The Health and Care Bill has finally been made law in the biggest shake-up of the NHS since the Lansley Reforms in 2012. The Bill has many implications which affect several different areas of the UK’s health landscape and fundamentally changes the principles by which the NHS seeks to deliver care to patients.
This is chiefly derived from the increased emphasis on collaboration within the NHS rather than overly bureaucratic forced competition. As such, NHS organisations are compelled to work together to achieve the best results for patients in their locality and should seek to work with a wider range of local partners, including social care and housing providers. This is codified by Integrated Care Systems (ICS) being put on a statutory footing.
ICSs have been developed to put local people first and it is beholden upon ICS Boards to deliver plans of action which best reflect the health needs of their individual locality widely, but also on a more granular ‘neighbourhood’ and ‘place’ level.
Automatic tendering has been prohibited in a bid to allow more flexible and less restrictive decision making, while greater freedom has been granted to providers seeking to tender services both to and for patients. Financial stability will also be prioritised to prevent wastefulness and poor decision-making in the NHS.
Modern slavery in supply chains is also tackled by the Bill. Tougher regulations will be outlined to accurately establish whether providers have benefitted from slavery and the steps by which they would be excluded from the tendering process.
On a less encouraging front, the consensus from analysts is that workforce and social care cost plans do not go far enough. People will have their care costs capped at £86,000, but only personal contributions will be counted, leading to accusations of unfairness. While NHS workforce projections will be outlined once every five years at a minimum.
The Secretary of State for Health has also been granted significant powers over the NHS, including the ability to direct NHS England beyond the objectives of the NHS Mandate. These powers were watered-down by ping-ponging in Parliament but remain significant. The Health Secretary will be permitted to intervene in ‘notifiable’ changes to local services if they see fit but will be time-limited to 6 months and be asked to publicly justify their decision.
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