Don’t ask for ‘unhelpful’ national mandates, warns NHSE director

NHS England’s national medical director has warned health campaigners against demanding “unhelpful” new national rules and mandates, as power was moving to local integrated care boards.

Claire Fuller told the Pathways from Homelessness conference in London that she was against central mandates because “we have never really made anything better by making anything rigid”.

She said the shift of ICBs to becoming strategic commissioners will give them a “greater understanding of their population” need and empower them to “commission services more appropriately, and in theory, move the money around to match it”.

Dr Fuller, who was chief executive of Surrey Heartlands ICB before joining NHSE, said: “The way you increase your voice is by coming together with a single message… the more we connect you through the national [neighbourhood health] pilots, the national programmes that are going on, the stronger it gets.

“But you have to remember: as passionate as the people are in this room, there are probably twelve other rooms meeting around the country today [that are] equally passionate about what they care about and [concerned about] causing harm because we are getting it wrong…

“The more we can not lobby as individual groups, and the more we can lobby for the things that make care better because we know that is true, the more we will get to… reducing the inequalities that go around.”

Read full story (paywalled)

Source: HSJ, 25 March 2026