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NCB plans ‘at least five layers of management’

27 January 2012

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At least five layers of management will run the GP-led commissioning system, under the latest organisational structure draft of the NHS Commissioning Board (NCB).

A document prepared ahead of an NCB meeting in February shows the organisation also expects to employ around 3,500 members of staff.

Of this number, 2,500 will be spread out over 50 local offices around the country, 200 will be placed in four yet-to-be-announced commissioning sectors and 800 will be based at its head office in Leeds.

Work is now underway to allow SHA and PCT clusters to agree on the locations of the local offices and CSUs with emerging CCGs.

It is believed the local offices will be based in the areas covered by the current PCT clusters.

The NCB’s running costs budget for 2014/15 has been placed at £492m.

It is expected that 75% of its total budget will be deployed at a “sub-national” level, which is said to reflect the nature of the clinician-led reforms and aid transition.

The cost of CSUs is excluded from the NCB’s budget and will instead be funded by the running cost provision for CCG support.

The management structure outlined in the document has led Labour MPs to dub the reforms an “utter shambles”.

“In most cases there should be no more than five layers of management in each directorate, from National Director to the ‘front line’,” says the document.

“The exception to this will be the Performance and Operations Directorate, where an additional layer (or layers) will be required to link through to the local offices.

“The principle of no more than five layers of management is based on extensive evidence of effective organisational structures, which has been applied in the DH and other public sector organisations.”