Heath and Care Bill 2021

The integration and innovation white paper was published by government in February 2021.  It set out proposed reforms to be included in a Health & Care Bill (the Bill) to restructure parts of the NHS in England and create a 'truly integrated' healthcare system with less bureaucracy. Following this, MPs on the Health Select Committee held an inquiry to gather feedback on the Government’s proposals. The RCGP submitted a written response to the inquiry, which was later supported and referenced in the committee's report to government.

The Bill was published and first introduced in the House of Commons on 6 July 2021, with the reforms set to come in to effect as early as April 2022. Chair of the RCGP Martin Marshall responded to the Bill’s first reading and we will be closely monitoring its progression through Parliament over the next few months.

What changes are included in the Bill?

Amongst several significant changes, the Bill places integrated care systems (ICSs) on a statutory footing to make them accountable for commissioning and delivering services to the patients in their footprint. The Bill also includes a new duty on NHS England and local authorities to collaborate on the delivery of care and provide the Health Secretary with increased powers to intervene in the reconfiguration of services.

Further information on the Bill, and the RCGP's work to influence it, can be found below.

About ICSs

ICS stands for Integrated Care System. There are currently 42 ICSs in England, made up of GP surgeries, community and mental health trusts, hospitals and other primary care services, with local authorities and other care providers. The providers, commissioners and local partners in an ICS are responsible for planning and delivering healthcare services to patients in their area.

The Health and Care Bill proposes to establish ICSs as statutory bodies in all parts of England.

Timeline and key links

January 2021

February 2021

March 2021

May 2021

July 2021

Contact us

If you have any questions, concerns or insights relating to the proposed reforms, you can email us at policy@rcgp.org.uk.

Health and Social Care Act 2012

The Health and Social Care Act

The Health and Social Care Act received Royal Assent in March 2012. It has huge implications for patient care in England, placing into law the most extensive restructuring of the NHS in its history.

The implementation of the Act is ongoing, with new Clinical Commissioning Groups (CCGs) taking on full responsibilities on 1 April 2013.

This section contains a record of the College’s response to the Act when it was passing through Parliament, as well as input the College has had on the passage of subsequent regulations that enforce the Act.

Section 75 Regulations

On 28 February 2013 the RCGP wrote to Ministers expressing our concerns that regulations laid before Parliament relating to Section 75 of the Health and Social Care Act would severely restrict CCGs’ freedom to decide not to expose services to market competition.

Read the RCGP’s letter to Earl Howe regarding the Section 75 regulations [PDF]

In response to concerns raised by RCGP and others, the Government revised and relaid these regulations before Parliament on 11 March. The RCGP believes that whilst the new version of the regulations is a step in the right direction, they do not go far enough in terms of clarifying that CCGs will have autonomy to decide not to put services out to competition.

On 14 March 2013 the RCGP wrote to the House of Lords Secondary Legislation Scrutiny Committee expressing our view that Clause 5 should be removed from the new version of the regulations.

Read the RCGP’s letter to the House of Lords Secondary Legislation Scrutiny Committee [PDF]

On 23 April RCGP briefed members of the House of Lords ahead a motion to annul the new version of the regulations. RCGP called for the regulations to be withdrawn so that the wording of some sections (particularly Clause 5) could be clarified.

Read the RCGP's briefing to Members of the House of Lords regarding the Section 75 regulations [PDF]

On 24 April Peers voted not to annul the regulations. RCGP will be engaging with the regulator, Monitor, to ensure that assurances from the Government that CCGs will be free to chose not to put services out to competition where they feel this is in the best interests of patient care, are reflected in the guidance which will be used to interpret the regulations. 

RCGP activity during the Act’s passage through Parliament


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