The Health Service Journal has today commented that the 'legislative genie is out of the bottle', referring to the fact that there appears to be mounting pressure on the government to update NHS legislation to bring it into line with current policy and what is happening on the ground across the NHS.
From working with our clients, it is clear that the legislative framework is out of date in a number of areas and this can lead to extra costs and delays when implementing strategic initiatives. This is particularly acute when looking at mergers and closer collaboration across local healthcare systems. Much will need to be worked through to update legislation, and two questions stand out regarding this development:
1. When will current policies, largely derived from the Five-Year Forward View published in 2014, be sufficiently well developed to allow legislation to be updated in a way that will allow it to remain relevant for the foreseeable future?
2. When will Parliament have sufficient time to consider such a significant bill, given its current pre-occupation with Brexit?
There are at least four broad areas, with thinking in some seemingly more fleshed out than others: Underpinning sustainability and transformation programmes and integrated care systems with legislation, and establishing integrated care trusts. Removal of the need to automatically refer trust mergers to the Competition and Markets Authority. Some health procurement exempt from international competition rules. Reorganisation of the centre including: > Abolishing Health Education England, with the functions moving to NHS England/Improvement > Resolving NHS England/Improvement joint working > Depending on changes to competition rules, separating out competition functions (technically part of Monitor) from NHSE/I > Some public health responsibilities and functions moved from Public Health England to NHS England