Hancock launches yet another set of NHS reforms


The Health and Social Care Secretary, with the support of NHS England and health and care system leaders, have set out new proposals to ‘build on the successful NHS response to the pandemic’. They say that the proposals will bring health and care services closer together to build back better by improving care and tackling health inequalities through measures to address obesity, oral health and patient choice.


The measures have been set out in a government white paper to be published on GOV.UK.


The measures include proposals to make integrated care the default, reduce legal bureaucracy, and better support social care, public health and the NHS. Officials have said that the reforms will enable the health and care sector to use technology in a modern way, establishing it as a better platform to support staff and patient care, for example by improving the quality and availability of data across the health and care sector to enable systems to plan for the future care of their communities.


The proposals are designed to be flexible, allowing the health and care system to continue to evolve, and are designed to better equip the NHS and local health services to meet the longer-term health and societal challenges over the coming decades.


Key measures included in the ‘Integration and Innovation: working together to improve health and social care for all’ white paper include:


  • The NHS and local government to come together legally as part of integrated care systems to plan health and care services around their patients’ needs, and quickly implement innovative solutions to problems which would normally take years to fix, including moving services out of hospitals and into the community, focusing on preventative healthcare
  • Hardworking 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 it has the potential to lead to better outcomes for patients. This will mean staff can spend more time on patients and providing care, and local NHS services will have more power to act in the best interests of their communities
  • The safety of patients is at the heart of NHS services. The upcoming bill will put the Healthcare Safety Investigations Branch permanently into law as a statutory body so it can continue to reduce risk and improve safety. The Healthcare Safety Investigations Branch already investigates when things go wrong without blaming people, so that mistakes can be learned from, and this strengthens its legal footing
  • A package of measures to deliver on specific needs in the social care sector. This will improve oversight and accountability in the delivery of services through new assurance and data sharing measures in social care, update the legal framework to enable person-centred models of hospital discharge, and introduce improved powers for the Secretary of State to directly make payments to adult social care providers where required
  • The pandemic has shown the impact of inequalities on public health outcomes and the need for government to act to help level up health across the country. Legislation will help to support the introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed


The legislation will fold Monitor and the NHS Trust Development Authority into NHS England while maintaining the clinical and day to day operational independence of the NHS. Corresponding reforms will ensure the Secretary of State for Health and Social Care has the right levers to ensure accountability back to Parliament and taxpayers.


The white paper sets out the government’s proposals for legislation, building on the extensive consultation that has already been undertaken by NHS England. A bill will be laid before Parliament later in the year.


The government intends to bring forward separate proposals on social care reform later this year.


Health and Social Care Secretary Matt Hancock said:


“The NHS and local government have long been calling for better integration and less burdensome bureaucracy, and this virus has made clear the time for change is now.


“These changes will allow us to build back better and bottle the innovation and ingenuity of our brilliant staff during the pandemic, where progress was made despite the legal framework, rather than because of it.


“The proposals build on what the NHS has called for and will become the foundations for a health and care system which is more integrated, more innovative and responsive, and more ready to respond to the challenges of tomorrow, from health inequalities to our ageing population.”


Sir Simon Stevens, Chief Executive of the NHS, said:


“Our legislative proposals go with the grain of what patients and staff across the health service all want to see – more joined-up care, less legal bureaucracy and a sharper focus on prevention, inequality and social care.


“This legislation builds on the past seven years of practical experience and experimentation across the health service and the flexible ‘can-do’ spirit NHS staff have shown in spades throughout the pandemic.”


Prof Helen Stokes-Lampard, Chair of the Academy of Medical Royal Colleges, said:


“We welcome the central proposals to drive integration and support greater collaboration through integrated care systems (ICS), that go beyond the traditional NHS boundaries. This is absolutely the right direction of travel for health and care more widely.


“Legislation won’t make collaboration happen, but it can remove barriers and facilitate the changes that the NHS really needs as we move into the post-pandemic recovery stage.


“It is vital that we see genuine clinical engagement at every level of the operation of the ICS to drive collaboration.


“We will look forward to reviewing the full range of proposals and engaging in the development of the legislation.”


Ed Garratt, Executive Lead for the Suffolk and North East Essex Integrated Care System, said:


“I welcome the white paper, as the lead of an integrated care system, as it gives clearer accountability for the NHS and at a system level formalises shared governance across the NHS, local government and other partners. The proposals will support greater collective effort on improving outcomes for our population, which is the ultimate purpose of our work.”


Commenting on the publication of the government’s White Paper, Malcolm Harrison, Chief Executive of the Company Chemists’ Association (CCA), said:

“We hope the proposed changes in this White Paper will create an environment that allows the community pharmacy sector to do more to help relieve pressure within the rest of the NHS. With waiting times for hospital treatment at their highest for ten years, community pharmacies are needed now more than ever to provide patients with clinical care, close to home. However, to deliver on this, pharmacies need fair funding for both the services they currently provide and for any additional workload they are ready and willing to deliver.

“It is not yet clear how the national and local commissioning of services will work in this new system. It is vital that everyone can access consistent care across the country, and that the good intentions of the White Paper do not lead to a healthcare “postcode lottery”. We also welcome the intention to improve data sharing. The ability for records to be easily accessed and shared by those providing patients with care could transform levels of safety and efficiency, helping to deliver the joined-up NHS that the White Paper is calling for.”


Royal Pharmaceutical Society England Chair Claire Anderson said:

“Steps to facilitate more efficient ways of working are welcome but must be backed by investment and a comprehensive workforce strategy.

“These changes must help not hinder our health and care staff, who are focused on looking after patients during a global pandemic.

“Staff are already under pressure and I’d urge the Government to ensure they get the help they need, supporting their wellbeing, boosting recruitment, and investing in education and training.

“Long-term reforms must also ensure we make the most of the whole of the pharmacy workforce to deliver patient care and reduce health inequalities.

“The white paper includes a welcome focus on patient safety and we know pharmacists’ clinical leadership will be key to supporting this across the health service.

“National plans must be backed by sufficient resource to support local delivery and it will be vitally important for the Government to engage with both patients and health professionals as the proposals move forward.”


Some parts of this article are being shared under the Open Government Copyright licence.


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