New reforms for the NHS

The UK government has unveiled plans for a new round of NHS reforms that aim to pave the way for health and care services to work more closely together, improve care and tackle health inequalities.

The reforms, set out by health and social care secretary Matt Hancock in a new White Paper, seek to ‘cast aside the barriers’ that currently prevent a truly integrated system, driven by proposed changes to the legal framework to enable the health and care system to deliver care to communities with less legal bureaucracy (and increased accountability).

‘For example, the NHS will only need to tender services when it can lead to better outcomes for patients – rather than the current requirements that force them to spend time on competitive tendering even when it adds limited to no value,’ according to a government press release. ‘We want to leave clinicians with more time to focus on frontline care, and for leaders to keep driving the innovation we’ve seen throughout the pandemic’.

As well as steps to cut transactional bureaucracy and facilitate statutory integrated care systems, the new legislative measures, designed to support change already underway within the health service, will ensure that NHS England is accountable to government and the taxpayers that use it ‘while maintaining its clinical and day-to-day operational independence’.

The government also said it would introduce measures to enhance quality and safety in the NHS, ‘including the creation of an independent statutory body to oversee safety investigations’, and work with local authorities ‘to develop enhanced assurance frameworks for social care, that will support improved outcomes and experiences for people and their families’.

“The proposals build on what the NHS has called for and will become the foundations for a health and care system which is more integrated, more innovative and responsive, and more ready to respond to the challenges of tomorrow, from health inequalities to our ageing population,” said Hancock.

“Our legislative proposals go with the grain of what patients and staff across the health service all want to see – more joined-up care, less legal bureaucracy and a sharper focus on prevention, inequality and social care,” said Sir Simon Stevens, chief executive of the NHS. “This legislation builds on the past seven years of practical experience and experimentation across the health service and the flexible ‘can-do’ spirit NHS staff have shown in spades throughout the pandemic”.

“These are the most important set of reforms the NHS has had in a decade,” noted NHS Confederation chief executive Danny Mortimer. “The reality is that the 2012 reforms have largely failed and changes are needed. The reforms will help unlock some of the barriers front-line services face when trying to join up care for the public. The future of health and care must now be based on collaboration and partnership working – these reforms will provide the necessary updates to legislation to make this happen.

“The NHS traditionally fears disruptive reorganisations. But this time round there is much support for these reforms given they will boost efforts to integrate patient care. The use of competition and outsourcing as the main tools to improve quality of care and value for money for taxpayers will be replaced by collaboration and partnership working. This is what leaders across the NHS want. But that doesn’t mean we should end up with local monopolies as we must continue to work effectively, as we now do, with independent and voluntary sector providers.”

The legislative proposals for health and care reform as outlined in the White Paper will begin to be implemented in 2022.