4.16 Existing accountability arrangements will remain in place at a national level during 2011-12 and 2012-13, with the NHS Chief Executive remaining accountable for delivery. The NHS Chief Executive will hold the NHS to account for delivery of the requirements set out in the NHS Operating Framework for 2011-12 through a single integrated process. Strategic health authorities will remain accountable, at regional level during 2011-12 and 2012-13, for operational delivery and the transition to new commissioning arrangements. By the end of October 2011, the ten strategic health authorities will be clustered into four groups.
4.17 The primary care trust clusters that are now in place aim to sustain capacity in the system to oversee management and implementation of medium-term QIPP plans. From June 2011, at the latest, clusters will be responsible for 'ownership and leadership' of cluster-wide QIPP plans. From June 2011 to April 2013, they will be responsible for ongoing management and updating of medium-term QIPP plans, but should slowly hand over responsibility for them to clinical commissioning groups responsible for local delivery. This will be overseen and supported by the NHS Commissioning Board, who will take full control of implementation of the QIPP challenge from April 2013 onwards. In 2013-14, they will be carrying out QIPP plans developed between them and the primary care trusts cluster, and then they will be fully responsible for developing the QIPP plans for 2014-15.
4.18 Through cluster arrangements, primary care trusts must work with clinical commissioning groups to develop their operating plans. In some areas QIPP savings projections have been disaggregated to the level of commissioning groups and developing commissioning groups have been encouraged and supported to take on areas of QIPP delivery for which they are best placed.