Failing trusts will pay for new intervention regime

NHS England’s new “provider improvement programme” (PIP) is expected to cover about 15 trusts which will have to pay for NHSE’s interventions themselves, HSJ has learned.

NHSE is also beginning a restructure to cut and overhaul its RSP team into a new PIP team, despite concerns from staff, according to internal documents.

They say the new, renamed regime is generally expected to cover about 15 trusts at a time. They will normally enter when they have the lowest level of performance under NHSE’s new performance regime, and are judged to have a “low” capability to improve. Those which have “suffered a catastrophic failure of governance, either [of] quality or finance” will also be likely to enter the PIP, according to documents seen by HSJ.

According to a document seen by HSJ, as of a month ago, NHSE expected 10 trusts to enter the PIP, but a list is still being finalised based on the overhauled national performance and assessment framework.

Alongside the changes, NHSE has launched a consultation on restructuring its RSP team ahead of other parts of the planned merger of NHSE and the Department of Health and Social Care. The RSP team is expected to see a 27.8 per cent cut in whole-time equivalent posts, from 51 to 37. 

HSJ understands members of the team have raised concerns that the speed of their changes will leave them disadvantaged in the reorganisation, or lead to further disruption.

One source said the changes would mean more cost from external temporary staff and consultancy. The PIP regime will use senior figures from outside NHSE, on a temporary basis, and management consultants, documents suggest.

One states: “A blended support model will be agreed, [with staff ] deployed from across: the NHSE team, including from the PIP team (depending on capacity and capability); from the wider NHS family, including temporary board appointments, buddying or other NHS organisations; and/or consultancy support under a national commissioned framework.”

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Source: HSJ, 23 June 2025