A shadow no bigger than the size of Comrade Sir David Nicholson's gripping fist passes over the NHS landscape today, with the shadow establishment of the NHS Commissioning Board.

Below is the text of the recent update from DH.

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In July this year, ‘Developing the NHS Commissioning Board’ was published, which set out initial thinking for how, subject to the passage of the Health and Social Care Bill, the new commissioning system could work in the future and provided some early thinking about the role of the NHS Commissioning Board (NHS CB) within that system.

This short update note provides further information on the development of the NHS CB.

The four phases of the development journey
Subject to the passage of the Health and Social Care Bill, the NHS CB will not take on its full responsibilities until 1 April 2013, but will come into existence in shadow form on 31 October 2011. Given this long lead time to full establishment and given that there is a period of double running with the existing NHS system, it feels important to be clear about the NHS CB’s responsibilities and accountabilities between those dates.

There are broadly four phases of development:

1. October 2011 to March 2012 – the NHS CB is established as a Special Health Authority (SpHA), responsible for developing clinical commissioning groups as well as designing the new commissioning architecture and the NHS CB as an organisation.

2. April 2012 to September 2012 – the SpHA takes over some National Patient Safety Agency functions and, subject to its passage through Parliament, the Bill is enacted.

3. October 2012 to March 2013 – the SpHA becomes an Executive Non-Departmental Public Body (ENDPB), responsible for planning for 2013/14.

4.April 2013 – SHAs and PCTs will be disestablished, and the NHS CB will take on its full statutory responsibilities.

Recruitment to the NHS CB will follow these four phases, so that as its responsibilities grow, so too will its workforce.

Senior structure of the NHSCB
Since the publication in July, thinking has developed about the shape of the NHS CB’s senior team. Subject to discussion with the Board of the NHS CB, the plan is to split the original post of Director of Finance, Performance and Operations into two. It is proposed therefore, that there will now be a Director of Finance and a Chief Operating Officer in the senior team, recognising the scale of the budgetary responsibilities and the new complexities of financial discipline and management in a completely new system.

Similarly, subject to the agreement of the Board of the NHS CB, the plan is that the executive (voting) posts will be – Chief Executive, Medical Director, Chief Nursing Officer and Finance Director.

In order to support the design of the NHS CB and to provide early clarity for other staff, it is anticipated that recruitment to all nine permanent Director posts will begin in the next few weeks, following the principles and processes set out in the national HR transition framework document and the NHS CB’s People Transition Policy.

The posts are:

Medical Director

Chief Nursing Officer

National Director: Finance

Chief Operating Officer

National Director: Commissioning Development

National Director: Patient and Public Engagement, Insight and Informatics

National Director: Improvement and Transformation

National Director: Policy, Corporate Development and Partnership Chief of Staff