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Changes to the Structure of the NHS in England

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28 Mar 2013


Monday, 1 April 2013 marks the commencement of the majority of the major changes to the structure of the NHS in England that were set out in the Health and Social Care Act (2012).


The impact of the new system will be to change the way in which health services are commissioned, the way in which NHS money is spent in England and to open the NHS to increased competition from other providers of health services.


The changes will also increase the tailoring of health and social care services at a local level. Local Clinical Commissioning Groups (CCGs), which will include GPs and other healthcare professionals, will be made responsible for commissioning the majority of health and social care services. Local government will also be given increased responsibility in relation to public health.


IanRitchieCommenting on this changes, Mr Ian Ritchie, President of the Royal College of Surgeons of Edinburgh said:

"These changes will have a significant impact on the circa 8,000 Fellows and Members of our College practising in England. They are potentially the biggest transformation to the structure and operation of the NHS in England since it was established in 1948 and it is vitally important that throughout this period of substantial change that standards are maintained and the needs of patients remain paramount.


"The maintenance and promotion of standards have always been central to the ethos of The Royal College of Surgeons of Edinburgh and the importance of such an approach has been underlined by the findings of the Francis Report. There is always a risk that the distraction caused by change can result in individuals and organisations taking their focus away from the patients themselves and it is essential that, with change on this scale, this does not occur."


Professor Graham Layer, Consultant Surgeon and Director of Professional Standards at the Royal Surrey County Hospital NHS Foundation Trust and Honorary Secretary of The Royal College of Surgeons of Edinburgh, added:

g.layer"As a surgeon who has worked within the many differing configurations of the NHS over the years, I am struck how so many changes will be occurring at a similar time. The CCGs are going live, we are dealing with the fallout from the Francis Report and the new challenges from the Care Quality Commission, and there is an on-going 'cost improvement programme' resulting in much disquiet within Trusts. Added to all of this, the GMC have issued their new 'Good Medical Practice' guidance for us to digest, on top of revalidation and the substantial Doctors and Dentists Review Body Report.


"Quite how the new systems and relationships will work after April is anyone's guess and occupies much discussion in the surgeons' coffee room. To me, the only clear future direction is that we, as surgeons, owe patients the very best of care in a safe and secure environment and we must always aim for excellence, whatever the management structures in which we find ourselves working."


For further information, visit the NHS Commissioning Board's website.

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