The Department of Health and Social Care (DHSC) has published a White Paper that sets out legislative proposals for a Health and Care Bill.
‘Integration and innovation: working together to improve health and social care for all’,
it details proposals for NHS and social care reform, with a focus on integrated care and services adding value for end-user’s implementation date approx. April 2022.
Alongside the Government’s proposals for the future design of the public health system, including the creation of the National Institute for Health Protection (NIHP) and the closure of Public Health England, a range of targeted proposals in primary legislation relating to public health are proposed. They include :- Making it easier for the Secretary of State to direct NHS England to discharge public health functions alongside the existing section 7A provisions.
Help tackle obesity by introducing further restrictions on the advertising of high fat, salt and sugar foods, as well as a new power for ministers to alter certain food labelling requirements.
The process of fluoridation of water in England will be streamlined by moving the responsibilities for doing so, including consultation responsibilities, from local authorities to central government.
Whilst the legislation is not the vehicle for wholescale social care or public health reform, the Government has sought to use it to address specific problems where legislative change could be beneficial. The Government has indicated that Social Care reforms remain a manifesto commitment and the Government intends to bring forward separate proposals on social care reforms later this year.
The Ten Key Points
1. Integrated Care Systems (ICSs) will become statutory organisations and will be responsible for strategic commissioning. An ICS will comprise (a) an ICS Health and Care Partnership which will bring together parts of the system, including local authorities, primary care, independent sector and voluntary sector; and (b) an ICS NHS Body which will be responsible for the day-to-day running of the ICS.
2. An ICS will be set a financial allocation by NHS England. The ICS NHS Body will develop a plan to meet the health needs of its population and develop a capital plan for the NHS providers in its geography. The ICS NHS Body Chief Executive will become the Accounting Officer for the NHS money allocated to the ICS.
3. Most services will be designed and delivered at Place level. Places will generally be aligned geographically with local authority boundaries and there must be joint decision-making with local authorities.
4. There will be a duty to collaborate. NHS providers will be told to work together in provider collaboratives and organisations across the health and care sector will have a duty to collaborate.
5. There will be reduced bureaucracy across the system to remove transactional barriers to collaborative working.
6. Population health is at the heart of these proposalsis.
7. The government will have the power to impose capital spending limits on Foundation Trusts.
8. NHS England will formally merge with NHS Improvement
9. There will be changes to social care and public health changes including ensuring better integration with the NHS through the ICS structure.
10. Patient Safety and regulatory change. Using the new Health and Care Bill to re-position the existing Health Services Safety Investigations Body (HSSIB) as statutory body.