1. Organisational Alignment and Capability Programme
Moving towards new ways of working
FINAL 1.0

2. Introduction
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.

3. Background to the OAC programme
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.

4. What the next three months look like
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.

5. Timeline for transition
Phase 1 – Transition
Short term – likely to mid-January
Phase 2 - Shadow To March 31
Phase 3 – Finalised operating models
From 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.

6. How we refer to the new structures
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.

7. The new regional structures

8. 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.

9. 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.

10. The Central team from January 5
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.

11. Regions – what will be different from April 1
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,

12. The Central team – what will be different from April 1
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.

13. Next steps – supporting change
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.

14. Senior appointments

15. The Central team
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. 

16. South
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

17. Midlands and East
East Director of Commissioning Operations – Andrew Pike Medical Director - Christine MacLeod Director of Finance - Adrian Marr Director of Nursing - Margaret Berry Central Midlands Director of Commissioning Operations – David Sharp Medical Director - Aly Rashid Director of Finance - Chris Ford Director of Nursing - Manjit Darby Locality Director - Trish Thompson Locality Director - Dominic Cox North Midlands Director of Commissioning Operations – Wendy Saviour Medical Director - Ken Deacon Director of Finance - Ros Franke Director of Nursing - Brigid Stacey Locality Director - Vikki Taylor. West Midlands Director of Commissioning Operations – Andrew Reed Medical Director - Kiran Patel Director of Finance - Brian Hanford Director of Nursing - Sue Doheny Locality Director - David Williams Locality Director - Karen Helliwell Regional Director of Specialised Commissioning: Catherine O'Connell.

18. North
Cheshire and Merseyside Director of Commissioning Operations – Clare Duggan Medical Director – Kieran Murphy Director of Nursing – Tina Long Director of Finance – Phil Wadeson Director of Delivery – Andrew Crawshaw Director of Commissioning – Tony Leo Cumbria and the North East Medical Director (and interim Director of Commissioning Operations) – Mike Prentice Director of Nursing – Bev Reilly Director of Finance – Audrey Pickstock Director of Delivery – Alison Slater Director of Commissioning Strategy – Christine Keen Lancashire and Greater Manchester Director of Commissioning Operations – Graham Urwin Medical Director – Raj Patel Director of Nursing – Trish Bennett Director of Finance – Ian Currell Director of Delivery – Jane Higgs Director of Commissioning – Rob Bellingham Yorkshire and the Humber Director of Commissioning Operations – Moira Dumma Director of Nursing - Margaret Kitching Director of Finance – Jon Swift Locality Director – Brian Hughes Locality Director – Alison Knowles Locality Director – Julie Warren-North Regional Director of Specialised Commissioning – Alison Tonge Regional Specialised Commissioning Finance Director- Robert Cornall Regional Specialised Commissioning Clinical Director – Alison Rylands