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Transforming the Delivery of Heath and Social Care

The case for fundamental change

As a result of the changes contained in the Health and Social Care Act 2012, the NHS is implementing one of the most radical reorganisations in its history. These changes are dominated by the abolition of old organisations such as primary care trusts and strategic health authorities, and the creation of new structures such as clinical commissioning groups and health and wellbeing boards. The architecture of the NHS at a national level is also being reshaped through the establishment of the NHS Commissioning Board and the ‘re-invention’ of Monitor as a sector regulator.

In our view the reforms embedded in the Health and Social Care Act 2012 fail to address the longer-term underlying trends and pressures affecting health and social care services. This is due to the fact that these reforms are mainly concerned with how the NHS is organised, rather than how care is delivered. Different and more fundamental changes are needed to the provision of health and social care services if they are to be fit for the future. This paper makes the case for fundamental change, drawing on evidence and examples from a wide variety of sources.