Last reviewed 11 February 2021

Health and Social Care Secretary Matt Hancock has announced that “now is a good time” to reform the NHS and social care systems to reduce unnecessary legislative bureaucracy and increase integration.

Ten years on from the last major piece of health and care legislation, the Government’s Integration and Innovation: Working Together to Improve Health and Social Care For All white paper builds on legislative changes contained in the Long Term Plan, available here, and follows consultation undertaken by NHS England.

The proposals reverse NHS reforms in England introduced under former Prime Minister David Cameron via The Health and Social Care Act 2012, which saw the creation of NHS England and replacing primary care trusts with GP-led clinical commissioning groups (CCGs) to organise local services.

With the support of NHS England and health and care system leaders, Matt Hancock said new plans build on learning from the NHS’s successful and innovative response to the Covid-19 pandemic and aim to support the future recovery process. He said 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”.

The Department of Health and Social Care (DHSC) said the legal framework is being modernised to enable targeted improvements for the delivery of public health and social care. It said the reforms will ensure that the systems are less legally bureaucratic, more accountable and more joined up. To achieve this the NHS, local government and partners will all be brought together to tackle the needs of their communities as a whole.

Measures to tackle obesity, oral health and patient choice are included in the plans. Integrated care will be the default and will better support social care, public health and the NHS. The health and care sector will be supported to use better technology, ensuring platforms to support staff and patient care, improving the quality and availability of data across the health and care sectors, and facilitating better planning for the future care of communities.

The NHS will only need to tender services when this has the potential to lead to better outcomes for patients.

Measures to deliver on specific needs in the social care sector 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 improve powers for the Government to directly make payments to adult social care providers where required.

Academy of Medical Royal Colleges Chair Professor Helen Stokes-Lampard supported the greater collaboration through integrated care systems (ICS), that go beyond the traditional NHS boundaries, saying: "This is absolutely the right direction of travel for health and care more widely."

The British Medical Association's (BMA’s) response to the consultation stated that plans could cause “significant changes” to the working lives of GPs.

The upcoming bill will put the Healthcare Safety Investigations Branch (HSIB) permanently into law as a statutory body so it can continue to reduce risk and improve safety. The bill will be laid in Parliament when parliamentary time allows to carry the proposals into law.

Details of the Government’s White Paper is available here.