The Government outlined its plans for NHS reform in the White Paper: Equity and Excellence: Liberating the NHS. This briefing outlines the main features of the proposed reforms and assesses whether they are fit for purpose.
The NHS is facing a major financial challenge. Official NHS sources suggest that, to meet rising demand, there will be a funding shortfall between 2011 and 2014 of £15 to £20bn. The recent White Paper Equity and Excellence: Liberating the NHS, reveals the Government's plans for reforming the NHS in England.
The White Paper outlines a number of key reforms, including:
- giving groups of GP practices ‘real’ budgets to buy care;
- abolishing all PCTs and SHAs, and creating a new NHS Commissioning Board (now NHS England);
- scrapping performance targets, including waiting times;
- transforming Monitor into an economic regulator.
The reforms will result in fundamental changes to the organisation and delivery of care in the NHS in England
The Nuffield Trust briefing concludes that the reforms are substantial and will result in fundamental changes to the organisation and delivery of care to patients in the NHS in England.
While the briefing supports the overall direction of travel, it warns that the reforms will require significant management expertise to implement smoothly. In particular, GP commissioning consortia will need support in several areas.
The briefing warns that the emphasis on competition, patient choice, contracting and public reporting of outcomes to achieve better quality care is risky, particularly given that they will occur at a time when the NHS faces sustained financial challenges, upheaval and cuts in management, and arms-length bodies are merged or abolished.
This briefing will be of interest to healthcare policy-makers, senior managers and clinicians, academics and others interested in the NHS reform agenda.
Nuffield Trust (2010) The coalition Government's NHS reforms: an assessment of the White Paper. Briefing. Nuffield Trust.