• Senior NHS England and NHS Improvement non-executives to sit on opposite board
  • Joint finance committee is being held to help delivered a shared view of sector position 
  • NHS Improvement chief executive wants to end ”duplication [and] directly contradictory instructions”

NHS Improvement and NHS England have moved to appoint shared board directors, created a joint finance committee, and are seeking to avoid ”duplication [and] directly contradictory instructions”.

At a meeting of NHS Improvement’s board yesterday chair Baroness Dido Harding set out steps to work more closely, with the aim of reducing the regulatory burden.

NHS England’s deputy chairman David Roberts, also chairman of the Nationwide Building Society, has been appointed as a non-voting non-executive director on NHS Improvement’s board.

NHS Improvement non-executive director Richard Douglas, formerly director general for finance at the Department of Health, has taken on the same role at NHS England.

They will be joint chairs of a new joint finance committee across the two organisations, which is aimed at ensuring “both organisations are working from a common understanding of the financial targets and financial performance of the health system as a whole”.

Since 2013, commissioner and provider financial positions have been reported and managed separately, with separate targets agreed with government. This has often led to conflicts between commissioners and providers locally and conflicting messages from the regulators.

NHS Improvement and NHS England are also planning to hold joint board meetings in May and September.

Many NHS leaders have been calling for some time for the two regulators to work much more closely together or to merge.

A merger would require primary legislation - unlikely during this Parliament as the government has no Commons majority. It is also understood that legal advice to the national organisations has said they cannot share their entire board or top leadership – as is the case with Monitor and the NHS Trust Development Authority – because of their very distinct legal basis.

Chief executive Ian Dalton said work was under way on extending joint working in executive teams, referring to joint regional directors recruited in the south east and south west. He said: “I am committed to much better working with NHS England. In addition to our work in the south we have now kick-started a ‘joint venture’ to look at our joint working more broadly.

“We are determined to streamline our activities so trusts don’t get duplication or directly contradictory instructions but also protect NHS Improvement’s distinct role where appropriate.”

He also set out plans to improve “as a matter of urgency” how NHS Improvement operates, noting concern in the regulator’s staff survey.

He said: “Underlying many of the staff survey points is a lack of clarity on our purpose and how different parts of the organisation work together to deliver this purpose. Our structure and operating model underpins this and, as you would expect, I will be addressing these as a matter of urgency.”