The Health and Social Care Secretary, with the support of NHS England and health and care system leaders, will today set out new proposals to build on the successful NHS response to the pandemic. The proposals in the Integration and Innovation White Paper 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.
Action will support recovery by stripping away unnecessary legislative bureaucracy, empowering local leaders and services and tackling health inequalities. The reforms build on the NHS’s Long Term Plan proposals and a bill will be laid in Parliament when parliamentary time allows to carry the proposals into law.
The measures set out today will modernise the legal framework to make the health and care system fit for the future and put in place targeted improvements for the delivery of public health and social care. It will support local health and care systems to deliver higher-quality care to their communities, in a way that is less legally bureaucratic, more accountable and more joined up, by bringing together the NHS, local government and partners together to tackle the needs of their communities as a whole.
The proposals build on the NHS’ recommendations for legislative change in the Long Term Plan and come a decade on from the last major piece of health and care legislation. While the NHS has made practical adaptations within the current legal framework, this can be unnecessarily time consuming and changes are now necessary as part of the future recovery process from the pandemic.
The measures include proposals to make integrated care the default, reduce legal bureaucracy, and better support social care, public health and the NHS. 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.
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.
By acting now, the government can make permanent some of the beneficial changes where COVID-19 has catalysed new and better ways of working and clear the path for improvements into the next decade such as delivering on manifesto commitments including 50,000 more nurses and 40 new hospitals.”
Responding to the Integration and Innovation White Paper, Richard Murray, Chief Executive of The King’s Fund, said: “Most important in these proposals is the welcome shift away from the old legislative focus on competition between healthcare organisations, towards a new model of collaboration, partnership and integration. The White Paper marks a decisive step away from the Coalition’s 2012 reforms.
“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.
“It is clear Ministers also intend to take greater control of national decisions about the NHS. The independence given to NHS England is seen as one of the successes of past reforms, and whilst it is right to clarify who is accountable for the health service, government should protect the day-to-day clinical and operational independence of the NHS.
“There is much to welcome in the ambition of the White Paper, but the history of the NHS is littered with reform plans that overestimated benefits and underestimated disruption. These latest proposals add up to a major reform package and come at a time when the NHS, local authorities and charities are still battling COVID-19. In implementing these proposals, it will be essential to avoid distracting health and care services from dealing with the crisis at hand.
“Health and care services are facing chronic staff shortages, deep health inequalities laid bare by the pandemic, and an urgent need for long term reform of social care. In addition to the structural reforms proposed in this White Paper, there is a pressing need for government to chart a way out of these deep-seated challenges.”