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What does closer collaboration between NHSE and NHSI mean for healthcare leaders?

What does closer collaboration between NHSE and NHSI mean for healthcare leaders?
By Valeria Fiore Journalist intern
26 May 2018



NHS England and NHS Improvement will transform the way they work together ‘to provide more joined-up, effective and comprehensive system leadership to the NHS’, it has been announced.

The two organisations, who held their first joint board meeting on 24 May, discussed how working collaboratively could help the health service shift from ‘fragmentation to coherence’ and give better support to local health systems.

NHS Providers chief executive Chris Hopson said this greater collaboration ‘could herald a profound shift in the way the NHS is led at a national and regional level’.

So, how will the NHSI and NHSE decision to work together impact the daily lives of healthcare leaders?

Here is our pick:

  • Less duplication

NHSI and NHSE are committed to moving ‘from a world where local health organisations (trusts, CCGs) sometimes receive different and conflicting messages from the national bodies, to one where – through our integrated regional teams – we have a single conversation with them’.

At an organisational level, this will be achieved through the introduction of a single NHS medical director, a single NHS nursing director/chief nursing officer for England, and a single chief financial officer.

These senior NHS figures will be responsible for functions including leadership, people management and supporting a shared approach to urgent, emergency and elective care, the board papers said.

NHS Confederation chief executive Niall Dickson said the organisation’s member lamented receiving contradictory messages from the organisations.

He said: ‘Closer working will be welcomed across the NHS as we have long called for a merger and this is real progress towards that.’

  • Leadership and workforce

Collaboration between NHSI and NHSE will help the NHS remedy ‘a gap in national leadership’.

NHSE and NHSI functions will be implemented at a regional level through seven integrated teams led by regional directors. They will be held accountable for ‘quality, finance and operational performance’ of all NHS organisations in their area, the board papers announced and will decide when and how to intervene in CCGs, systems or providers.

  • Information and digital technology

The NHS bodies are committed to ‘a single approach to transforming how the NHS uses digital information and technology to improve quality of care, health outcomes and efficiency’.

The board papers said: ‘Our work identified the need to go further in embedding the importance of the digital agenda in all the work we do with the provider sector, so that it is an integral part of improving quality and efficiency.’

The decision comes just days after NHS England named three local partnerships as the new local health and care record exemplars (LHCRE), which will implement an electronic shared local health and care record over the next two years.

  • NHS estates, procurement and back office services

A NHSI/NHSE joint agenda means there will also be a single approach ‘to helping the NHS manage its estates/facilities, equipment, consumables and corporate services more efficiently and effectively’, the board papers said.

Data published by NHS Digital last year showed that for the period of 1 April 2016 to 31 March 2017, the total costs of running the NHS estate were £8.bn, 3.6% up on 2015/16 figures.

  • A shared culture

Back in 2014, health secretary Jeremy Hunt called for a “culture change in the NHS, with increased emphasis to be placed on moving towards greater transparency.

However, many healthcare leaders expressed their concerns around who would be leading that culture change.

NHSE and NHSI have now committed to a ‘joint approach to culture and behaviours will be developed with all staff, building on their input about what should be maintained and what needs to change in our current operating styles and leadership behaviours’.

  • Risks

Will this new approach work? NHS Providers chief executive Chris Hopson said:

‘Success will depend, in large part, on following through on the commitment to devolving power to the regional directors who, in turn, must have the expertise and credibility to work well with trust leaders.

‘It will also require a realistic planning, finance and performance framework, and a genuine commitment to involve frontline leaders in developing the detail of future plans.’

Click here to read the board proposals in full.

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