Intended for healthcare professionals


Proposed changes to NHS legislation

BMJ 2019; 365 doi: (Published 11 April 2019) Cite this as: BMJ 2019;365:l1670
  1. Hugh Alderwick, assistant director,
  2. Tim Gardner, senior policy fellow,
  3. Ruth Thorlby, assistant director,
  4. Jennifer Dixon, chief executive
  1. Health Foundation, London, UK
  1. Correspondence to: H Alderwick hugh.alderwick{at}

Workarounds that need greater clarity

In the midst of political chaos over Brexit, national NHS bodies have asked the government to consider changing NHS legislation.1 The changes are designed to make it easier for the NHS to deliver its long term plan, which focused on integrating services, boosting prevention, and improving care quality.2 NHS England is consulting on the proposals and the parliamentary health and social care select committee is currently examining them.3

Why do NHS leaders think new laws are needed? The answer lies in the legacy of the last round of legislative changes in the NHS and shifting directions in health policy.

The Health and Social Care Act 2012 sought to strengthen the role of competition in the health system and introduced changes to the NHS’s structure. These included abolishing some organisations (such as strategic health authorities) and creating new ones (such as clinical commissioning groups (CCGs)). Fast forward to 2019, however, and competition rarely gets a mention in NHS policy. Instead, the long term plan—like the five year forward view before …

View Full Text

Log in

Log in through your institution


* For online subscription