbie left last month, as well as the provider development role held by Andrew Cash.

It is understood Mr Cash, who was on secondment from Sheffield Teaching Hospitals foundation trust, will return there. The new role also takes on aspects of the director of policy and strategy role, held by Bill McCarthy, whose departure was announced last month. However, the DoH will retain a strategy post to carry out the rest of Mr McCarthy's job.

The DoH's current director of finance, Richard Douglas, remains in post with a remit to focus on negotiating with the Treasury for NHS funding needs while the new post 'faces' the NHS.

The new medical director role was designed to concentrate on clinical engagement and 'lead the work' of the national clinical directors, currently the job of chief medical officer Professor Sir Liam Donaldson. Mr Nicholson said Sir Liam would focus on public health and health protection 'as the government's senior medical adviser'.

The new NHS leadership team will consist of NHS chief executive David Nicholson, the three new posts, director general of workforce Clare Chapman, director general of IT Richard Granger, chief nursing officer Chris Beasley, new director general of the commercial directorate R Channing Wheeler and the 10 strategic health authority chief executives.

In a statement for HSJ, Mr Nicholson said a new emphasis on devolving more power to staff and patients required 'different leadership' at the top for what he called 'the third stage of reform'.

'We need a different skill set at national level to support local NHS staff in the task of delivering this transformation on the ground. This was why, last year, the role of chief executive of the NHS was separated from the permanent secretary of the DoH,' he said.

He explained that the focus for the new commissioning role would be 'to manage the environment in which providers and commissioners operate. It will also develop policy for new provider organisations, which the SHAs will implement'.

He said: 'This post should not be interpreted as a move away from the purchaser/provider split but a recognition of the distinctive role the department plays in having oversight of the system as a whole.'

He emphasised the new finance role was intended to 'strengthen the operational grip' on efficiency and productivity. Although the possibility of greater independence for the NHS from ministers and the DoH has long been the subject of speculation, Mr Nicholson denied a connection.