Reform proposals will speed up integration and improve patient care

11 February 2021

  • The government has published a new white paper, which outlines legislative proposals to health and care.
  • The Community Network, run jointly by NHS Providers and NHS Confederation, is the national voice of NHS community providers.

Commenting on the government's white paper for NHS reform, NHS Confederation director of communications Daniel Reynolds and NHS Providers director of policy and strategy Miriam Deakin, representing the Community Network, said:

"Better integration between health and care services is vital for improving patient care. Community health services, which already work closely with social care, GP and hospital services, are key to driving that change. These proposals will move us forward.

"At the same time, the proposals in the white paper are wide-ranging and we must be mindful of the timeline for implementing them, considering the operational pressures the system is under. In the coming months the Department of Health and Social Care and NHS England will need to engage in the detail of the proposals and seek consensus on any issues that need to be resolved.

"For community providers, proposals to put in place a legal framework for Discharge to Assess are particularly important. The legal framework that is being proposed will replace current requirements for all Continuing Healthcare and Care Act assessments to take place prior to discharge, and allow assessments to take place after an individual has been discharged from acute care. These proposals are consistent with the existing direction of travel during the COVID-19 pandemic however we would question whether primary legislation is required to make this happen or whether guidance could work effectively and avoid recreating a new statutory model that is too prescriptive.

We also welcome proposals to simplify procurement processes, which divert time and money away from improving patient care.


"We also welcome proposals to simplify procurement processes, which divert time and money away from improving patient care. This is especially important for community providers who often face regular re-tendering processes under contracts with local authorities (under immense financial pressure).

"However, we also acknowledge that local authorities and the NHS are subject to the same competitive procurement regime, and the creation of two separate regimes for councils and the NHS has the potential to cause tensions and fragmentation. Considering this, the government must engage meaningfully with both local authorities and NHS providers of community services to fully evaluate the risks and benefits of reform.

"We also note a range of provisions in support of public health including the creation of the National Institute for Health Protection. While any focus on public health is welcome, we look forward to a much fuller debate on tackling the wider determinants of health, reducing health inequalities and ensuring vital preventative services have the stable, long term funding.

"As the Bill progresses, we look forward to working with the Community Network, government and others to ensure the views of community providers are appropriately reflected."

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