The government has launched its Health and Social Care White Paper which sets out proposals for the NHS’s response to the Covid-19 pandemic.

The government said the proposals will modernise the legal framework to make the health and care system fit for the future and put in place improvements for the delivery of public health and social care. It said it will support local health and care systems to deliver higher-quality care to their communities, in a way that is less bureaucratic, more accountable and more joined up, by bringing together the NHS, local government and partners together to tackle needs as a whole.

The reforms also aim to enable the health and care sector to use technology in a modern way, establishing it as a better platform to support staff and patient care.

Health and social care secretary Matt Hancock said: “The NHS and local government have long been calling for better integration and less burdensome bureaucracy, and this virus has made clear the time for change is now. These changes will allow us to build back better and bottle the innovation and ingenuity of our brilliant staff during the pandemic, where progress was made despite the legal framework, rather than because of it.

“The proposals build on what the NHS has called for and will become the foundations for a health and care system which is more integrated, more innovative and responsive, and more ready to respond to the challenges of tomorrow, from health inequalities to our ageing population.

Sir Simon Stevens, chief executive of the NHS, added: “Our legislative proposals go with the grain of what patients and staff across the health service all want to see – more joined-up care, less legal bureaucracy and a sharper focus on prevention, inequality and social care. This legislation builds on the past seven years of practical experience and experimentation across the health service and the flexible ‘can-do’ spirit NHS staff have shown in spades throughout the pandemic.

“The proposals are designed to be flexible, allowing the health and care system to continue to evolve, and are designed to better equip the NHS and local health services to meet the longer-term health and societal challenges over the coming decades.”

In response to the launch of the White Paper, David Hare, chief executive of the Independent Healthcare Providers Network, said: “With today’s NHS performance figures showing record long waits with almost 225,000 people waiting over one year for vital NHS treatment, these proposals for NHS reform must be judged not only on whether they ensure that patients receive integrated, joined up care, but also that they ensure that patients have quick access to diagnosis and treatment.

“Since March 2020, independent sector providers have treated millions of NHS patients, including 2.5 million patients under the unprecedented contract whereby all independent hospital capacity was put at the disposal of the NHS in response to Covid-19. It is clear that independent healthcare providers will continue to be vital in supporting the NHS over the coming years by improving access and efficiency in NHS care.

“We are therefore pleased to see a recognition in today’s White Paper that patients will be able to choose from a wide range of healthcare providers so long as they meet NHS standards. We want to see this sit alongside models of integrated care which bring the best of public, voluntary, and independent sector providers together to deliver great care to NHS patients and to avoid what the former health secretary Jeremy Hunt described as ‘cosy local monopolies’.

“We will look closely at proposals for a new provider selection regime where patients and taxpayers alike will want assurances that the NHS will have access to the best and most innovative services regardless of who provides them, and that poorly performing services will be challenged to improve, including through the option of alternative provision.”

Care England, the representative body of independent adult social care providers, stated it welcomed the publication of the White Paper as a step towards real integration between health and social care.

The organisation’s chief executive Professor Martin Green said: “The publication of the NHS White Paper is an opportunity to recognise the interrelationship between health and social care and craft a long-term vision for both sectors. Care England looks forward to working with the government to develop this vision.

“The current situation where health and social care sit in distinct silos is not good for citizens, and is certainly not making the best of the resources available. We hope that these reforms will reshape the NHS and move us towards a system that is measured by the outcomes and which has a seamless interface between health and social care.  Care England would therefore like to engage with the development and implementation of the White Paper. For, if anything, the Covid-19 pandemic has demonstrated the need for the adult social care sector’s voice to be heard in the development of future health and care systems.”

Unison head of health Sara Gorton weighed in with: “Scaling back the damaging internal market that forces the NHS to compete against itself and the private sector can’t happen soon enough. Eight years ago, the then government was warned its changes wouldn’t work and would tie the NHS up in needless competition and contract drafting. Yet ministers carried on regardless.

“Today’s proposals are at least an admission they got that wrong and the start of a process to undo their costly mistakes. But the most disappointing element is what’s missing. The pandemic has laid bare the extent of the social care crisis, yet the sector must now wait many more months before it receives government attention.

“Politicians have talked about integrating health and social care for years. But that can’t happen while care is in a state of permanent crisis. A well-funded national care service that mirrors the NHS is needed now. That must be the government’s priority.”

Dr Rhidian Hughes, chief executive of the Voluntary Organisations Disability Group, said: “VODG supports the policy focus for more integrated health and social care services but approaches today’s White Paper with a degree of caution.

“On the back of NHS’s proposals to reorganise itself better and the expansion of integrated care systems, the content of the White Paper is heavily focused on systems, frameworks, and legislation, when what we need is to put people at the heart of a Health and Care Bill and for person-centred policies to be front and centre of proposals. Furthermore, according to today’s White Paper, separate proposals for social care reform will be announced later this year – a further delay to already long-awaited and overdue promises of reform.

“The coronavirus pandemic has shown us that the impact of a poorly organised health and social care system is felt most by people who draw upon social care services and community support to live the lives they choose. To genuinely learn from such lessons as well as prepare for the recovery of our health and care system, reform must truly embrace the support that people need to live fulfilling and independent lives and the breadth of organisations providing this support.

“Voluntary sector disability organisations are at the heart of the communities they support and their contribution to society is significant. It is our hope that the government’s ambitions for integration, will genuinely see greater collaboration and partnership working between the NHS and the voluntary sector.

“There are some encouraging measures included in today’s White Paper and we look forward to engaging with ministers on the detail of these to ensure critical unresolved challenges that have long been prevalent in the sector are resolved and that reform genuinely puts people at the heart of decision-making and policy development.”

Date published: February 12, 2021

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