The White Paper Equity and Excellence: Liberating the NHS  (July 2010) proposed changes to the governance, regulation and accountability arrangements of the NHS in England:

• The Care Quality Commission (CQC)  (which was created in 2009 through a merger of the Healthcare Commission, the Mental Health Commission and the Care Service Inspection Service) will continue to register and inspect all health care providers.
• From April 2012 Monitor, which currently regulates foundation trusts, will become an economic regulator, with responsibility for all providers of NHS care from April 2013.
• All NHS providers will have a joint licence overseen by CQC and Monitor, with the CQC responsible for essential levels of safety and quality and Monitor responsible for ensuring continuity of essential services and for financial regulation.
• Monitor will also in set ‘efficient or maximum’ prices for NHS-funded services and have a duty to promote competition for all providers, whether NHS or private. It will have powers to open up the market to competition by for example, requiring monopoly providers to open their facilities to third parties.
• A new independent NHS Commissioning Board will allocate resources to GP commissioning consortia and hold them to account for managing public funds.
• Strategic health authorities which are currently the regional arm of the Department of Health will be abolished by 2012/13.
• Primary care trusts which purchase services from providers on behalf of their residents and hold them to account for delivery will be abolished from April 2013.
• The National Institute for Clinical Excellence is to develop 150 quality standards which the NHS commissioning board will develop into a comprehensive set of indicators against which progress can be measured.
• The white paper also sets out proposals to use information to improve accountability, through use of, for example, patient experience surveys, which will allow the public to see how their local services are performing and so will act as a driver in improving quality of care.
• A new body, HealthWatch England, will sit in the CQC and will act as a voice for patients. Local HealthWatch organisations be funded by and accountable to local authorities and will ensure that the views of patients are reflected in the commissioning of health and social care.
• There are nine professional regulators within the UK, most of them for individual professions, such as the General Medical Council and the Nursing and Midwifery Council. A number of smaller professions are regulated by the Health Professions Council. All these regulators are in turn regulated by the Council for Healthcare Regulatory Excellence.