Live Q&A: Beyond NHS England – Navigating changes at NHSE and DHSC

What impact can we expect from the abolition of NHS England (NHSE) and changes at the Department of Health and Social Care (DHSC)? What do these changes mean for your market access and NHS engagement strategies? How will the changes to integrated care board (ICB) budgets impact product launches?

In our second instalment in our series of special Q&A sessions with senior decision-makers in the NHS, we explored the impact of the abolition of NHSE and what we can expect going forward.

Katie Mulholland (Senior Consultant, UK Market Access, Petauri Evidence) led the discussion with:

• Richard Smale (Director of System Coordination, NHSE South West)
• Gail Fortes Mayer (Associate Director of Strategic Commissioning, NHS Arden and Greater East Midlands Commissioning Support Unit)
• Phil Richardson (Former Dorset ICS System Lead, now Chief Innovation Officer, Petauri Evidence)

We have produced a short summary of the discussion. To request a copy of this, please email evidence@petauri.com.

In our first live Q&A in early April , we explored the evolving landscape of stakeholder engagement, the stability of clinical networks amidst administrative changes, and the crucial role of Health Innovation Networks (HINs) in new product access. We emphasised the importance of balancing immediate cost savings with long-term value and prevention, and the necessity of continually testing access strategies and co-designing outcomes with key clinical and management leads.

Since then, several critical developments have emerged. The new Revenue Finance and Contracting Guidance for 2025/26 has introduced stringent financial planning requirements, including a 2% efficiency mandate and a shift towards needs-based allocations for acute and mental health services. These changes aim to ensure financial sustainability and effective resource allocation across ICBs.

Additionally, the cost reduction targets for ICBs have been clarified, with specific reductions varying by region. For instance, the Buckinghamshire, Oxfordshire & Berkshire West (BOB) ICB must reduce its running costs by 35%, aligning with the new national average cost per head of population. This effort includes addressing areas of duplication and reducing non-patient-facing roles to streamline operations and improve efficiency.

We have also seen the abolition of the unpopular elective payment limit and the introduction of new Best Practice Tariffs (BPTs) to encourage outpatient procedures where clinically appropriate. These measures are part of a broader strategy to enhance service delivery and prepare for future challenges.

On Thursday 15th May, Katie and Phil explored these changes with NHS leaders Richard Smale and Gail Fortes Mayer.

This webinar was not be recorded to enable our speakers to share their views openly in these changing times and facilitate a live, active discussion. We will be producing a short written summary of the key discussion points. To request a copy of this, please email evidence@petauri.com.

About our speakers

Richard Smale (Director of System Coordination, NHSE South West)

Richard has worked for the NHS for over 30 years in a broad range of roles including as an accountant, general manager, head of IT services, and as Executive Director of Strategy and Transformation. These roles have involved working for community, mental health, and acute providers, as well as a Commissioning Support Unit, Clinical Commissioning Group, and ICB. His current role is with NHSE South West where he works to coordinate the relationship with local integrated care systems.

Following the recent announcements of the integration of NHSE with the DHSC, and the required reduction in the size of ICBs, Richard will be the Programme Director for the transition programme in the South West. In this context, Richard will bring relevant insights into the changes in the structure of the NHS that are expected to emerge over the coming months.

Gail Fortes Mayer (Associate Director of Strategic Commissioning, NHS Arden and Greater East Midlands Commissioning Support Unit)

Gail has 20 years’ experience in the NHS in commissioning and performance improvement roles. Her past and current roles have involved overseeing commissioning for specialised services, elective and diagnostic pathways, long-term conditions, and cancer. As such, she is ideally placed to comment on the practical implications of the changes we are witnessing in NHSE and DHSC, and the budgetary challenges facing ICBs.