Strategic Health Authorities

REPORT OF THE CHIEF EXECUTIVE OF THE ISLE OF WIGHT, PORTSMOUTH AND SOUTH-EAST HAMPSHIRE HEALTH AUTHORITY

This paper provides an update on the national reorganisation of NHS organisations.

“Shifting the Balance of Power within the NHS: Securing Delivery” was published by the Department of Heath at the end of July, setting out a programme to reconfigure NHS organisations to ensure they could deliver the modernisation programme set out in the NHS Plan.

The document gives the reasons for change, the proposed timetable for reorganisation and the new roles and responsibilities proposed for Regional Offices, Strategic Health Authorities, Primary Care Trusts (PCTs) and NHS Trusts.

· PCTs will become the lead NHS organisation in assessing need, planning and securing all health services and improving health. They will forge new partnerships with local communities and lead the NHS contribution for joint work with local government and other partners. PCTs will be accountable to the Secretary of State through the Strategic Health Authority.

· About 30 Strategic Health Authorities will replace almost 100 health authorities. They will step back from service planning and commissioning to lead the strategic development of the local health service and performance manage PCTs and NHS Trusts on the basis of local accountability agreements. Strategic Health Authorities will be accountable to the Secretary of State.

· NHS Trusts will continue to provide services, working within delivery agreements with PCTs. Trusts will be expected to devolve greater responsibility to clinical teams and foster and encourage the growth of clinical networks across NHS organisations. High performing Trusts will earn greater freedom and autonomy in recognition of their achievements. NHS Trusts will be accountable to the Secretary of State through the Strategic Health Authority.

· The Department of Health will change the way it relates to the NHS, focussing on supporting the delivery of the NHS Plan. The NHS Executive Regional Offices will be abolished and four new Regional Directors of Health and Social Care will oversee the development of the NHS and provide the link between NHS organisations and the Department. The Modernisation Agency, Leadership Centre and the University of the NHS will support the development of frontline staff and services

It is likely that Hampshire and the Isle of Wight is likely to be the core of the new local Strategic Health Authority. “Shifting the Balance” makes it clear that the aim is for simple and sustainable organisations, each serving a population of about 1.5 million people. Efforts will also be made to ensure that local authorities are not split between Strategic Health Authorities and that the new organisations do not straddle the boundaries of regional offices. On this basis, Hampshire and the Isle of Wight appears to be the most logical option – with a population of about 1.8 million and bringing together the unitary authorities in Portsmouth, Southampton and Isle of Wight with Hampshire County. Whilst the option of Hampshire, Isle of Wight and Surrey has been considered this would lead to potentially the largest Strategic Health Authority in the country with a population of almost 3 million.

The proposals will be subject to public consultation from September to November 2001.

Most staff employed in the new regional structures will be based in one of the nine locations where there are regional Government offices. We are located in the Government Office of the South East. This includes Kent, Surrey, Sussex, Berks, Hants, Isle of Wight, Bucks and Oxon (i.e. NHS South East without Northants). This office is based in Guildford.

The four Regional Directors of Health and Social Care will cover larger areas than the existing regions. This area will be included in the new South region, which would incorporate the existing South West and South East (excluding Northamptonshire) regions. It is not yet clear where this will be based.

AUG 01	Discuss key issues from “Securing Delivery” with key stakeholders
SEP-NOV 01	Consultation on boundary changes for Strategic Health Authorities
DEC 01	Agree boundaries for new Strategic Health Authorities, subject to consultation and decision of Secretary of State for Health
end DEC 01	Appoint Chairs and Chief Executives Designate for new Strategic Health Authorities
NOV 01-JAN 02	Advertise and appoint next wave of PCT Chief Executives
JAN 02	Establish PCTs under shadow arrangements
APR 02	Establish new Strategic Health Authorities. PCTs become fully operational. Dissolve existing Health Authorities and some Community Trusts.
OCT 02	Full implementation of new responsibilities, subject to legislation
APR 03	Establish new offices of Regional Directors of Health and Social Care

Contact point: Ms Penny Humphris, Chief Executive, Isle of Wight, Portsmouth and South-east Hampshire Health Authority ( 02392 838340.