All parts of the NHS need to join up to provide better care

Patients and service users have been telling us for ages that the GP, hospital, community, ambulance, mental health and social care family, separated at birth in 1948, needs to join up to provide them with better care.

A good example is why should patients have to keep their own health and care records - in an exercise book on a fridge in one recent case we encountered - to ensure that the different health and care professionals they deal with, know what each other has done?

This bill will take important steps to help ensure this integration of different care services happens faster and more consistently. But we shouldn't overestimate the power of changing health and care structures - it's an important step but nowhere near sufficient by itself to provide what's needed.

These measures address important flaws in the current legislation, reforming rigid procurement rules, replacing competition with collaboration, and ensuring the commissioning of health services is more strategic and less costly.

But questions remain, for example on the proposed new powers for government ministers to direct NHS England, transfer powers between different health bodies and intervene in local service changes.

Trusts and foundation trusts will rightly remain responsible for the near £90bn spent on ambulance, community, hospital and mental health care services and the 800,000 staff who deliver those services. How will their powers and accountabilities align with the new integrated care systems the government will now give formal powers to?

It's vital that the government works closely with the sector to frame detailed answers to these questions, while recognising the urgent day to day operational pressures trusts continue to face from the pandemic.

This was first published in the Guardian.