Secretary of State for Health and Social Care (): Over the summer, I
have reviewed DHSC's reform plans, the legislation and the work
underway across the Department of Health and Social Care (DHSC)
and NHS England (NHSE) to deliver the vision set out in the
10-Year Health Plan. I have been clear that our focus must remain
on the health and care of patients and communities across the
country, and on supporting the staff who deliver those services.
On 1 April 2027, subject to the passage of the Health Bill, we
will bring NHS England back into the Department of Health and
Social Care. As set out in the 10-Year Health Plan, we cannot
continue with two parallel national organisations carrying out so
many overlapping and uncoordinated functions. This is
particularly important as we strengthen partnerships and
integration between the NHS and social care and shift more care
into the community and towards prevention.
As we devolve power out to the frontline, the new DHSC must
transform into a streamlined and agile organisation executing a
core set of national functions effectively. The national centre
should offer local areas a single vision, clarity on the future
strategy, and a set of national priorities and minimum standards.
It should also oversee the execution of a sophisticated and clear
rules-based system that rewards success, coordinates an overall
improvement offer and intervenes where performance falls short.
Before the 2012 reforms, most of these functions sat within the
Department of Health. This included the period between 2006 and
2012, when the NHS achieved its strongest performance and public
satisfaction levels. Our future model will therefore draw on that
experience of effective national leadership and delivery, while
reflecting the needs of today's health and care system.
We will maintain the crucial role of the NHS Chief Executive and
establish an NHS Group within DHSC, focused on NHS operational
delivery and working alongside the Department's other core
responsibilities, including policy development, social care and
public health.
The vast majority of NHSE's current national delivery functions
will transfer into the NHS Group. Elsewhere, we will bring
together existing DHSC and NHSE expertise in combined teams,
strengthening our ability to bring policy-makers together with
operational service delivery experts across a range of issues.
This will be particularly important for areas such as
neighbourhood health, where delivery depends on close working
between the NHS, social care, other government partners and the
voluntary sector.
I want to see greater devolution to local organisations and
communities, alongside closer alignment between the NHS, social
care, Mayoral Strategic Authorities (MSAs) and local councils. We
will therefore continue work and consultation on how boundaries,
partnerships and the alignment of powers should evolve across
regions, MSAs and local areas.
NHS regional teams will support this transition given their
knowledge of local circumstances, communities and patients needed
to support performance improvement. These teams will not transfer
into DHSC on 1 April 2027.
To support the continuing work of the seven existing regional
teams, we will establish a transitional Special Health Authority.
It will be accountable directly to the Health and Social Care
Secretary, through the NHS Group within the Department.
The transitional Special Health Authority will not exercise
national functions. Its purpose is to support existing regional
teams, allowing them to remain close to the frontline
organisations they support, rather than being centralised within
the Department. We have agreed that this should be a temporary
arrangement that will support the transition towards a more
devolved model.
This can be achieved within the existing legislative framework
and does not require amendments to the Health Bill. The
legislation already provides for the establishment of the special
health authority and for relevant functions of the Secretary of
State to be conferred.
I also believe that decisions about care must be informed by the
experiences of patients and the public. That is why I have chosen
to retain and strengthen Healthwatch, and why the Department will
soon appoint a new Patient Experience Director. This role will
support patients and families who have experienced harm and
injustice, listen to their concerns and help them get answers.
Alongside the voices of patients and families, we must draw more
fully on the expertise of those who provide care. I will
therefore establish the first Clinical Council, bringing together
a small group of senior clinicians to strengthen clinical
leadership across the system and advise Ministers on the NHS's
major clinical priorities. Their experience of treating patients
and improving services will directly inform our decisions.
These reforms must help us get back to what the NHS does best:
caring for people when they need it most. That is the purpose
behind every target and every plan - not changing structures for
their own sake, but so that patients get timely care and families
get the support they need.
