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Moving towards new ways of working

OrganisationalAlignment and Capability Programme

FINAL 1.0

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This document explains how NHS England will operate between January 5, 2015 and April 1, 2015 to ensure there is a smooth transition as we move towards implementing the new structures and operating model as part of the Organisational Alignment and Capability Programme.

Introduction

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The programme was established in May 2014 to take forward the recommendations from the initial “stocktake work” in April led by Karen Wheeler, National Director: Transformation and Corporate Operations, and Rosamond Roughton, Director of NHS Commissioning, on behalf of  Chief Executive Simon Stevens and the NHS England Board.

The main scope is to address the following:• To ensure the organisation is clearer and focused on its core

purpose and priority objectives. • To build new capabilities for the organisation, which are critical for

it to carry out its role as a commissioning organisation. • To streamline and align the functions and structures which support

the organisation to work more effectively across the national support centre, regions and area teams to minimise duplication and make more effective use of our resources.

• To revise the structures to deliver the necessary cost savings by April 2015, so NHS England can live within its budget for 2015/16.

Background to the OAC programme

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In January, we are moving into a three-month phase before the new structures are formally in place for April 1, 2015.

• As we start to transition into the new structures,  we are also keen to use this opportunity to embed new ways of working so we are more joined up between the centre and regions, and across directorates, and to ensure we embed clinical advice and patient engagement in our core work.

• We also need to think about the findings from the staff barometer, and what we each need to do to improve our staff engagement and motivation.

• We have asked each National and Regional Directorate to factor organisational development thinking into their implementation plans.

What the next three months look like

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Timeline for transition

Phase 1 – TransitionShort term – likely to mid-January

Phase 2 - ShadowTo March 31

Phase 3 – Finalised operating modelsFrom April 1

• This phase will see the handover of specific activities and functions from outgoing teams to incoming teams eg. former area directors begin handover to newly appointed Directors of Commissioning Operations.

• Shadow arrangements put in place with new teams operating and being strengthened as new appointments are confirmed.

• Processes and systems begin to be put into place to support new arrangements from April 1.

• The development of new arrangements ready for April 1 eg governance, decision making and accountability.

• New operating model in place to support our new way of working.

• Staff who secured a new role at a higher band/salary as part of the programme will formally take up their new role at this point and be remunerated from April 1 onwards.

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As we start to reflect the new structures and operating model it’s important that we all start to use the new names for different parts of our organisation.

• We now have four regional teams and these will operate on a single level.

• The new 12 sub regions are now integrated into these new regional teams. We should no longer to refer to area teams.

• A central team replaces the National Support Centre.

How we refer to the new structures

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The new regional structuresThe new regional structures

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Regions - What will change on January 5

Where appointed, the new designated Directors of Commissioning Operations will start their handover from the existing area directors – in the run up to officially starting in their new roles on April 1. Between January 5 and April 1 they will assume formal accountability for:

• Existing area budgets, including all direct commissioning budgets on the current footprint

• Managing transition, including developing new teams and HR• Operational delivery for 2014/15• Planning for 2015/16• Working as part of the regional team to support the development of

new working arrangements• Working with stakeholders to ensure new arrangements are

understood and in place• Updated Emergency Planning Response and Resilience

arrangements• Overseeing existing area governance and decision making

arrangements until revised arrangements are proposed and agreed with their regional director.

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Regions - What won’t change on January 5

• Current office bases for area and regional staff. There will be no ‘HQ’ locations in the new geographies

• Regional Director responsibilities and accountabilities

• Existing formal governance mechanisms

• Existing budget envelopes

• Key deliverables and priorities

• Existing relationships with stakeholders.

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What will change on January 5• Where appointed on this date, Senior Responsible Officer (SRO)

designates will have in place a timeline for the handover from existing SROs and becoming responsible for their new function

• This will include a timeline for formal accountability for all aspects of their new function and leadership of their team.

What won’t change on January 5• Existing formal governance mechanisms• Existing budgets• Key deliverable and priorities• Staff office locations.

The Central team from January 5

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• Specialised commissioning directors will assume responsibility in relation to their function and budget

• Specialised commissioning and integrated regional teams will be fully operational and revised operating arrangements will be in place

• Regional Directors will have a single budget for their regions

• New structures will be implemented in full

• New ways of working with partners will be implemented,

Regions – what will be different from April 1

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• New ways of working will be implemented in full

• New operating model will be implemented, supported by robust corporate systems and processes

• New ways of working with partners will be implemented.

The Central team – what will be different from April 1

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• Between now and April the four regions and central directorates have been asked to produce their own organisational development plans to support implementation of the new operating model.

• These will be developed and delivered locally but there will be a set of criteria that will need to be included in all plans to ensure consistency across the organisation.

• Further detail on our new operating model will be shared in the coming weeks.

Next steps – supporting change

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Senior

appointments

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John Holden has been appointed as the new Director of Policy, Partnerships and Innovation in the Commissioning Strategy Directorate.  John was previously Director of System Policy in Commissioning Strategy and will start his new role on 5 January. 

The Central team

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South West

Director of Commissioning Operations – Anthony Farnsworth

Medical Director – Caroline Gamlin

Director of Nursing – Lindsey Scott

Director of Commissioning – Linda Prosser

Director of Operations and Assurance – Laura Nichols

Director of Finance – Neil Kemsley

 

South Central  

Director of Nursing – Jan Fowler

Director of Commissioning – Debra Elliott

Director of Operations and Assurance –Louise Watson

Director of Finance – James Drury

 

Wessex

Director of Commissioning Operations – Dominic Hardy

Director of Nursing – Ruth Williams

Director of Operations and Assurance – Jaqueline Cotgrove

Director of Finance – Mark Orchard

 

South East  

Director of Commissioning Operations – Felicity Cox

Director of Nursing – Sally Allum

Director of Commissioning – Sarah Creamer

Director of Operations and Assurance – Elliott Howard-Jones

Director of Operations and Assurance – Pennie Ford

Director of Finance – Paul Hyde

South

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EastDirector of Commissioning Operations – Andrew PikeMedical Director - Christine MacLeodDirector of Finance - Adrian MarrDirector of Nursing - Margaret Berry  Central Midlands  Director of Commissioning Operations – David SharpMedical Director - Aly RashidDirector of Finance - Chris FordDirector of Nursing - Manjit DarbyLocality Director - Trish ThompsonLocality Director - Dominic Cox North Midlands  Director of Commissioning Operations – Wendy SaviourMedical Director - Ken DeaconDirector of Finance - Ros FrankeDirector of Nursing - Brigid StaceyLocality Director - Vikki Taylor. West Midlands  Director of Commissioning Operations – Andrew ReedMedical Director - Kiran PatelDirector of Finance - Brian HanfordDirector of Nursing - Sue DohenyLocality Director - David WilliamsLocality Director - Karen Helliwell Regional Director of Specialised Commissioning: Catherine O'Connell.

Midlands and East

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Cheshire and MerseysideDirector of Commissioning Operations – Clare Duggan Medical Director – Kieran MurphyDirector of Nursing – Tina LongDirector of Finance – Phil WadesonDirector of Delivery – Andrew CrawshawDirector of Commissioning – Tony Leo

Cumbria and the North EastMedical Director (and interim Director of Commissioning Operations) – Mike Prentice Director of Nursing – Bev ReillyDirector of Finance – Audrey PickstockDirector of Delivery – Alison SlaterDirector of Commissioning Strategy – Christine Keen

Lancashire and Greater ManchesterDirector of Commissioning Operations – Graham Urwin Medical Director – Raj PatelDirector of Nursing – Trish BennettDirector of Finance – Ian CurrellDirector of Delivery – Jane HiggsDirector of Commissioning – Rob Bellingham

Yorkshire and the HumberDirector of Commissioning Operations – Moira DummaDirector of Nursing - Margaret KitchingDirector of Finance – Jon SwiftLocality Director – Brian HughesLocality Director – Alison Knowles Locality Director – Julie Warren-North

Regional Director of Specialised Commissioning – Alison TongeRegional Specialised Commissioning Finance Director- Robert CornallRegional Specialised Commissioning Clinical Director – Alison Rylands

North