Government announces plans to reform NHS for more joined up care

  • 11 February 2021
Government announces plans to reform NHS for more joined up care

The government has formally announced plans to reform the NHS in a bid to deliver a more joined up health and care system.

The white paper, which was leaked earlier this week, details plans to embed lessons learned during the Covid-19 pandemic and make legislative changes to reduce red tape around procurement and data sharing.

It will “modernise the legal framework” to make the health system “fit for the future”, according to a Department of Health and Social Care statement.

The plans follow health secretary Matt Hancock’s ‘bureaucracy-busting mission’, which aims to improve the use of data within the NHS and would see the health service capitalise on “good practice” responses during Covid-19.

These new proposals would see integrated care become the default and would enable the NHS to use technology in a modern way to support staff and patient care, including improving quality and availability of data, the DHSC 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,” Hancock said.

“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.”

He suggested the plans would enable the Conservative party to deliver on election promises including 50,000 more nurses and 40 new hospitals.

Sir Simon Stevens, chief executive of the NHS, added: “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.”

Under the plans Integrated Care Systems (ICSs) would be enshrined in law with every area in England covered by a system, Digital Health News reported earlier this week.

The documents, first published in Health Policy Insight, also revealed government plans to reduce the role of private sector organisations and instead give the health secretary greater control over objectives for the NHS. The health secretary would also take greater control over NHS England.

Commissioners would no longer be required to put contracts out to tender and instead there would be a new policy which gives the NHS and local authorities greater flexibility over who would provide healthcare services.

Ed Garratt, executive lead for the Suffolk and North East Essex Integrated Care System, said: “I welcome the white paper 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.”

The government has already begun its drive for better use of data, set out in the white paper, with the launch of a review led by Dr Ben Goldacre into how data can be used for research and analysis.

It will complement the forthcoming Data Strategy for Health and Social Care which will set the direction for the use of data in a post-pandemic healthcare system.

The data strategy, to be led by NHSX, was also recommended by Hancock in his November 2020 call to end bureaucracy in the NHS.

A bill on the plans published today are due to be brought before Parliament later this year.


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9 Comments

  • In the digital H & SC world surely the primary requirement is to give all access and control of all THEIR H&SC DATA? unless of course, you believe in a nanny state…

  • Another use of the word ‘integrated’ which, like ‘joined up’, suggests excellence and synergy of all the entities involved. I have never seen anything done by Government which approaches these phrases in practice. Why is this? Because the Government does not know how to create and implement a project, alpha to omega, as witnessed by nearly everything they do. Such grand plans begin with as fanfare, the promise of almost unlimited funds and then …. silence. No sponsor, no detailed objectives and deliverables, no team announced (a body maybe), no milestones, review process, (external) quality assurance and all the other things which make a project bring home the bacon. In addition, you will search the internet in vain for a record of what is going on; e.g ‘Project X – progress to date…’.
    The only good which comes out is a big report which marked ‘F&F’, file and forget. In the case of the NHS, take a look at the ‘projects’ in the link below:

    NHS Futures Plans ‘Fiction List’
    https://drive.google.com/file/d/1zARs51c1X-Ygzxr0zpGcMhvRaNx77BVM/view?usp=sharing

    I gave up believing in any far-reaching ‘NHS’ project some time ago.

    • Quite so. Lewis Carroll described this phenomenon very succinctly in 1871:

      “When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’

      ’The question is,’ said Alice, ‘whether you can make words mean so many different things.’

      ’The question is,’ said Humpty Dumpty, ‘which is to be master — that’s all.”

      ― Lewis Carroll, Through the Looking Glass

      • Thanks Terry , I know you sent me this previously but unfortunately it was on my now retired NHS machine. Great to see it out in public for those of us interested in the history of NHS IT – without which its hard to understand the current mess.

    • Terry,
      Many thanks for this: You are absolutely right about past proclamations regarding Government attempts to “digitalise” – or “integrate” the NHS – and your documentation of the past initiatives and political announcements is a resource I shall cherish!
      I have read the leaked White Paper: there seems to be an almost total lack of any of the details necessary to allow a smooth transition from the current situation to the new NHS structure envisioned: in 2013 – when the Health & Social Care Act 2012 (HSCA2012) came into force, this led to a crisis in the day to day functioning of the NHS – certainly for general practice – with the abrupt removal of basic functions such as making the normal, regular payments needed for practices to function, transfers of medical records, pension contribution deductions in time for the correct figures to be submitted to the pensions authorities & the inland revenue etc – with the added problem that not only had the structures been abolished – most of the people with knowledge had been made redundant, taking their institutional knowledge away with them.
      At the moment, this reads like a wish-list: is it too much to hope that lessons from the last re-disorganisation in 2013 have been learned – or even noted?

      • Thanks Joe. tcritchley07 at gmail dot com
        It has more ‘plans’ in it than the one you had.

  • Potentially, the digital NHS is Uneven,digitally the NHS is in a mess, Uneven, maybe our party politicians can make (y)our NHS more digitally level, you can not ignore history, so far, digitally, my KIDZ NHS has become Uneven and it is not the fault of the current or previous party politicians, let us hope the restructuring will get it back on track

    • … but Mary, will anyone take any notice? I defy Matt Hancock and Matthew Gould to read my document and then appear in public talking abut ‘NHS Futures’.

  • “Our legislative proposals go with the grain of what patients and staff across the health service all want to see . . .”

    This is a bare faced lie. I can think of nothing worse than giving unlimited powers to the Secretary of State, who will use the NHS to serve the needs of the digital economy as opposed to the healthcare needs of the nation. Integrated Care Systems imply locality based healthcare. What could possibly be more inequitable? Patients have long had virtually no choice over how they engage with the NHS. These changes will ensure that they will have absolutely none, and absolutely no control over how their health data is used, or with whom it is shared.

    The proposals will complete the process, already far advanced, of making the NHS the biggest threat we face, if we cannot avoid any need for healthcare. I find this a total nightmare.

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