Opinion: NHS England scrapped: Verdict on big healthcare plans

Scrapping NHS England is a big sign of intent by the government, as it looks to drive widespread reform into the healthcare system, but this move must not come at the expense of patient care quality levels, nor the ability to recruit and retain vital NHS staff.

The UK government has recently announced that taxpayer-funded quango NHS England is going to be abolished to avoid duplication of work and bring the health service “back into democratic control”, by which they mean it will fall under the responsibility of the Department of Health and Social Care.

A brief history and summary of NHS England

NHS England has existed since 2013, following the Health and Social Care Act 2012. Working alongside the government, it managed the whole of the health service in England, including its near £200 billion annual budget. It helped to:

• Identify where funding should go
• Negotiate deals with providers to get value for money on products and services
• Recruit and train staff
• Be responsible for primary care
• Oversee the delivery of NHS services as a whole

It is a decade-old organisation that employs over 15,000 staff members in England, five times as many as the Department of Health and Social Care employs, and the Health Secretary, Wes Streeting, has confirmed the decision to scrap it will cost some 9,000 civil servants their jobs.

Will scrapping NHS England be successful?

The hope is that this change will benefit taxpayers and patients alike. The government’s goal is to enable the system to work better by bringing it “in-house”, reallocating funds (rumoured to amount to £500 million) to frontline services, improving efficiency and achieving better outcomes for patients.

In my role leading the medical negligence team at Wilkin Chapman; I agree with the Health Secretary that the first port of call with medical care, where appropriate, should be with primary care. I see many instances where a serious problem could have been avoided had the issue been identified at an early stage, where it was eminently more treatable with a more favourable outcome.

I hope that this change can improve the funding available for general practices because access to good quality care at an early stage avoids more complex, substantial problems later down the line. The long-term plan seems to have this in mind, which is wholly positive news.

Questions and concerns

There remain some concerns about the wider impact that this change will have, including the impact on training and education, staff numbers, and whether this will actually improve the quality of the service being delivered.

From our perspective, we want to ensure now, and always, that when things do go wrong that should have been avoided, patients have access to appropriate justice, and that lessons are learned.

Fundamentally however, the best way for satisfaction with the NHS to improve, is by improving the standards of care being provided and it remains to be seen whether these changes will help that.

This change comes at a particularly demanding time for the NHS, with constrained funding and a significant demand and wait for care to be provided. Whilst this is very much early days and it is hoped that the improvements being sought will be realised, the NHS is, in parts, in a very difficult situation, and I hope that the government can find a way to make reforms without compromising patient care.