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.
Legislating on the future of health and care in England
Healthcare leaders' views on the NHS reform white paper and implications for the forthcoming health and care bill.
31 March 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.
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
The Queen's Speech 2021
An overview of the Queen’s Speech, analysis of bills that carry implications for health and care, and a look at what they mean for the sector.
11 May 2021
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1 April 2021
Beware ministers seeking to reassert control over the NHS
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17 February 2021
Legislation must require clinical and lay members on ICS boards
The recent health and care white paper has broadly been welcomed by health leaders, but there are still concerns that need to be addressed.
1 April 2021
Health and Social Care Committee report on white paper proposals
Commenting on the Health and Social Care Committee's report on the Government’s White Paper proposals for the reform of health and social care.
14 May 2021
Absence of social care in Queen's Speech 'disappointing and disheartening'
Commenting on the Queen's Speech.
11 May 2021