Context and Overview

We have developed our Operating Model in response to the changes in the health and care system set out in the Health and Care Bill, in particular to the development of statutory Integrated Care Systems (ICSs) which ICSs are implementing with the guidance of NHS England and NHS Improvement. The primary purpose of our Operating Model is in describing how our business will be delivered through the relationships between national and regional teams in support of our Regions who lead our collaborative relationships with ICSs.

ICSs are positioned as the default system level through which we will conduct our business, both directly and in how we consider ICSs in the other important relationships through which we carry out our work. We will need to lead and manage the tension between our role in delivering national requirements and supporting those of service partners; and convening local health systems to influence our work to meet the needs of their populations; particularly in a time of pressure on public spending, demand management and recovery. 

Our Operating Model includes the principles which will guide how we do our work, building on our values.  The descriptors given in this v1 relate to the application of the principles in the relationships between national and Regional teams in supporting our Regions’ relationships with ICSs.  As we work with the principles we will build on these descriptors to include application in other work activity and relationships. 

Our primary duty under legislation is to secure an effective system for the planning and delivery of education and training of healthcare workers.  We must exercise our functions with a view to:

• ensuring a sufficient number of skilled healthcare workers are available having regard to likely future demand, sustainability of supply and longer-term education and training objectives;
• securing continuous improvement in the quality of education and training and health services;
• promoting and using research;
• securing education and training provided in a way which promotes the NHS Constitution;
• seeking advice and receiving representations from key partners and stakeholders.

Within the health and care workforce and education landscape, we have significant roles in provision of postgraduate medical and dental education; leadership, supporting and commissioning wider clinical professional education, workforce planning and workforce transformation. 

ICSs as partnerships of health and care organisations, coming together to plan and deliver joined up services have four aims:

• Improve outcomes in population health and healthcare
• Tackle inequalities in outcomes, experience and access
• Enhance productivity and value for money
• Help the NHS support broader social and economic development

ICSs will have a duty to have regard to the need to promote education and training to assist us and the Secretary of State in the discharge of our primary duty.

Our Operating Model is set within an ‘all levers, all levels’ integrated planning framing.  This framing integrates workforce planning with population health, service and financial planning.  It enables our role and activities to be articulated in a wider framing in which workforce supply planning in and across different planning units to meet overall workforce need can take place. The integration of health and social care can be supported by utilising the framing in ICSs. Our Operating Model elements comprise:

• This, v1 of our Operating Model, which includes the principles; core activities and a delivery spectrum guiding how we will conduct our business set within an integrated planning framing. This has been tested through a range of key business areas and will be further developed to include sections on accountability and corporate enabling functions/work areas; and to take account of NHSE&I’s Operating Model development and the Health and Care Bill progression.
• Guidance on the HEE and ICS Relationship.  V1 covers the key areas of work activity on which we, through our Regions will collaborate with ICSs, based in the ten ICS People function outcome areas contained in NHSE&I’s ICS People function guidance and set within the integrated planning framing applied to ICSs.  This will be developed through further engagement.
• Worked examples of our Operating Model in action. This knowledge repository will be developed as our Operating Model is applied in practice

Dr Navina Evans CBE

Chief Executive

David Farrelly

Chief Operating Officer