NHS England changes will 'give CCGs freedom'

The Organisational Alignment and Capability Programme consultation document, seen by HSJ, was shared with staff earlier this week.

Overall, the organisation expects to strip out 300 posts and has notified 815 staff they will be “affected by change” either through being at risk of redundancy or potential major changes to their role.

The document reveals plans for a major shake-up of NHS England’s medical directorate and confirms the creation of two new directorates focused on specialised commissioning and commissioning strategy as well as a new “field force” model in the North, South, and Midlands and East regions.

The 47 page document also confirms plans to target job cuts at senior managers on Agenda for Change band 8c and above in local area teams in order to reduce running costs by 15 per cent.

The document said as well as protecting “day to day capacity” of the organisation, the rationale for the approach was that “CCGs will increasingly be the local leaders of NHS commissioning and will need the freedom to fulfil that role”.

More than 700 of the staff affected by changes are based in the regions and area teams, which will have 333 posts cut overall.

Staff working in the North and Midlands look to be hardest hit due to low vacancy rates compared with other parts of the country.

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The field forces, which are already in operation in London, will be supported by a new national commissioning operations directorate.

The document said this would be focused on strengthening “the operational resilience of the NHS and the associated performance monitoring”.

It would also deal with the increased demand for “information and assurance” relating to primary care.

With a 30 per cent cut in posts, the medical directorate will see the biggest reductions.

Many of these roles will move into the specialised commissioning directorate, while the innovation and research function will move into the commissioning strategy directorate.

National clinical directors will continue in post but will be funded through programme costs rather than running costs in a move that is likely to prove controversial with CCGs, which have been told they cannot fund clinical leadership posts through programme costs.

The document confirms NHS England will cease its revalidation role and is still planning to transfer patient safety functions to its “delivery partners”.

However, new organisations have not been identified to host these functions.

In a joint statement the trade unions Managers in Partnership, Unison, Unite and the Royal College of Nursing said staff should be helped to find new jobs within the wider NHS if a role was not available at NHS England.

It continued: “Many of the staff affected by these changes are long serving, senior NHS staff who have been victim of the government’s Health and Social Care Act.

“This caused a great deal of uncertainty for all staff in the health service, as well as costing millions of pounds to introduce while NHS trusts and providers struggle with reduced budgets.

“The recognised trade unions will be working together to protect these experienced staff, and patient services.”