Published: 16/09/2004, Volume II4, No. 5923 Page 5

The health service's corporate 'university', NHSU, is preparing itself for a full-scale reorganisation of its 'structures, process and people' following a review of the fledgling institution, HSJ has learned.

A series of memos from NHSU director Bob Fryer warn staff they should be prepared for significant changes in order to justify the organisation's existence to stakeholders, following the review of education arm's-length bodies by NHS Appointments Commission chief executive Sir William Wells.

The review, which reported to ministers at the end of July, has only been seen by a handful of key people, including Mr Fryer and John Bacon, Department of Health group director for health and social care services delivery and the NHSU's DoH 'sponsor'.

Mr Fryer is due to meet Mr Bacon today to discuss its implications.

Ministers are also expected to hold initial discussions on the review this week, and a response is expected in 'early October'.

But Mr Fryer has already sent staff a series of memos, seen by HSJ, which make clear that the DoH 'action plan' based on the review will call for fundamental restructuring that 'will not be achieved simply by tinkering around the edges of our current operations'.

Mr Fryer says staff should expect the organisation to be required to deliver 'more clarity about the NHSU's role and status in securing the delivery of learning for health and social care', find ways to 'focus our activities so as to deliver more effectively' and, crucially, 'convince our stakeholders - in health, social care and higher education - about the need for NHSU'.

He continues: 'This process of change is likely to involve structures, processes and people.'

In a further memo sent to staff this week, Mr Fryer invited them to attend a briefing in London next week following today's meeting with Mr Bacon. The meeting is to discuss the implications of the review, which he says 'raises issues for NHSU primarily around delivery, our focus and our relationships with the NHS'.

He adds that both he and outgoing Modernisation Agency director David Fillingham support a previously proposed merger with the agency 'in principle' and that these discussions have been 'reflected' in the Wells review.However, he stresses that a merger 'is most certainly not a done deal, ' and there are issues for ministers yet to decide.'

The Wells review, part of the wider review of arm's-length bodies unveiled by junior health minister Lord Warner in July, was conducted amid mounting NHS criticisms of the fledgling education provider, which has intensified since workforce development confederations - and their multi-professional education and training budgets, worth£5bn - merged into strategic health authorities.

The criticisms have centred on the organisation's failure to communicate their role effectively and encourage top-level support.

'It became clear that although the NHSU had laudable principles, they got lost because it didn't know who its champions were and how it would communicate with the NHS, ' said one WDC chief executive, who added its stumbling block has been 'naivety about who is in charge and who you have to woo and win'.

Another WDC chief executive said the organisation failed to answer fundamental questions about its role and purpose.

'People were saying we have a lot of higher education institutions, do we really need another one?

And what was it trying to be - a commissioner, a provider or a broker?'

Sources close to NHSU have told HSJ that, at the very least, the organisation will probably be advised to ditch its bid to gain the royal charter as a university - which has been seen as irrelevant to its original aim of being an accessible source of higher education for 'disenfranchised' parts of the NHS workforce.

One senior NHS workforce source predicted such a move would require a new director as 'Bob Fryer came to be vice chancellor of an NHS university - if there is not going to be one, he will not stay.'

Mr Fryer and NHSU declined to respond to speculation.