The plan recognises that NHS delivery takes place at the frontline, and cannot be dictated from the centre. From this flows recognition of the importance of NHS trust boards working within strong local health and care systems, coupled with responsiveness to the views and needs of staff and communities, respect for good governance, and legal decision making.
Measures:
- The plan sets out, in concrete terms, how NHS Improvement and NHS England will realise their stated ambition of supporting trusts and local systems to improve, moving away from a rigid, top down, command and control, approach that over-emphasises regulation and performance management.
- In establishing and maintaining new models of care and system working, the plan needs to be clear on either adhering to the current legislative framework or setting out proposals for change.
- The importance of good governance through strong organisational boards, working within strong local systems, is recognised and supported in the interactions of the national and local NHS bodies.
- The plan supports local health and social care systems to work together, including reference to the implications of shared financial planning, risk management, governance and regulation.
- Lines of accountability and powers of delegation are clear, and underpinned by appropriate organisational autonomy.
- The value of diversity is recognised and expectations raised for how NHS organisations reflect the make up of their workforce and communities.
- The principles of good regulation, including a proportionate risk-based approach, are upheld.
- The plan is developed and monitored in a way that promotes and reflects good governance, autonomy and accountability.