The new white papers main theme is, working together, promoting collaborative partnerships and integration to strip out needless bureaucracy, enhance public confidence, and to promote public health, social care, quality and safety. The new paper comes at a time when the NHS is still fighting a Covid-19 crisis amidst chronic staff shortages, inequalities and a need for reform.
This new model will encourage varied service models to meet local needs and improve the care for patients who rely on multiple services. The new services will be locally driven however the government will protect day to day clinical and operational NHS service provision, care must be taken not to detract from the Covid-19 demands.
The New White paper does propose some changes to public health and social care however the focus is mainly on reform of the NHS whilst encouraging collaborative integrated care whilst giving more power to the local government of the services. The effectiveness of these changes should be carefully monitored to ensure the desired outcomes are achieved.
NHS England will allocate a budget to the new ICH NHS body to cover the care for the local community and to deliver their plan to meet the needs of the local community. The ICH NHS body will work collaboratively with current strategic planning groups many of which will transfer over to the newly formed ICH NHS body,
The ICH health and care partnership will be set up to address the local public and social care needs.
The new ICSs will work closely with the Health and Wellbeing boards and consider their Joint Strategic Needs Assessment and Wellbeing strategies.
The collaborative working will be supported by the NHS and local government to deliver the NHS’s long-term plans aims
- Better health and wellbeing
- Better quality healthcare
- Financial sustainability
Whilst the government will retain power to impose capital spending limits, engender and protect patient choice rights
The success of the local partnerships influence over the local NHS body may vary due to the legislation not being the key driver more the strength and influence of the local ICSs and their ability to stay focussed on local not national needs. Change can be derailing and the abolition of the CCGs currently in place could lead initially to a drop in service level initially at a time when healthcare services are under extreme pressure.
The reduction in bureaucracy will be welcomed to streamline pricing processes and shift from activity-based payments and to more collaborative and local tariff approaches. This should engender a diversity of providers from all sectors.
Health Education England will be given more flexibility and will adapt a regional model.
The Secretary for State will have appropriate and structured intervention powers over NHS England and will publish the NHS Mandates which NHS England will be expected to achieve. At each parliament a report will be published setting out roles and responsibilities and workforce planning across all the service providers.
Ministers will have more power to intervene, but how this will work in practice and what powers would they exert on the MHRA and NICE, should such Regulatory Bodies be exempted?
CQC are being tasked to assess how local authorities are meeting their adult social care duties and the Secretary for State may intervene when the service are failing.
When patients are discharged from acute care their assessment may take place after discharge with the new proposals.
New Public Health Services will commission services to tackle key health issues.
The MHRA will be given the powers to enable them to put in place comprehensive reciprocal health care agreements with other countries .
The main areas of concern would be the timing of the reform, whilst we are batting Covid-19 and have staff shortages. What services may struggle to restart at the end of the pandemic and how to fill any GAPs in service. How the new ways of working will be supported and developed to ensure that the cultural changes required are effective. If the reduced parliamentary involvement in local healthcare may be deleterious. The White paper will stimulate some heated debate as the Bill passes through parliament.