Road ahead for the ‘Liberated NHS’

After 14 months of extensive debate and more than 1,000 amendments, The Health and Social Care Bill will soon become the law. This law is expected to ‘Liberate the NHS’ and will give rise to a new NHS structure.

Despite almost two years of uncertainty around the Health Bill, change always brings opportunities to make things better. In the new NHS:

• GPs along with NHS professionals such as hospital consultants and nurses will be given responsibility for spending £60-80bn of NHS budget.
• Clinical Commissioning Groups (CCGs) will replace Primary Care Trusts and will decide on patient care, treatments and payments.
• All hospitals will become foundation trusts and will compete for treatment contracts from CCGs.
• NHS providers will be expected to bring in more competition on the basis of quality and safety.
• Local councils will play a role in health and well being including taking responsibility for public health aspects such as obesity, smoking and alcohol abuse. This will be led by a new body – Public Health England.
• The NHS Commissioning Board will become responsible in the ‘big bang’ roll out of the bill from 1 April 2013.

Massive structural change like this is never easy. 2012 is a big year for the NHS and pretty much all the foundation work for the new structure has already been done. Both the CCGs and NHS Commissioning Board will require significant support in establishing themselves and discharging their responsibilities, and the role of clinical support services will be key. Even with this bill in the New NHS, going forward, there are a number of points to remember.

• The NHS is still free at the point of use (in as much as it ever was). Despite  speculation about the NHS becoming  privatised etc,  nothing seems to have changed on what will be charged.
• The Secretary of State is still responsible for provision of care in the NHS in England.
• Funding will still be an issue and that will continue to have impact on the quality and outcomes of care.

There is a lot of dissatisfaction and mistrust in the grass roots of the NHS and a huge amount of concern about the functioning of the NHS, which was clearly visible during the campaigns to stop the bill. Therefore there is a lot of work that needs to be done to rebuild the confidence that this reform will deliver what was promised.

Let’s not forget, underpinning all this reform is the QIPP agenda and the £20bn of savings to be made. In addition, the NHS IT Strategy is now handed over to the NHS Commissioning Board and we still await clarity on that.

That is the reality. Mandated change will bring plenty of new opportunity. Now the debate is pretty much over, time to get on with implementing the bill and make it work!