Responding to the government's Integration and Innovation White Paper, Richard Murray, Chief Executive of The King’s Fund, said:
'Most important in these proposals is the welcome shift away from the old legislative focus on competition between health care organisations towards a new model of collaboration, partnership and integration. The White Paper marks a decisive step away from the coalition government's 2012 reforms.
'By sweeping away clunky competition and procurement rules, these new plans could give the NHS and its partners greater flexibility to deliver joined-up care to the increasing numbers of people who rely on multiple different services.
'The thrust of these reforms is about giving local health and care leaders the freedom to make decisions based on the needs of their local population. Yet, running counter to that ambition, ministers are also proposing they have the power to intervene earlier in local decisions about the opening and closing of NHS services. The government and national NHS leaders should be looking to step away from the damaging model of top-down command and control in the NHS.
'It is clear that ministers also intend to take greater control of national decisions about the NHS. The independence given to NHS England is seen as one of the successes of past reforms, and while it is right to clarify who is accountable for the health service, the government should protect the day-to-day clinical and operational independence of the NHS.
'There is much to welcome in the ambition of the White Paper, but the history of the NHS is littered with reform plans that overestimated benefits and underestimated disruption. These latest proposals add up to a major reform package and come at a time when the NHS, local authorities and charities are still battling Covid-19. In implementing these proposals, it will be essential to avoid distracting health and care services from dealing with the crisis at hand.
'Health and care services are facing chronic staff shortages, deep health inequalities laid bare by the pandemic, and an urgent need for long-term reform of social care. In addition to the structural reforms proposed in this White Paper, there is a pressing need for the government to chart a way out of these deep-seated challenges.'
Notes to editors
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The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.