Editorials

What will the Health and Social Care Bill mean for the NHS in England?

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e2159 (Published 20 March 2012) Cite this as: BMJ 2012;344:e2159
  1. Chris Ham, chief executive
  1. 1King’s Fund, London W1G 0AN, UK
  1. c.ham{at}kingsfund.org.uk

Implementation will be as important as legislation in determining its impact

To summarise the contents of the Health and Social Care Bill in a BMJ editorial is akin to paraphrasing War and Peace on Twitter (box). The provisions of the original bill, already long and comprehensive, have been made even more complex after about 50 days of parliamentary debate. Some 2000 amendments have been made to the bill in response to the work of the Future Forum and the concerns of peers.1 2

The Health and Social Care Bill explained

Main legislative changes
  • Primary care trusts and strategic health authorities will be abolished as part of a radical structural reorganisation, with new health and wellbeing boards being established to improve integration between NHS and local authority services

  • Clinical commissioning groups will take over commissioning from primary care trusts and will work with the new NHS Commissioning Board in doing so

  • A new regulator, Monitor, will be established to regulate providers of NHS services in the interests of patients and prevent anticompetitive behaviour

  • The voice of patients will be strengthened through the setting up of a new national body, HealthWatch, and local HealthWatch organisations

  • A new body, Public Health England, will lead on public health at the national level, and local authorities will do so at a local level

Key amendments
  • New duties to promote integrated care have been placed on key bodies including the NHS Commissioning Board, Monitor, and clinical commissioning groups

  • GP consortiums have been renamed clinical commissioning groups and the original deadline for establishing them by April 2013 has been relaxed—they will now take on their new responsibilities only when they are authorised to do so

  • Several changes have been made to widen clinical involvement in commissioning, with clinical commissioning group governance arrangements also strengthened and a requirement added for them to publish a members’ register of interests to …

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