Health secretary reveals package of NHS reforms

White paper proposals will cut bureaucracy and drive integration between health and social care, says Hancock, but could also boost DHSC powers
Health secretary Matt Hancock Jonathan Brady/PA Wire/PA Images

By Jim Dunton

11 Feb 2021

Health secretary Matt Hancock has published  proposals for NHS reform aimed at driving health and social care integration, reducing bureaucracy and strengthening prevention work.

Measures included in the Integration and Innovation: working together to improve health and social care for all white paper will move more services out of hospitals and into the community, free staff from running “unnecessary tendering processes” exercises,  and attempt to reduce health inequalities.

The proposals also include a legal framework to allow the NHS and local government to better plan health and care services around patients’ needs and implement innovative solutions more quickly.

Additionally, the white paper features a package of measures to deliver on specific social-care sector needs, including improving oversight and accountability in the delivery of services through new assurance and data-sharing measures.

Under the proposals, the health secretary will also be granted stronger powers to directly make payments to adult social care providers where it is felt to be necessary.

Hancock said the measures outlined in the white paper had been shaped by lessons from the coronavirus pandemic and would modernise the legal framework to make the health and care system “fit for the future”.

“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,” he said.

“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.”

Hancock said that if it acted promptly, the government could turn some of the “beneficial changes” that had been catalysed by the Covid-19 response into permanent fixtures.

NHS England chief executive Sir Simon Stevens said the legislative proposals outlined in the white paper went “with the grain” of what patients and staff across the health service wanted to see.

“This legislation builds on the past seven years of practical experience and experimentation across the health service and the flexible ‘can-do’ spirit NHS staff have shown in spades throughout the pandemic,” he said.

The last major wave of NHS reform in England was carried out under Andrew Lansley in the early years of the coalition government. It was unpopular with health professionals and confused even Lansley's cabinet colleagues. Key elements of the package involved the breakup of primary care trusts and the creation of GP-led clinical commissioning groups, along with the transfer of more public-health responsibilities back to local government.

The Department of Health and Social Care said today's proposals to cut down on “unnecessary tendering processes” for healthcare services would mean the NHS only needed to tender services when it had “the potential to lead to better outcomes for patients”. 

It said the move would mean staff could spend more time on patients and providing care, and local NHS services would have more power to act in the best interests of their communities

Elsewhere, the white paper proposes putting the Healthcare Safety Investigations Branch permanently into law as a statutory body. The branch already investigates when things go wrong, on a no-blame basis, so that lessons can be learned.

DHSC said the pandemic had shown the impact of inequalities on public health outcomes and the need for government to act to help level up health across the country. It said legislation outlined in the white paper would help to support the introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm TV watershed.

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