Reforming Health and Care

Following the publication of the Department of Health and Social Care’s new White Paper on its legislative proposals for a Health and Care Bill last month, the Mills & Reeve health and care team have provided commentary on a number of the reform proposals from procurement and competition to digital and data, Integrated Care Systems and service reconfiguration.

The key aims of the proposals are to:

  • Remove barriers that stop the health and care system from being truly integrated;
  • Remove much of the transactional bureaucracy that has made sensible decision-making harder for example; and
  • Ensure a system that is more accountable and responsive to the people that work in it and the people that use it.

Health policy commentators have largely welcomed the proposals describing them as “important, but not revolutionary” and going with “the grain of policy and practice, but risk getting lost in the long grass of bureaucratic change.” [Professor Judith Smith and Professor Robin Miller at the Health Services Management Centre]

Equally Nigel Edwards of the Nuffield Trust highlights a number of tensions and risks ahead with the significant changes proposed in the White Paper.

One of the issues Nigel highlights is around the new drivers of change explaining that with the reforms marking a departure from the traditional market principles and competition underpinned by the 2012 Health and Social Care Act to drive the NHS, one of the new levers proposed is a new power for the Secretary of State for Health and Social Care to direct the NHS on strategic priorities.

But the principal driver of change will be the Integrated Care Systems – and we discuss some of the knotty issues around ICSs, including the proposals around two ICS boards, joint committees and the importance of place in an article here.

What's next?

The Department's proposals outlined in the White Paper are expected to come into force in 2022; we now await the publication of legislation to understand how many of these proposals will work in practice.

You can read our collection of commentary on the reform proposals below:

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