Risks facing the commissioning board: in its own words

Design of the NHS Commissioning Board reveals:

• “The NHSCB running costs budget for 2014/15 will be £492m. This represents a reduction of around 50% for the NHSCB. It is expected that additional transitional funding will be available in 2013-14, the board’s first full year of operation. This will be used non-recurrently and not played out into recurrent directorate budgets.”
• “The role of the [regional] sector[s] will be relatively ‘narrow’, and will be an integral part of the operations directorate. The staff working in the sectors and local offices will be part of the operations directorate. Other directorates will not have staff formally attached to the sectors or local offices.”
• “The NHSCB will follow an “hour glass” model, in which the sectors are relatively small and sub-national influence in the Board is concentrated at local office level.”
• “In most cases there should be no more than five layers of management in each directorate, from national director to the ‘front line’. The exception to this will be the Performance and operations directorate, where an additional layer (or layers) will be required to link through to the local offices.”
• “The operations directorate functions in London will be organised on a slightly different basis to the other three sectors. London will have an integrated mix of sector and local office structures, recognising the distinct pattern of services and relationships with partners and stakeholders in the capital.”
• “A range of national functions are currently hosted by the SHAs. Work is currently taking place, through the SHAs, to confirm which of these will need to be funded from the Board’s running costs.”
• “Responsibility for specialised services will not sit wholly within one directorate. Rather, all parts of the Board will play an important role in the arrangements for these services, providing an exemplar for [the board’s] matrix working. Within this approach the board will maintain a clear focus on the entire spectrum of specialised services, with a single national director taking overall responsibility for co-ordination.