News / New regime changes strategic role

The 10 strategic health authorities in England are to be downgraded to regional offices of the new independent NHS Commissioning Board.

The Queen’s Speech (see box), which set out the coalition government’s legislative programme for the year, includes a health bill. This will involve reducing the number of quangos, reforming regulation and setting up an independent NHS Board to allocate resources and provide commissioning guidance.

The creation of the board raised questions about the future of SHAs, and the Department of Health moved to clarify this. It said SHAs would become the board’s regional arms, while their provider performance management function would be transferred to foundation trust regulator Monitor.

This is happening increasingly as more and more trusts gain foundation status. However, there are questions over whether Monitor would manage the performance of non-foundations and community providers that were not integrating with foundation trusts.

A Department spokesperson said the board would aim to drive up quality and deliver better value. ‘It will oversee NHS commissioning, with providers regulated by Monitor, which will become an economic regulator, and the Care Quality Commission regulating quality.’

‘The board will combine functions currently provided by the Department of Health and strategic health authorities, and deliver these in a much more streamlined way.

‘So the remit of SHAs will change – the board will exercise its functions through the regional offices that will report directly to the chief executive.’

Before the health bill becomes law, SHAs will continue to have a vital role in delivering financial control and driving up quality and productivity.

‘They will play a key role in creating an NHS that is able to focus on outcomes and deliver through strong commissioning. The process of change will begin with SHAs themselves, where there will be a clearer split between their commissioner and provider responsibilities,’ the spokesman added.