The UK may be edging further along the roadmap out of lockdown but the impact of COVID-19 on our healthcare services is still stark. One key change taking place and a piece of good news for private healthcare is that upcoming NHS reforms look set to reduce the role of the private sector in the public health service.
The February 2021 government white paper proposed changes that would roll back major parts of the health service shake-up imposed under David Cameron in the 2012 Health and Social Care Act. Entitled “Integration and Innovation: working together to improve health and social care for all”, the policy paper was published by the Department of Health and Social Care. It proposes replacing local commissioning groups with new, larger integrated care organisations.
Reforms are designed to encourage closer collaboration between the NHS and local authorities with a view to improve overall structure and deliver population-level healthcare for 42 separate areas in England. The reforms would support the NHS in a “more integrated” way and build on proposals outlined in the NHS’s January 2019 Long Term Plan.
The need for more joined-up care has also been made a priority in order to address population growth in the over-65s. 2020 marked the first year in history where there were more people aged 65 and over in the world than under-fives. Tackling health inequalities and reducing unnecessary legislative bureaucracy are also high on the list.
More specifically, manifesto commitments include 50,000 more nurses and 40 new hospitals as well as measures to meet specific needs in the social care sector, including new assurance and data sharing initiatives as well as a move towards person-centred models of hospital discharge.
Significant investment will also be made into reducing time spent on unnecessary tendering processes for healthcare services. This will free up more time for providing care and empower local teams to act in the best interests of their communities.
An Uncertain Future
These upgrades are a long time coming but COVID-19 has been the true catalyst for change. Developing these proposals from paper to reality is now essential to aid the NHS in its recovery process from the pandemic. It also means key issues, such as the need for joined-up care, can be addressed before problems escalate further.
While such proposals are obviously extremely positive, it’s important to consider both the present and the immediate future when it comes to healthcare. Things are certainly moving in the right direction for the NHS. But the true impact of these changes is unlikely to manifest for at least another decade. There remains a great level of uncertainty over when and how, and how effectively the changes will manifest.
Concerns have already been raised over how services will be structured, in particular regarding who would procure services, the role of GPs, and potential takeover of GP practices by big, profits-motivated companies.
Key industry figures have also expressed concerns over the impact the rollout of reforms may have on the quality of care. Hugh Alderwick, head of policy at the Health Foundation states that: “The experience from the long history of NHS reorganisations tells us that moving agencies around, changing who’s in charge, and setting up new governance can distract from service improvements, that’s a big risk that’s going to need to be kept a close eye on when we think about the implementation of the proposals.”
Confusion and Clarity
MPs have warned that the reforms “risk sowing confusion and undermining safety” with a lack of clarity over who is ultimately responsible for services. Specifically, concerns were raised that the policy paper “lacked detail on the involvement of patients in local services and needed urgent clarification of the new powers the health secretary will have.”
With the reforms proposing new powers for the health secretary to intervene in local reconfigurations, the extent of such power also remains unclear.
In contrast, private healthcare offers a level of certainty and peace of mind with which public services simply cannot compete. Having more than proved its value during the challenges of COVID-19, private is the best route to take for fast-track access to quality support.