NHS Commissioning Board London

1. NHS Commissioning Board London

2. Introduction • The role of the National Commissioning Board • The role of the regional offices • The progress made so far • How the regional office will interact with the new system

3. The role of the National Commissioning Board • Directly Commissioning £25 billion worth of services including primary care, some public health services such as immunisation and screening, and specialised health services • Allocating £60 billion to CCGs and supporting them in the effective use of that money to buy local services • Planning for civil emergencies and making sure the NHS is resilient • Developing relationships and agreements with delivery partners at national level, and at local level on health and wellbeing boards • Leading the development of strategy and vision for the NHS, and promoting the research, innovation and change which will make the NHS world class in all it does • Setting policies and standards for the NHS, in particular in respect of information, leadership, competition • Developing incentives, tools and guidance to help clinical commissioners achieve their goals

4. The London context • An unstable acute provider landscape, which requires ongoing system oversight and coordination • Aninterlocking healthcare system, with patient flows across borough boundaries and major ongoing service reconfigurations • A high proportion of specialised care that will be directly commissioned by the NHSCB • Aunique political and stakeholder environment • Variable performance of primary care and a high proportion of single and double-handed GP practices

5. Operate as a part of the NHS Commissioning Board • Fit with the footprint of organisations with which relationships are key to the London Region’s success • Focus on delivering the national commissioning priorities at a regional and local level • Delivery of a national, clinically-led strategy and the creation of a clinically and financially-viable provider landscape will require significant service transformation and reconfiguration • Reduce complexity by acting as a link between the public, patients and services at a local level, and the NHS CB and system at a national level There are 10 design principles

6. Play a coordinating and oversight role across the NHS in London, ensuring roles and accountabilities are aligned to delivery • Enable ‘assumed autonomy’, but hold CCGs and providers to account and ensure performance remains high • Have internal clear accountabilities, minimise internal complexity and avoid conflicts of interest • Localise activity where relationships or local knowledge are key and centralise activities where economies of scale or skill are achievable • Remain flexible to the changing needs of the local system and population, and of the national priorities There are 10 design principles

7. NHS CB London programme architecture System Transition Programme NHS Commissioning Board (Operations Directorate) T1: CCGs, CSOs and NHS CB sector arrangements for London Governance lines: NHS CB London Office Start-up Programme Board Reporting line Direction Delivery assurance PMO Start-up Programmes Programme Management Governance Operating Model and OD HR Planning Finance Business Intelligence Estates and Infrastructure Comms and Engagement Transition Planning

8. Place and people • The intention is that the London regional office will be based at Southside (current SHA base) on Victoria Street • Organisational design for the CB is ongoing – due to be completed by end of July • Appointing to posts will be governed by the nationally agreed “Policy and Process on Filling Posts in Receiving Organisations” • Where a function is not transferring in its current state, the new function will be filled in turn by a matching process, then ring-fenced competition in the first instance • We will keep people fully informed as the structures and processes are finalised

9. A B C D E F Current view of proposed directorates NHS CB Chief Operating Officer Regional Director London Operations and delivery Service transformation, improvement and innovation (STII) NHS commissioning Finance Medical Nursing

10. Patch team (core) – Functions performed • NHS commissioning functions sit outside the Patch teams • Primary care commissioning and contract management • Public health commissioning • Specialised commissioning • Military and Offender Health • Finance, STII, BI, Medical and Nursing also have central core teams outside the Patch team members • Professional accountability of the various Patch team members will continue to be through their respective directorates The role of Patch Teams Regional Director Director, Operations and Delivery Area Director Patch 1 Area Director LAT 1 Area Director LAT 1 • Ops & Delivery • CCG authorisation • CCG Assurance • System coordination and oversight • Finance (with support from central team) • CCG assurance • Supporting the CCG financial strategy • STII (with support from central team) • CCG development • Innovation & service transformation • BI (with support from central team) • Analytical support Additional resources patch teams can draw on when needed • Medical • Nursing • Specialised commissioning • Public health commissioning

11. The London structure

12. Transition is assuming three major phases Phase1 Phase 2 Phase 3 Closedown and Legacy

13. For more information www.london.nhs.uk/getting-ready-for-2013

14. Any questions?