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NHS England is advertising for a new deputy chief operating officer and national director of urgent and emergency care (UEC).

This follows the announcement last month that national director for emergency and elective care Dame Pauline Philip will stand down later this year.

Taking over the reins ahead of what is expected to be one of the toughest winters on record should already mean that only those with the strongest stomachs need apply.

But the job description also includes this line: “You will be responsible for ensuring that government, patients and the public all maintain a high level of confidence in NHS-funded UEC services.”

This feels like Quite A Big Ask. It also assumes there is currently a “high level of confidence” in these services among patients and ministers, which is certainly debatable.

The new role formalises the separation of responsibility for elective and UEC leadership at national director level, a split which has largely existed informally since Sir Jim Mackey was appointed elective adviser in 2021.
The job advert says applications must be submitted by 21 August.

The ‘eye’ in ICS

Responsibility for intervening against providers which fail to deliver against key targets during winter will lie with integrated care systems in the first instance, NHS England has said.

NHSE has said ICSs will be responsible for “initial problem solving and intervention” if providers fail to deliver their agreed role, as system working “means a new approach to accountability”.

NHSE’s letter on winter planning, published on Friday, suggests a step away from performance management of trusts by NHSE’s regional and national directors.

A broad range of measures were revealed as part of the letter last week, including the addition of 7,000 more beds – although some of these will be in “virtual wards” in people’s homes and “pathway improvements” as well as new physical beds.

The letter also revealed the key targets for integrated care systems this winter, which include category two response times, ambulance handovers and delayed discharges.

But the letter admitted a “more significant set of actions” would be needed if covid levels reach “reasonable worst-case scenarios”.

Also on hsj.co.uk today

In news, we report that a trust is facing a backlog of millions of pounds of work to mend critical pieces of infrastructure, despite having already made significant repairs, and in our weekly round-up of health news from beyond the walls of HSJ – The Primer – we look at yet more dire warnings about the state of NHS capacity.