Why Is NHS England Being Abolished?
NHS England, established in 2013, oversees the NHS’s budget, commissioning services, staff training, allocating funds, and setting performance targets.
The government cites duplication resulting in NHS England and the Department of Health and Social Care (DHSC) doing the same job, such as overlapping roles in overseeing services like primary care, as a key reason for its abolition. NHS England will be brought back into the DHSC which is said to ensure direct ministerial oversight, reducing red tape and redirecting resources to frontline care, such as reducing hospital waiting times.
The Previous Model (2002–2013)
Before NHS England’s creation under the Health and Social Care Act 2012, the NHS operated under a model established around 2002. In this framework, the Department of Health set national policies and budgets, holding direct accountability for NHS performance. Ten Strategic Health Authorities provided regional oversight, coordinating services and ensuring that national priorities were integrated.
Approximately 150 Primary Care Trusts planned local services, such as GP care and hospital treatments. For example, Primary Care Trusts commissioned services to meet targets like reducing diabetes complications, which could involve funding hospital departments or GP-led initiatives.
NHS Trusts and Foundation Trusts, which still exists, delivered the actual care. For example, maternity services and A&E care.
The Existing Model (2013–2025)
Introduced by the Health and Social Care Act 2012, the current model established NHS England to manage the NHS independently. NHS England replaced DHSC’s (then Department of Health) direct control, and the regional oversight provided by the Strategic Health Authorities.
Primary Care Trusts were replaced by Clinical Commissioning Groups (CGS), which later transitioned to Integrated Care Boards and responsible for local NHS services and promote integrated care across NHS providers, local authorities, and social care.
New Model
The new model will return many of NHS England’s current functions to DHSC. It may revert the NHS to a structure resembling the 2002–2013 model, with modern adjustments.
The current 42 Integrated Care Boards may act like leaner Primary Care Trusts, commissioning local services and fostering collaboration across NHS providers and social care. It is unclear whether the regional oversight provided by NHS England will be assumed entirely by DHSC or distributed to new regional structures and the current 42 Integrated Care Boards.
Trainee Solicitor, Yusuf Takoliya observes: “Regardless of the structure adopted, I hope that patient care will remain the Government’s primary concern, with efforts to reduce waiting times.”
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