• Scrapping of regulation department will be part of radical rebuilding of NHS Improvement
  • Plans will affect around 140 staff
  • Changes are part of a new focus on supporting and improving trusts
  • Formal regulatory powers will move to new regional directorates, which will be “most significant regional entities we’ve had for a number of years”

NHS Improvement is to scrap its regulation department – with its responsibilities largely devolved to seven new regional directors.

In his first major interview since taking over at NHSI, Ian Dalton said new regional directorates – which will be jointly operated by NHSI and NHS England – will become the “most significant regional entities we’ve had for a number of years”.

He said the changes are being made as part of a radical rebuilding of his organisation, which will be more focussed on supporting and improving trusts, alongside its formal regulatory functions.

To reflect this new focus, he said there needs to be a “mindset change” within the organisation and NHSI is “not going to have a regulation department in future”.

Mr Dalton added: “As a fundamental purpose it struck me as odd that we were described as the sector regulator. That might have been the case when Monitor was in its early days but it’s not the mindset I think we have to express going forward.

“I came with a view that we were fundamentally to improve the NHS and provider sector. It’s what it says in the name, and that’s what I think we should be doing. 

“This is in no way to denigrate some of the fantastic people that we’ve got in the regulation department who will continue to be important to us, but it’s important to send a signal about the mindset of the organisation we’re trying to be.”

The regulation department, which carries out formal interventions such as placing a provider into special measures, is led by Stephen Hay and has around 140 substantive members of staff. The majority of these staff are expected to be redeployed across the system. Asked about a potential reduction in posts as a result of integration work with NHS England, Mr Dalton said that plans for the future workforce between the organisations had yet to be drawn up.

NHSI’s regulatory functions under the 2012 Health and Social Care Act will still have to be discharged in relation to mergers and formal intervention, and Mr Dalton said they will be routinely delivered by the new regional directors, with some remaining functions split between national teams.

Mr Dalton, who led a strategic health authority in the north east before moving to leadership roles at NHS England and Imperial College Healthcare Trust, said of the regional posts: “These are the most significant regional entities we’ve had for a number of years…

“I think they are different though [from SHAs], we’re not recreating SHAs [which were scrapped in 2013]. The regional directors will not be running individual organisations but will be part of an integrated national management team, part of an executive team within an organisation which is effectively a joint venture led by two organisations [NHSI and NHS England].

“This is a process of devolution. It’s fair to say many decisions about the oversight and support of the NHS and organisations within it have been taken in London regardless of where the recipients of that decisions are [and] I don’t think that’s been to the NHS’s advantage.”

Although the regional directors will take on the formal regulatory functions, Mr Dalton, said their first move will be to “try and drive improvement rather than use the hard end tools of regulation”. He said the posts are still planned to be filled in September.

On the wider integration work between NHSI and NHS England, Mr Dalton said it was “not driven by a need to release the very small costs of our organisations,” but suggested it would still help to meet routine cost improvement targets.


NHS regional directors to be given regulatory powers