Every part of England to be covered by an integrated care system (ICS), incorporating local NHS bodies, local government and other organisations, together tasked with supporting integration of health and social care. Enhanced “powers of direction” for the government over a newly merged body comprising NHS England and NHS Improvement.
A recognition that competition is not the only way of driving service improvement, the reduction of bureaucracy on commissioners and providers, and elimination of the need for competitive tendering where it adds limited or no value. A requirement for health and adult social care organisations to share anonymised information where such sharing would benefit the health and social care system. Introduction of powers for the health and social care secretary to require data from all registered adult social care providers about all services they provide, whether funded by local authorities or privately by individuals. A new duty for the Care Quality Commission (CQC) to assess local authorities’ delivery of adult social care services, and a power for the secretary of state to intervene where, following assessment under the new CQC duty, it is considered that a local authority is failing to meet their responsibilities. Powers enabling the health and social care secretary to make emergency payments directly to all social care providers when needed to prevent instability in care. Increasing collaboration between ICSs and with NHS England on commissioning to make decisions, pool funds and facilitate services to be arranged for their combined populations. Power to impose capital spending limits on foundation trusts, which have greater autonomy that non-foundation trusts, where necessary as a safeguard for financial sustainability. Establishment of a statutory medical examiner system within the NHS for the purpose of scrutinising all deaths that do not involve a coroner, to increase transparency for the bereaved. Tackling obesity by conveying a new power on ministers to alter certain food labelling requirements, in addition to already announced further restrictions on the advertising of high fat, salt and sugar foods including before the 9pm watershed. Responsibility for the process of introducing fluoridation of water to be moved from local authorities to central government. Bringing forward measures to enable the health and social care secretary to set requirements in relation to hospital food. Allowing the Medicines and Healthcare products Regulatory Agency to develop and maintain publicly funded and operated medicine registries in order to provide patients and prescribers, as well as regulators and the NHS, with the information they need to make evidence-based decisions. Powers to implement comprehensive reciprocal healthcare agreements with countries outside the EEA and Switzerland to support the health of citizens when they travel abroad, subject to bilateral agreements. Remove the Competition and Markets Authority’s function to review mergers involving NHS foundation trusts, placing oversight in the hands of NHS England. Allowing the secretary of state to intervene at any point of a reconfiguration process – for example, the closure of several stroke units being replaced with a single centralised hyper-acute unit. At present the secretary of state can only intervene in reconfigurations after a local authority referral. A duty for the health and social care secretary to publish a document once every five years setting out roles and responsibilities for workforce planning and supply in England.