Daily Insight: Who’s in charge?

The New Hospitals Programme is one of the most high-profile government projects running at the moment.

Boris Johnson’s government has made the delivery of “48 new hospitals” (several of which are not new or full hospitals) a key feature of its plans this decade, which means much responsibility rests on the shoulders of NHP’s leaders.

But who are the chiefs tasked with this huge infrastructure project?

Details of NHP’s leadership and structure have now been set out for the first time, after HSJ obtained internal NHP documents.

The documents show NHP comprises different divisions overseen by five directors, who report to NHP senior responsible officer Natalie Forrest and chief programme officer Morag Stuart.

The divisions include areas such as design, digital, analytics, transformation, with around 170 staff working on NHP overall.

Two of the seven chiefs have NHS experience: Ms Forrest and transformation director Josie Rudman.

Several of NHP’s senior leadership team hail from other government departments, including the Ministry of Defence and Department for Transport, while former directors at Mott MacDonald and Crossrail have also been recruited.

With the target date just eight years away and only one project completed so far, the race is well and truly on.

Burden Care Fund?

The Better Care Fund, a joint arrangement that sees the NHS and local government pay into a shared pot that is mostly used to support social care services, is popular among cash-strapped local authorities, who are generally content with how the scheme operates. It may be less popular among leaders in the NHS, who in 2022-23 will have to contribute £4.5bn.

This sum could grow even further under government plans to use the Better Care Fund as a “delivery vehicle” for further integration of health and social care, according to a senior local government official. Lincolnshire Council’s Glen Garrod has said the BCF could expand its “profile… scope and coverage” as it is linked to the government’s integration white paper published earlier this year.

The white paper, which was developed by Number 10, contained proposals to devolve substantial budgets to “places” that appeared to cut across the organisational direction of travel for integrated care systems and are being resisted by NHS England.

More broadly, the news that ministers are mulling an expansion of the BCF will cause further headaches for NHS finance directors, who may question why they are having to transfer money out of their own budgets to pay for non-NHS care services.