King's Speech 2026: NHS Modernisation Bill

Wednesday, 13 May 2026 12:18

“My Ministers will push forward with significant reforms to… the National Health Service” The NHS Modernisation Bill is integral to the Government's plans to improve care for patients through investment and modernisation. It will enhance patient safety and experience through a new Single Patient Record, enabling joined-up, proactive care and empowering patients. The Bill puts power and resources in the hands of frontline NHS organisations by...Request free trial

“My Ministers will push forward with significant reforms to… the National Health Service”

The NHS Modernisation Bill is integral to the Government's plans to improve care for patients through investment and modernisation. It will enhance patient safety and experience through a new Single Patient Record, enabling joined-up, proactive care and empowering patients. The Bill puts power and resources in the hands of frontline NHS organisations by abolishing NHS England and stripping back national bureaucracy.

These are necessary steps to reduce inefficiency, drive innovation, and support early intervention to help people stay well for longer. This will help put the NHS back on its feet so it's there for patients when they need it, a better place for staff to work and better value for taxpayers.

What does the Bill do?

Lord Darzi's 2024 Review of the NHS in England found the NHS in a critical condition. A system too rigid and complex, over-centralised and with unclear accountability, using fragmented and outdated information systems resulting in poor patient care and experience.

The 10 Year Health Plan for England sets out the Government's vision to deliver high-quality healthcare for the public. An NHS that harnesses digital technologies, unlocks the value of health data, empowers patients and clinicians, embeds patient voice in decision-making, and gives greater power to local leaders, supported by a streamlined and accountable national centre.

The Bill will:

Build the Single Patient Record - by enabling the NHS to bring together patients health and social care records into one place to improve patient safety and experience. It will enable people to see their own health records securely on the NHS App, empowering them to make informed decisions about their own health. This will apply to those receiving maternity and frailty care by 2028, with learning from this applied to the wider rollout.

Abolish NHS England - by transferring NHS England's functions into the Department of Health and Social Care or the wider system, it will reduce bureaucracy, freeing up resources to be reinvested in the frontline – and in doing so will restore democratic ministerial accountability for national decision-making.

Strengthen local democratic accountability in health systems - by placing new requirements for mayoral nominees to be on Integrated Care Boards (ICBs).

Streamline the patient safety landscape and ensure better outcomes for patients and staff by transferring the Health Services Safety and Investigations Body functions to the Care Quality Commission. It will also help bring confidence that the Government has learnt from previous experiences by extending the time limit for the Care Quality Commission to bring legal action against a provider.

Embed patient voice in national decision-making by transferring the functions of Healthwatch England to the Department of Health and Social Care, and developing a new Patient Experience Directorate in the department to make the public's voice more directly involved in the formulation of policy.

Support ICBs to become strategic commissioners by transferring responsibilities for all but the most specialised commissioning functions to ICBs, including primary care, dentistry, ophthalmology and pharmacy.

Give ICBs the flexibility in how to manage their local systems by refining the membership of their boards. The Bill will also streamline the planning process to ensure there are ICB plans at neighbourhood and strategic level, eliminating the requirement on a local area to have an Integrated Care Partnership and allowing for greater flexibility.

Empower providers through Foundation Trust reform, giving them more flexibility to design and deliver healthcare around local needs by removing the requirement for a Council of Governors. The power to deauthorise Foundation Trusts as a last resort option will also return to Ministers.

Ensure the voices of patients, service users and local people feed directly into the services they receive, by transferring the functions of Local Healthwatch to where local decisions are made. The functions relating to healthcare will transfer into ICBs, while the functions relating to social care move to local authorities. Putting patients at the heart of care means devolving decisions to a local level, so those who truly

understand the needs of their communities are trusted to shape and integrate services more effectively.

Territorial extent and application

The majority of the Bill will extend to England and Wales, with some provisions extending to the whole of the UK. The majority of provisions will apply to England only.

Key facts

Accountability has been lost in layers of bureaucracy. Since NHS England's creation in 2013, the number of staff working in NHS England (including previously independent digital, workforce and trust regulator bodies) and the Department of Health and Social Care has risen by 50 per cent. Local leaders have complained of “two centres”, creating confusion and inertia, and diluting democratic accountability for the NHS. The public rightly expects to hold politicians to account directly for the quality of the services they are paying for.

The reintegration of NHS England and the restructuring of ICBs is expected to

save £1 billion a year by the end of this Parliament.

The wider national health and care landscape includes 23 arm's length bodies, some of which have overlapping responsibilities, creating confusion and slowing decision-making. This Bill will clarify the role of local health bodies, giving them real flexibility to design and deliver health services to best meet the needs of their local populations.

The Hewitt Review of integrated care systems, published April 2023, highlighted challenges to the system from competing requests for information from both NHS England and the Department of Health and Social Care. For example: “... in December 2022, in one instance one integrated care system received 97 ad-hoc requests from DHSC and NHSE, in addition to the 6 key monthly, 11 weekly and 3 daily data returns.”

There are more than 70 different channels or organisations that offer a place for patients or users to share feedback. The Dash Review of patient safety across the health and care landscape, published July 2025, concluded that even though there are multiple organisations representing the voice of the user (including local Healthwatch), patient experience has not been given the attention that it deserves.

A cluttered patient safety landscape has resulted in an overwhelming number of recommendations, varying in quality and value with

recommendations overlapping or contradicting others. The Thirlwall Inquiry found that there have been over 1,400 recommendations from 30 inquiries that have taken place in England and Wales in the last 30 years, related to its Terms of Reference alone. The various inquiries and reviews into maternity care over the last five years resulted in over 450 recommendations.

Information silos across hospitals, GPs and community care force patients to repeat their stories and clinicians to work with incomplete data. This is not just an inconvenience: it puts patient safety at risk. When clinicians do not have all the relevant facts available, they cannot make the best decisions, and patients lose out. A lack of joined up care records also means that the NHS misses opportunities to diagnose and treat people early.

According to Healthwatch England's May 2025 Report, nearly one in four adults have noticed inaccuracies or missing details in their medical records, such as incorrect personal details, inaccurate records of medication, diagnoses, treatments, and conditions. Over one in four of those who have noticed inaccuracies say they have had to repeat their patient history.

Independent public deliberations showed support for the Single Patient Record was strong and wide. It was described as a “long overdue fix to fragmented care” and 76 per cent were in support of a single patient record.

A survey of 1,888 English adults (aged 18-75), by the King's Fund in February 2025, found that nearly two in three patients and carers have experienced at least one problem over the last year with their care, such as having to chase for test results, attending an appointment but the right information was not available, or inability to change or cancel appointments. The survey concluded that this is leading to patient frustration, with four in 10 who faced administration problems less likely to seek care in the future.

In the year up to April 2018, there were over 11 million occasions of a patient presenting to a hospital using a different Electronic Patient Record system to their previous attendance (Warren et al, ‘Measuring the Scale of Hospital Health Record System Fragmentation in England', August 2020).

In the year up to April 2018, nearly 4 million patients accessed care at two or more NHS hospitals trusts, highlighting the demand for effective inter-hospital data sharing. 65 per cent of maternity complaints to the Parliamentary and Health Service Ombudsman between 2020 to 2022 related to communication failures.