The role and design of NHS England

1. The role and design of NHS England A Regional Perspective

2. Introduction Trevor Wright Head of Strategic Systems and Technology NHS England (North) trevorwright@nhs.net

3. About us • The NHS Commissioning Board (NHS CB): • was established as a special health authority on 31 October 2011 and as an executive non-departmental public body on 1 October 2012; • plays a key role in the Government’s vision to modernise the NHS and secure the best possible outcomes for patients. • From 1 April 2013 it will be known as NHS England

4. The role of the NHS England Patient-focused, clinically-led organisation that has the culture, style and leadership to truly improve outcomes for patients • To allocate resources to clinical commissioning groups (CCGs) • To support CCGs to commission services on behalf of their patients (according to evidence-based quality standards) • To have direct responsibility for commissioning services: • primary care; • military and prison health services; • high secure psychiatric services; and • specialised services.

5. NHS England structure • Area teams – commissioning high quality primary care services, supporting and developing CCGs, assessing and assuring performance, direct and specialised commissioning, managing and cultivating local partnerships and stakeholder relationships, including representation on health and wellbeing boards • Four regions - providing clinical and professional leadership, co-ordinating planning, operational management and emergency preparedness and undertaking direct commissioning functions and processes within a single operating model • National support centre in Leeds and a presence in London

6. Our ways of working • A nationwide organisation • Matrix working at the heart - to provide simplicity, aid efficiency and ensure singularity of approach • We intend to ensure that everything that the NHS England does: • contributes to improving outcomes; • has been clinically-led; • promotes equality and supports a reduction in health inequalities; • is informed by the needs, views and wishes of patients and the public; and • promotes innovation and puts research into practice.

7. Key facts and figures • The overall running costs budget (£527m) represents a reduction of almost half on costs and staff, compared to the current costs of functions transferring to the Board • Around 75% of the budget will be deployed locally: • reflects that the majority of NHS England’s functions will be carried out locally, with the vast majority people based up and down the country in local area teams and regions; and • provides strong local presence to best manage the transition. • Eight directorates, with nearly half of the senior posts filled by clinical staff and a range of clinical professions represented throughout, plus extensive clinical advice and input from clinical networks and clinical senates

8. NHS England’s Directorates Chairman Prof Malcolm Grant Chief Executive Sir David Nicholson National Medical Director Sir Bruce Keogh Chief Nursing Officer JaneCummings Chief Operating Officer and Deputy Chief Executive Ian Dalton National Director: Commissioning Development Dame Barbara Hakin National Director for Patients & Information Tim Kelsey Chief Financial Officer Paul Baumann National Director: Policy Bill McCarthy National Director: HR Jo-Anne Wass

9. Organisation Structure:Patients & Information Directorate Version 6.2 March 2013

10. Core Role and Purpose • To shape our health service to be open, responsive and transparent and give patients, carers, public, and those who serve them, the information and support they need to make the best decisions and choices they can. • To ensure that the values enshrined in the NHS Constitution are central to patients' and citizens' experience. • To use information and technology to improve outcomes and patient safety, and to transform the experience of those using the service.

11. Core Role and Purpose • To transform patient and public participation in the NHS so that we can develop the insight to help us improve outcomes – and guarantee no community is left behind or disadvantaged. • To put patients’ interests first – transforming the service offer of the NHS so that they can take control and make more informed choices, if they want to. • To set policies and standards for data and technology that facilitate an integrated, coherent and safer NHS; • To promote leadership and competition in open data and technology in support of innovation and improved outcomes.

12. Overarching Directorate Structure

13. Strategic Systems & Technology Structure

15. The size of the job • Demographics of the North of England • A population of 14,853,000 • Local Organisations in the North of England Health Economy • 9 Area Teams and 68 Clinical Commissioning Groups (CCGs), representing over 2536 GP practices • 75 Local Authorities and 50 Health & Wellbeing Boards. • 52 Acute Trusts, 40 of which are NHS FTs • 17 Mental Health providers, 14 of which are NHS FTs • 4 Community NHS Trust, all aspiring NHS FTs 3 Ambulance Trusts, 2 of which are aspiring NHS FTs. • 6 Commissioning Support Units delivering local IT to Area Teams and CCGs NHS | Patients and Information Directorate Induction | 02-Apr-13

16. The size of the job SST: Technology Strategy & Leadership • To ensure that the technology and information management interests of the Board and the NHS are realised effectively by delivery partners • To ensure that information systems and services are commissioned consistently, efficiently and effectively for the benefit of the patient • To provide the frameworks within which information and technology are managed effectively throughout the NHS and more broadly within the care services • To proactively work with the market to stimulate new technology-based services of benefit to patients and the public • To innovate on the use of technology, and to bring new developments in the market to the attention of the Board • To deliver a Technology Strategy that meets the ambitions of the NHS England • To stimulate technology leadership and innovation across the NHS

17. The size of the job Regionally : Technology Strategy & Leadership • To ensure that the technology and information management interests of the Board and the NHS are realised effectively by delivery partners • Providing a conduit for the NHS to influence delivery partners and ensure ‘fit for purpose’ solutions • To innovate on the use of technology, and to bring new developments in the market to the attention of the Board • To help coordinate a cohesive approach to innovation and the sharing of best practice • To stimulate technology leadership and innovation across the NHS • To support local organisations to develop effective leadership which recognises the potential for technology-enabled innovation.

18. The size of the job SST: Delivery Partner Management • To realise the Board’s information needs through an effective set of relationships with delivery partners • To ensure that the financial and commercial interests of the Board and the NHS are realised effectively by delivery partners • To provide the broad commercial and financial frameworks, and to actively manage them • To commission delivery partners to deliver the strategic systems required to achieve the Board’s ambitions

19. The size of the job Regionally: Delivery Partner Management • To realise the Board’s information needs through an effective set of relationships with delivery partners • To encourage collaboration and help develop effective business partnerships • To commission delivery partners to deliver the strategic systems required to achieve the Board’s ambitions • To work closely with Area Teams and CCGs to develop effective relationships with delivery partners

20. The size of the job SST: Nationally-Provided Business Systems • To ensure information products and services are appropriately established, delivered, operated and governed; including the whole portfolio of national systems and services commissioned by the Board • To ensure the Board’s business requirements are effectively translated into detailed requirements for information products and services to be commissioned from the information systems delivery partners • To commission all information systems solutions through the delivery partners as needed, on behalf of the Board and its strategic partners, ensuring effectiveness and value for money for the Board and for patients and the public in all deliveries • To commission national business information systems in line with the NHS information strategy and the technology strategy • To ensure expert advice on information technology and information systems is sourced as needed to deliver systems to expected quality and effectiveness

21. The size of the job Regionally: Nationally-Provided Business Systems • To ensure the Board’s business requirements are effectively translated into detailed requirements for information products and services to be commissioned from the information systems delivery partners • To act as a conduit to allow the NHS to specify and influence business requirements resulting in ‘fit for purpose’ solutions and well-informed delivery partners • To ensure expert advice on information technology and information systems is sourced as needed to deliver systems to expected quality and effectiveness • To ensure that the right expert advice is sourced based on the needs of the NHS and to ensure it compliments local capability

22. Strategic Programmes • A Vision and Technology Strategy for NHS • Technology and Informatics leadership • Stimulating the market for SMEs • Cross-cutting strategies • Role of centre vs local • Digital Primary Care • Access to primary care records • Appointment booking and repeat prescriptions • Switch GP online • Secure communications • NHS E-referrals • Integrated Digital Care Records • Electronic Prescribing NHS | Patients and Information Directorate Induction | 02-Apr-13

23. Regional Priorities • Interpreting and operationalizing national operating models and guidance • GP IT Support Operating Guidance: December 2012; http://www.england.nhs.uk/wp-content/uploads/2012/12/gp-it-op-model.pdf • Primary Care Operating Guidance: December 2012; http://www.england.nhs.uk/wp-content/uploads/2012/12/pc-it-op-model.pdf • Child Health Operating Guidance: March 2013; http://www.england.nhs.uk/wp-content/uploads/2013/03/child-health-it.pdf • Armed Forces Operating Guidance: March 2013; http://www.england.nhs.uk/wp-content/uploads/2013/03/armed-forces-it.pdf NHS | Patients and Information Directorate Induction | 02-Apr-13

24. Regional Priorities • Supporting Area Teams to make most effective use of Primary Care IT allocations • Developing Service Level Agreement with local delivery partners • Establishing new relationships • Stakeholder engagement • Developing effective leadership • Concluding transition NHS | Patients and Information Directorate Induction | 02-Apr-13

25. The Challenges • Capacity • Capability • Understanding the new ways of working: • When to help and when not to help? • What functions are mapped to where? • The ‘levers and incentives’ model • When to be ‘business-like’ and when to be pragmatic? • Managing the ‘lull’ NHS | Patients and Information Directorate Induction | 02-Apr-13

26. Leadership Challenges • The need to be ‘Informed Clients’ • The needs to be more ‘business-like’ • The need to develop effective partnerships • The need for rapid change and exploitation of innovation Considerations: • Professional registration? • Accreditation of delivery partners? • More effective collaboration? • Business partners, not suppliers? NHS | Patients and Information Directorate Induction | 02-Apr-13

27. Enough said! NHS | Patients and Information Directorate Induction | 02-Apr-13