NHS chief executive David Nicholson has written to NHS leaders to outline the next major step in the health and care system transition.
Two letters were sent; one to strategic health authority (SHA) and primary care trust (PCT) chairs; and one to senior leaders in the wider NHS.
Nicholson has set out "the last significant organisational change prior to April 2013" to aim for stability and resilience in the current system while it makes the transition to the new one.
He wrote to PCT and SHA chairs: "We are now very well placed to deliver a smooth transition to the new systems and structures by securing the current system, ensuring its resilience and providing continuity of leadership for functions transferring to new bodies.
"To say that this process has been challenging at times is, of course, a huge under-statement. Although we have all been responsible for complex change projects in the past, none of us have dealt with anything on this scale before. We have reached a crucial stage in the process and the new system must now gear up for the challenges it faces."
The letter to wider NHS leaders outlined management and leadership restructuring that Nicholson assured "will not impact on Clinical Commissioning Groups (CCGs) or local authorities as they prepare for their key roles in the new health and care system".
New system leaders will also be brought in to work alongside current SHA and PCT leaders.
People appointed to some leadership roles will manage relevant operational delivery in the current system and planning for the new structure.
Leaders working in this way will be accountable to their new organisations for future planning, and to PCTs and SHAs for current system delivery.
Nicholson said: "As we are now approaching the final six months of transition, arrangements are being put in place to enable new organisations including the NHS Commissioning Board (NHS CB), the NHS Trust Development Authority (NHS TDA), Health Education England (HEE), Local Education and Training Boards (LETBs) and Public Health England (PHE) to lead work relating to their future functions as they become ready to do so."
He added it will happen incrementally from 1 October 2012 to 1 April 2013.
Until April 2013 SHAs and PCTs will retain their statutory functions and governance arrangements. There will be no formal transfer of statutory functions, accountability, budgets or employment of staff before then.
The letters explained these arrangements will be implemented locally in line with current systems and structures.
