‘Engine rooms’ within systems help to facilitate and oversee transformation within many sustainability and transformation partnerships and integrated care systems. They sit below the executive leadership and provide support to drive forward integration and system redesign. They may include anybody from a programme director to a finance specialist.
This report highlights the variation in how engine rooms are set up in systems across the country, showing how they are adapting to specific local circumstances and ways of working. However, it outlines that, despite a lot of positive work being undertaken in systems across the country, there are three key obstacles to effective engine room working that are common to STPs and ICSs:
- Piecemeal and short-term funding, which is restricting systems’ ability to invest in staff and the infrastructure to deliver transformational change.
- Limited availability of staff with the requisite skillset, with a lack of resources to train existing staff and limited support on HR and governance issues.
- Mixed levels of engagement between systems and other key partners, and at times a lack of understanding over who does what at region, place and neighbourhood level.
The NHS Confederation hopes that this report will contribute to a process of shared learning between systems and provide a platform for solutions to be found in close collaboration with NHS England and NHS Improvement. We would also encourage the organisations to work with systems to develop a sustainable approach to resourcing, supported by a clear stream of funding.