• Regional bodies must reflect new, more collaborative approach, Baroness Harding told independent providers
  • Acknowledged complaints NHS was “shutting out” private providers
  • Criticised lack of collaboration in NHS for being worse than “cut-throat” telecoms sector

The NHS’ seven new regional directorates will become fiefdoms “over my dead body”, NHS Improvement chair Dido Harding said last week.

NHS Improvement and NHS England must “very fundamentally” change their culture and behaviour, Baroness Harding said. She added this change needed to be reflected through the whole system, including the new regional layer.

Baroness Harding specifically cited the lack of collaboration within the NHS and with its private, voluntary and social care partners at a conference for independent providers last Thursday.

There was more collaboration in the “cut-throat” world of telecoms than in the “supposedly caring health and social care sector”, the Conservative peer said.

The former chief executive of telecoms giant Talk Talk told the Independent Healthcare Providers Network annual conference: “Over my dead body are we going to create seven regional fiefdoms where we allow people to operate however they feel is right.

“We are creating a matrix where the regional axis is really important… But the national approach is really important too. We need people to operate as a team. That team has got to set some very different values and behaviours from the past… One of them is a willingness to work collaboratively from lots of different organisations.”

The leaders of the seven new regional teams are expected to be announced imminently.  

Baroness Harding said she accepted complaints from independent and voluntary sector providers that they were being “excluded from the conversations [about service provision]”.

“We have to shift that [but] that’s going to take time [because culture change takes years],” she added.

The former Bank of England non-executive director said improving the talent and leadership planning across the NHS was a core priority and had prompted the decision to appoint a new director of people, as set out in board papers published last week.

“I’m quite shocked by the absence of talent planning in the system… You don’t need to just look to the private sector for good talent planning,” she said. “The army does it. The civil service does it. There is no reason why we can’t.”

The NHSI chair pledged to address complaints that the NHS was “effectively shutting out independent, voluntary and social enterprise sector involvement” all over the country.

David Hare, chief executive of the lobby group Independent Healthcare Providers Network, added: “While the ambition to create integrated care is absolutely the right one, we, and others in the health world, have real fears that this vision for integrated patient centred care risks getting lost in a mistaken belief that integration is just about bringing everything into one organisation, with the only people around the table being the incumbent NHS providers… Vital capability and capacity [is being] lost as a result.”

Mr Hare also announced the rebranding of the lobby group, formerly called the NHS Partners Network. 

The move follows an expansion of its remit. Its interest was previously NHS funded healthcare in the independent sector, but it now covers independent providers providing both NHS and privately funded healthcare. It remains part of the NHS Confederation.