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Improvement Unit leads work to transform NHS continuing healthcare across England

MLCSU’s Improvement Unit set up and managed a successful programme management office (PMO) for the National NHS Continuing Healthcare (CHC) Strategic Improvement Programme.


NHS England established the national NHS CHC Strategic Improvement Programme to contribute towards the transformation and efficiency goals of the Five Year Forward View.

The programme goals were to:

  • Reduce variation in patient and carer experience in quality, timeliness and speed of assessment, eligibility decisions and appeal processes
  • Establish national standards of practice and outcome expectations
  • Ensure the best possible package of commissioning is in place
  • Achieve the spending review target of reducing growth in CHC expenditure, through standardisation and adoption of best practice
  • Ensure that assessments occur at the right time and place and reduce the number of full assessments for CHC in acute settings
  • Influence national policy framework and care market oversight to maximise the policy contribution
  • Strengthen the alignment between NHS England work programmes which have a CHC component, such as Personalisation and Choice.


The Improvement Unit established and managed the PMO for this highly complex and challenging national programme, working closely with NHS England colleagues, system leads, clinical commissioning groups (CCGs) and social care.

The programme consisted of two programme directors and five workstreams, and the Board was led by an independent chair, ensuring that all decisions received  the maximum challenge and assurance.


  • Programme Board establishment and management
  • Overall responsibility for PMO
  • Oversight of programme plan
  • Oversight and review of papers produced and collated for board by PMO
  • Production of additional board papers as required
  • Facilitate regular update meetings with Workstream Leads
  • Facilitate workshops/meetings involving multiple workstreams
  • Responsibility for benefits realisation plan
  • Creation and upkeep of programme plan
  • Regular meetings with Workstream leads to update plan and challenge on timelines and dependencies
  • Collation of workstream highlight reports into board report
  • Drafting of/input into additional board papers as required
  • Set up and management of Programme Board meetings and additional delivery group meetings as required
  • Give support to Programme Manager for Programme Board
  • Records management for programme
  • Onboarding and offboarding programme resources
  • Clear terms of reference and objectives for workstreams
  • Responsible for delivery of workstream objectives
  • Responsibility for completing workstream highlight report
  • Presentation of updates to programme board and national/system leads as required.