The “Reforming the NHS from within: beyond hierarchy, inspection and markets” report from the King’s Fund reviews different approaches to reforming the NHS in England. The focus is said to be on the implementation of new models of care in the medium and long term (rather than on immediate financial and practical issues).
It is argues that political interventions into running the NHS have tended to result in interventionist and centralised “top-down” approaches, which may have impeded effective reform to date. A new political settlement should clarify the strategic role of ministers (setting funding, establishing priorities and their accountability to Parliament) while leaving local NHS leaders sufficient freedom to innovate and space to lead effective service changes relevant to local circumstances. This report reviews three approaches to NHS reform in England since the late 1990s:
- Targets and performance management.
- Inspection and regulation.
- Competition and choice.
“[This paper] argues for a fundamental shift in how the NHS is reformed, learning from what has worked and what has not in England and elsewhere”.
Read more: Reforming the NHS from within. The Kings Fund.
Note: “Reforming the NHS from within” is the final publication from the “Time to Think Differently” programme, which debated the changes needed for the NHS and social care to meet future challenges. The Barker Commission, investigating the integration of health and social care, arose from this programme.
Ham, C. (2014). Reforming the NHS from within: beyond hierarchy, inspection and markets. London: Barker Commission [Commission on the Future of Health and Social Care in England] / The King’s Fund, June 2014.
It’s time to end top-down reform of the NHS. London: The King’s Fund, June 11th 2014.