NHS England has published a new framework that sets out how the organisation will operate in the new structure created by the 2022 Health and Care Act, and to outline how the direction at a national level will support integrated care systems (ICS).
It focuses on transformation, change, culture, partnership working, a shift to digital tools and supporting positive outcomes.
Following the establishment of ICSs and the new statutory framework, NHS England is changing the way it works and how it works, noting cultural and behavioural changes towards partnership-based working. It notes the organisation’s purpose and behaviours, how it will add value, medium-term priorities, accountabilities and responsibilities, and how NHS England will work with partners.
In its purpose statement “to lead the NHS in England to deliver high-quality services for all” the document outlines how the organisation will achieve this by: enabling local systems and providers to improve the health of their people and patients and reduce health inequalities; making the NHS a great place to work, where our people can make a difference and achieve their potential; working collaboratively to ensure our healthcare workforce has the right knowledge, skills, values and behaviours to deliver accessible, compassionate care; optimising the use of digital technology, research and innovation; and delivering value for money.
The document states: “The operating framework will be a key input into the design of the new NHS England. This will be further developed alongside the operating models and statutory responsibilities of our new partners, Health Education England and NHS Digital, as part of the new NHS England change programme.”
A number of measures are included in “what we do to add value”, including to agree local strategic priorities with individual ICSs, create the evidence based strategy for transformation, embed digital and data in programmes, set national frameworks including the Financial Framework, System Oversight Framework, People Plan, Digital maturity expectations, and provide technology architecture and policies, operate backbone systems, set minimum standards (for example, in cyber security and privacy) and promote interoperability and reuse.
12 leadership behaviours are set, defining the NHS England ‘how we do it’ approach; driven by the people and communities we serve; focussed on clear outcomes; inclusive and diverse; collaborating, co-producing, co-owning, being a great partner; accountability to role and team; trusting and empowering each other; working at pace when appropriate, with agility and courage; being ambitious and can-do; learning by doing, cycles of change; data-driven and evidence-based; hard on problems and supportive of people; transparent, honest and authentic.
On how the NHS England programme teams will work with regional teams, it aims to co-create the evidence based strategy for transformation and improvement, agree expectations on outcomes and provide subject matter expertise to support implementation. In order to deliver transformation, five priorities for the next 3-5 years have been noted:
- STOP: avoidable illness & intervene early
- SHIFT: to digital and community
- SHARE the best
- STRENGTHEN the hands of the people we serve
- SUPPORT our local partners
On the proposed merger of NHS England, Health Education England and NHS Digital on 1 April 2023, NHSE said it provides “a unique opportunity to create a ‘new’ NHS England, putting workforce, data, digital and technology at the heart of our plans to transform the NHS”.
The document continued to add: “This operating framework will be a key input into the design of the new combined organisation. The new NHS England change programme will seek to use the principles of the operating framework to ensure the new organisation maximises the potential of our move to system working; streamlining what we do nationally to give systems the space to lead and ensuring we focus our efforts on what we are uniquely placed to do at a national level. This will include being clear on interdependencies between regional and national functions in order to deliver our accountabilities.
“Part of our commitment in the creation of a new NHS England is to develop a new culture for the organisation, supported by a set of behaviours which we will co-develop and refine as part of the integration process.”
You can read the framework here.
