Hospital Dr News

NHS reform proposals promote integration and more Whitehall control

The Government has launched a white paper seeking to promote integration and cut bureaucracy.

The paper – called Integration and Innovation: working together to improve health and social care for all – sets out proposals to bring health and care services closer together.

The key NHS reform measures include:

•             Creating statutory Integrated Care Systems.

•             Scrapping mandatory competitive procurements by which NHS staff currently waste a significant amount of time on unnecessary tendering processes for healthcare services. Under today’s proposals, the NHS will only need to tender services when the NHS itself considered this has the potential to lead to better outcomes for patients.

•             Merging Monitor and the Trust Development Authority into NHS England.

•             Social care changes including new assurance and data sharing measures; updated legal framework to enable person-centred models of hospital discharge; and, improved powers for the Secretary of State to directly make payments to adult social care providers where required.

•             The introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed.

The White Paper builds on the past seven years of practical experience and experimentation across the health service kicked off by the NHS Five Year Forward View, and the NHS Long Term Plan and reinforced by the flexibility NHS staff and organisations have shown in throughout the pandemic.

NHS Confederation Chief Executive Danny Mortimer said: “These are the most important set of reforms the NHS has had in a decade. The reality is that the 2012 reforms have largely failed and changes are needed.

“The NHS 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.”

However, Dr Chaand Nagpaul, BMA council chair, warned against another major NHS reform being rushed through.

He said: “The immediate and forthcoming challenge for the NHS will be addressing the greatest backlog of care our health service has ever faced, alongside the continued pressures of Covid-19. This requires significant new resources and an immediate action plan, rather than risk being diverted by a reorganisation of the health service in the midst of the pandemic.”

There is concern that the independence of NHS England – considered to be one of the few positives of the 2012 NHS reforms – will be compromised.

Richard Murray, Chief Executive of The King’s Fund, said: “By sweeping away clunky competition and procurement rules, these new plans could give the NHS and its partners greater flexibility to deliver joined-up care to the increasing numbers of people who rely on multiple different services.

“The thrust of these reforms is about giving local health and care leaders the freedom to make decisions based on the needs of their local population. Yet, running counter to that ambition, Ministers are also proposing they have the power to intervene earlier in local decisions about the opening and closing of NHS services.

“The government and national NHS leaders should be looking to step away from the damaging model of top-down command and control in the NHS.”

A Bill will be laid in Parliament when parliamentary time allows to carry the NHS reform proposals into law.

To provide feedback on the proposals click here.

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