Sir David Nicholson has begun to set out how the NHS Commissioning Board will operate, warning it will not be “shy” to lead, and will involve itself in all aspects of commissioning.

In a letter to NHS leaders today, Sir David says commissioning consortia “will need support and direction in order to carry out [their] critical role effectively and providing and shaping that support will be the central role of the NHS Commissioning Board”. He was appointed as the first chief executive of the board in December.

His letter says he will set out the “high level structure” of the board in the spring, along with “proposed structures for the new Department of Health”. The appointment of a board chair is underway and Sir David said he wants to have an executive team “in place by October”.

Sir David says: “The board will be confident about leading change at scale - not through top down diktat, but neither being shy about claiming a leadership role. This national role of the board is a vital aspect of the new commissioning system, although it has not been the main focus of public discussion and debate.

“The board will safeguard the core values of the NHS, ensuring a fair and comprehensive service across the country and promoting the NHS Constitution. It will champion the interests of patients, using choice and information to empower people to improve services. It will directly commission a wide range of services, including both local primary care and the most specialised services in the country, meaning it will have direct responsibility for around £20bn of commissioning spend.”

Sir David says the board will “provide support to consortia and provide a national framework for local commissioning. It will offer a spectrum of support, from empowering and facilitating success, to intervening to support consortia in difficulty.”

He adds that the board’s role will include providing leadership to the commissioning system, describing the challenges and priorities for the system, supporting consortia to achieve authorisation, and operating a rules-based intervention regime to ensure consortia remain fit for purpose.

It will also provide leadership and support for quality improvement, set the Commissioning Outcomes Framework, design the quality premium for consortia, and translate national standards into commissioning guidance and standard contract and pricing mechanisms for local use.

The letter also makes it more clear that PCT clusters will become part of the commissioning board, and that it is Sir David’s intention it will operate as one organisation.

He says: “This national consistency [in forming clusters] is important in order to keep a tight grip on finance, performance and quality during the transition, and because the end-point will be a single organisation covering the whole country and supporting a vibrant system of local consortia: the NHS Commissioning Board.

“That is very different from the current system of separate statutory organisations, and we therefore need to develop a more consistent and uniform approach during the transition.”