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What the introduction of the Health and Care Bill could mean

The long-awaited Health and Care Bill was introduced to parliament during the 1st reading yesterday. This follows on from the proposals for legislative change outlined in the NHS Long-Term Plan, as well as what can be learned from the pandemic to benefit patients and staff.

The Bill aims to make the process less bureaucratic, more accountable, and more integrated, following the impact of the pandemic, to help the NHS recover moving forward.

This will mean the disposal of unnecessary bureaucracy on commissioners and providers, so that health and care staff are able to focus on patients and providing care, rather than paperwork. This is believed to then grant more power to local NHS organisations to act in the best interests of their communities, and ensure NHS resources are utilised in the best way. According to the Department of Health and Social Care (DHSC), ministers won't have any say surrounding the decisions made in the NHS about when to run procurements or who to award contracts to.

It aims to do this through a new procurement process, removing the competitive tendering element. The nature of what this entails has not yet been discussed, but would involve the end of CCG's. It comes after discussions with NHS England, the Local Government Association and the health and care sector, to refine the blueprint. This will also be informed by public consultation.

It hopes to ensure that NHS England and Parliament are both answerable to each other, as well as retaining everyday operational and clinical oversight.

It proposes to ensure there is an Integrated Care Board and an Integrated Care Partnership in each part of England, to deliver a more joined up care approach for its local population. This is expected to encourage clinicians, carers and public health experts to work collaboratively across health and care, as part of plans to tackle inequalities. The Bill will also introduce measures to tackle obesity and improve oral health.

Sir Simon Stevens, NHS Chief Executive, explained: “This Bill contains widely supported proposals for integrated care, which have been developed and consulted on over recent years by the NHS itself. They go with the grain of what our staff and patients can see is needed, by removing outdated and bureaucratic legal barriers to joined-up working between GPs, hospitals, and community services.

“In doing so, these pragmatic reforms build on the sensible and practical changes already well underway right across the NHS. And by enabling mutual support between different parts of the local health and care services they will undoubtedly both help tackle health inequalities and speed the recovery of care disrupted by the covid pandemic.”

Matthew Taylor, Chief Executive of the NHS Confederation, said: “Healthcare leaders are broadly supportive of the NHS Bill and there is much consensus that this is the right direction of travel, albeit one with a tight timetable and with lots to put in place over the next nine months.

“Our members are concerned, however, that some of the proposals are not what the health service wants to see, in particular those that could lead to significant centralised and ministerial involvement in everyday matters that affect the NHS. In their current form, these plans also bring with them the risk that arm’s-length bodies, including NHS England and NHS Improvement, could be split up or abolished without any real scrutiny.

“While the health service will be relieved their hard work in planning for these reforms has not gone to waste, they also now desperately need real clarity from the Government about what their funding will be from October onwards.”

The DHSC published their proposed plans in February, in the White Paper Integration and innovation: working together to improve health and social care for all. It also builds on recommendations made by NHS England and NHS Improvement in Integrating care: next steps to building strong and effective integrated care systems across England, as well as plans regarding the health secretary’s powers in terms of the system and targeted changes to public health, social care, and quality and safety matters.

Some of the key measures in the proposed Bill also include:

  • Bringing the NHS and local government together to plan health and care services focused on patients’ needs, and innovating solutions quickly, which would normally take years to fix, including moving services out of hospitals and into the community, focusing on preventative healthcare.
  • A package of measures to deliver on specific needs in the social care sector. It is expected to 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 introduce improved powers for the health secretary to make payments directly to adult social care providers where required.
  • Supporting the introduction of new requirements about calorie labelling on food and drink packaging, and the advertising of junk food before the 9pm watershed. This is in order to meet the government’s obesity strategy target of halving the number of children living with obesity by 2030, through various initiatives.

Health and Social Care Secretary, Sajid Javid, said: “The astonishing response of our health and care services to the Covid-19 pandemic has hit fast-forward on some of the bold changes the NHS set out to deliver in its Long-Term Plan, and shone the spotlight on other areas that require change to achieve better care for our communities.

“To help meet demand, build a better health service and bust the backlog, we need to back the NHS, as it celebrates its 73rd birthday this week, and embed lessons learned from the pandemic. This will support our health and care services to be more integrated and innovative so the NHS can deliver for people in the decades to come.”

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