A new Health and Care Act enacting the most significant reforms in a decade

The Health and Care Bill received Royal Assent on 28 April 2022 to become the Health and Care Act 2022.

The new Act includes a variety of measures relating to the health and care system, including putting the 42 Integrated Care Systems on a statutory footing in time for the 1 July implementation date. This will be a significant relief for ICS local leaders most of whom have already been working in ICS shadow form for some considerable time.

The new Act will see significant reform to the health and care system, with a shift away from competition between healthcare organisations and a move towards collaborative and integrated models of care. The new architecture is more permissive and flexible providing local health and care leaders with greater flexibility to determine accountability, governance and commissioning structures, helping to deliver joined-up care.

Since the Bill was first introduced to Parliament on 6 July 2021, health think tanks and NHS membership bodies such as NHS Confederation and NHS Providers have worked hard to secure change in some areas of concern such as:

• Secretary of State’s new powers over local service reconfigurations - there are new safeguards including the Government having a time limit of six months to consider any local reconfiguration proposal it calls in, and having to publicly justify it.

• Mental health expertise represented on Integrated Care Boards - helping to ensure progress towards parity of esteem and ICS working.

• Flexibility on conflicts of interests, with Integrated Care Board chairs having the flexibility to determine whether participation of a private sector organisation on an ICB constitutes an ‘undermining’ of the independence of the NHS as provided for in the Bill.

Other provisions

• Introduce the new Provider Selection Regime (you can read our earlier posting on the supplementary consultation on the proposals for regulations here).

• On patient safety, putting the Health Services Safety Investigations Body (HSSIB) on a statutory footing.

• Introduce regulation of non-surgical cosmetic procedures and improve the regulation of medical professions.

• Improve data sharing between health and social care and removing barriers in the hospital discharge process, helping to reduce delays for patients.

There are a number of other new measures not listed here but given the Act is a long read, fact sheets about the key elements of the Act have been published and theses can be viewed here.

Looking ahead

As the NHS leaders work towards the implementation date of 1 July for ICSs, we await the detail of the statutory guidance and regulatory framework which will set out the basis on which the system will operate from 1 July.  NHS England and NHS Improvement published several integrated care systems guidance documents and accompanying resources last summer to support the systems’ transition into statutory integrated care boards by 1 April 2022 before the timetable for implementation was delayed to 1 July.

For further information on ICS development visit our ICS Hub.