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New legislation proposes biggest shake-up of English health system in a decade Main Image

New legislation proposes biggest shake-up of English health system in a decade

Thu 29 Jul 2021

The Government claims that the new Health and Care Bill, which was introduced to Parliament in the summer, will reduce bureaucracy and create better partnership-working in the health system.

The Bill aims to create local collaboration in the health system with the introduction of 42 Integrated Care Systems (ICSs) across England, which will replace over 100 Clinical Commissioning Groups (CCGs).

Each ICS will be designed to deliver health priorities across local areas, and membership will be made up of Integrated Care Partnerships (ICPs), Integrated Care Boards (ICBs), local authorities, charities and other sectors.

There is some concern that the geography of the systems will be confusing for local people and some may cover areas which are too big and unwieldly, potentially leading to problems with service delivery.

The Bill will also amalgamate NHS England and NHS Improvement into a single body which will be known as NHS England (NHSE). It will remove the requirement that was previously placed on CCGs to put all health contracts out to tender.


Some critics are concerned about the direct powers which would be conferred on the Secretary of State for Health, making them the sole decision-maker on some aspects of health services and NHS England.

Jonathan Ashworth, the Shadow Secretary of State for Health, described the Bill as a “Trojan horse to hide a power grab by the Secretary of State”, and the British Medical Association (BMA) cautioned: “What should also have been ruled out is extending the powers of the Health Secretary.”

There is also concern about the provision of seats for private sector providers to sit on local boards. The BMA warned: “The threat of private health providers having a formal seat on new decision-making boards, and wielding influence over commissioning decisions, must be ruled out.”

What is clear is that there will be widespread change, however the Bill does not include proposals on how to fix the crisis in our social care system.

Commenting on the Bill, Sarah Russell, Public Affairs Manager at Headway, said: “Whilst we can broadly welcome the proposals for better local collaboration in the provision of healthcare, what is desperately needed is a long-term solution for the crisis in social care.

“The services that are provided to brain injury survivors by Headway groups are largely funded by local authorities and wider reforms on social care should include assurances that no brain injury survivor will be left without the support they rely on.”

The Bill will now progress through the Houses of Parliament and is on track to pass into law in April 2022. However, there are opportunities for the Bill to be amended and Headway will monitor any developments closely.


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