What the NHS white paper means for the future of health and care in England

A briefing for parliamentarians summarising the government's white paper on NHS reforms and their implications for health and care.

17 March 2021

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This briefing is written for parliamentarians, to provide a summary of the government’s white paper on reforms to health and care; the move towards a more integrated and collaborative way of working; and the NHS Confederation’s viewpoint on what is needed to support these reforms.

Key points for parliamentarians

  • The NHS is moving towards models of working that involve different services working in a more integrated and collaborative way to better manage resources and improve care. 
  • The government’s new white paper supports the move towards integration, legally mandating partnerships within the health and care system called integrated care systems (ICSs) and allowing systems to work together more seamlessly. 
  • The white paper describes two component parts of the ICS:
    • the NHS body, which is mandated to integrate NHS services
    • the health and care partnership, which is aimed at the wider integration of partners, including local government and voluntary sector partners.
  • The reforms outlined in the white paper are the most important NHS reforms for a decade and our members broadly welcome them. The reforms outlined a move away from competitive tendering and outsourcing of healthcare services contained in the last NHS reforms in 2012, which were largely unpopular.
  • We are concerned that the white paper includes measures beyond those intended to improve integration, such as giving the Secretary of State more control over the direction of NHS England and NHS Improvement, and new powers to intervene in service reconfigurations.
  • There is a pressing need for long-term planning and reform of the social care sector and guidance on the future of the public health system, which were omitted from the white paper.
  • The government must also be mindful of the timeline for implementing these measures, considering the operational pressures on the system during the pandemic.
  • The government must engage meaningfully with all partners across the health and social care system, especially with local authorities, to clarify its position alongside NHS service providers within the reformed system.