• Staff consultation reveals questions over number of proposed executive senior managers at NHSI and NHSE
  • Regulators’ staff “broadly welcome” new operating model
  • New model will require “significant changes” to leadership behaviour

Staff at NHS England and NHS Improvement have raised concerns that the new structure of their organisations will comprise too many senior managers, HSJ can reveal.

The concern was among a number of themes highlighted during the staff consultation into the closer working between the two bodies.

Under current plans, around 50 executive senior manager posts will be cut, reducing the number of such whole time equivalent posts from 373.8 to 325.2.

It comes as NHS England and NHS Improvement work towards creating a new operating model and structure aimed at saving 20 per cent of their costs. 

The themes were described in an email sent to executive senior managers across the two organisations by the joint working scheme’s programme director Paul West – a former member of NHS Improvement’s operational productivity team.

The plans are thought to affect between 200 and 250 executive senior managers.

According to the email, seen by HSJ, the main themes from the staff consultation were:

  • Questions over whether there were too many executive senior manager posts proposed;
  • An acknowledgement that there is “still duplication in some areas”;
  • Whether the organisations have gone far enough to shift resources to the regions; and
  • Whether chiefs have looked hard enough at how to make the regulators more efficient.

Staff “broadly welcome” the new proposed “single operating model”, and there is a “strong appetite for change”, Mr West said in his email.

But there was also “recognition” that making the new model work will need “significant changes” to leadership behaviour and culture, and “ways of working for all staff”.

Respondents to the consultation also want managers to “bring to life how this will be better than before, with a clearer connection to the long-term plan, why we are here and how we support the NHS”.

The themes and other feedback from the consultation have been shared with the organisations’ two chief executive: Simon Stevens (NHS England) and Ian Dalton (NHS Improvement).

The two leaders are also part of the new NHS Executive Group, which had its first meeting a fortnight ago.

Mr West described the meeting as “a good session” with the focus on members “getting to know each other”. This meant the group was unable to “discuss the joint working programme in detail”, but they will do so in February.

The executive group comprises Mr Stevens and Mr Dalton, the seven regional directors, and 11 national directors.

In total, the joint working team received 384 emails about the consultation on the senior management structures, and more than 200 emails on the proposed operating model.

Responses have been sent from both individuals and teams.

The consultation closes next Monday, when chiefs will meet with trade unions.

The following day, a “leadership forum” will be held, where executive senior managers will be briefed on the consultation outcomes.

On the same day, the managers will also receive notice from their organisation confirming if they will move to the new structure directly, if they will have to compete for a new job, or if they are “out of scope”.

Managers will have until 8 February to challenge their categorisation, and interviews for the new management posts will be held between 28 February and 28 March.

All NHSI and NHSE staff will receive the consultation outcomes report on 30 January.

Meanwhile, new teams are being set up to deliver the “next stage of our organisational design work”.

Staff can be nominated to be part of these teams, which will focus on:

  • How the new organisations split into the new regions and what that means for existing teams;
  • Designing new ways of working to create a fully integrated organisation;
  • Improving the way the organisations operate; and
  • The efficiency programme.

The NHS Executive Group is also keen to be involved in this, Mr West said in his email.