In February 2021, the Conservative government published Integration and Innovation: Working Together to Improve Health and Social Care for All. The white paper sets out the key elements of a forthcoming health and care bill that is expected in 2021. This will be the most significant legislative reform to the NHS since the Coalition Government published the Health and Social Care Act 2012.
The government’s reforms outline a move away from key tenets of the Health and Social Care Act 2012, most notably reducing the emphasis on competitive tendering and outsourcing of healthcare services in favour of embracing collaboration and partnership working.
If approved by parliament, the reforms will legally mandate partnerships called integrated care systems (ICSs) and allow health and care services to work together more seamlessly. In many ways, the NHS has already been working this way for a number of years given it was a key principle of the NHS Five Year Forward View and the NHS Long Term Plan. As such, the reforms are broadly supported, but there are concerns about specific aspects, including proposed increased powers for the Secretary of State of Health and Social Care over the NHS.
Health and care bill: Committee stage briefing
MPs urged to support an amendment imposing checks and balances on new powers for the health secretary to intervene in changes to local health services
21 September 2021
The direction of travel outlined by the Government in its white paper, Integration and Innovation: Working Together to Improve Health and Social Care for All, is broadly supported by our members.
The experience of recent years, and especially the pandemic, have shown the very real benefits of collaboration within the NHS and also with other public services. Our members are clear that the complex challenges facing the health and care sector over the coming years will require ever-closer collaboration, risk-sharing and flexibility, which the proposed legislation will facilitate.
However, over the course of several member events and private discussions, our members have voiced concerns over four key issues – these are outlined below. Sitting above these specific concerns is a general view among our members that the forthcoming legislation should aim to be as permissive as possible.
- The increased powers for the Secretary of State for Health and Social Care over the NHS, including over service reconfigurations.
- Governance and accountability, including how putting integrated care systems on a statutory footing will impact on the statutory responsibilities of NHS trusts and foundation trusts.
- The duty to collaborate and how it will operate in practice.
- The pace and timescales of the reforms and their implementation, especially as the NHS attempts to recover from the Covid-19 pandemic.
We will continue to engage the Department of Health and Social Care, NHS England and NHS Improvement and other parts of government in order to ensure that our members concerns are addressed in the legislation.
Health and care bill: Public Bill Committee written evidence
Committee urged to consider three key asks on SoS powers on service reconfigurations, integrated care board composition and ICS regulation.
13 September 2021
Joint statement on the second reading of the health and care bill
A statement from the NHS Confederation, NHS Providers and the Local Government Association on concerns about the health and care bill.
13 July 2021
Letter to the new Secretary of State about the NHS bill
NHS Confederation chair Lord Victor Adebowale and chief executive Matthew Taylor have written to the new Secretary of State for Health and Social Care
29 June 2021
Time to act together: two-hour crisis response
The Community Network, hosted by the NHS Confederation and NHS Providers, is shining a light on innovative practice among community providers.
28 September 2021
Unpacking system leadership
Matthew Taylor on system leadership and why thinking like a system but acting like an entrepreneur is the order of the day.
21 September 2021
Protect clinicians’ say over local health service changes, warn NHS leaders
Warning that new government reforms will hand ministers largely unchecked new powers over local health services
21 September 2021
Health Foundation warning on NHS funding ‘likely to be tip of iceberg’
Matthew Taylor comments on estimates from the Health Foundation's REAL Centre that the NHS needs up to £16.8bn up to 2024/25.
6 September 2021
HEE launches consultation on long term workforce planning
A formal call for evidence has been launched by Health Education England (HEE) to review the long-term strategic trends for health and social care.
28 July 2021
Health on the Line
New podcast series, hosted by Matthew Taylor, offers fresh perspectives on the healthcare challenges of our time and ways to confront them.
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