2012 Health and Social Care Act

The Health and Social Care Act 2012 provided the most extensive reorganisation of the NHS to date. It included:

  • Forming NHS England, the major commissioning body of the NHS. This caused competition between providers for the NHS to compete for funding, thus driving down the costs of healthcare. This act also established Clinical Commissioning Groups (CCGs) which NHS England distributed funds to. CCGs have now evolved into ICS (see: “Structure of the NHS”).

  • Forming Public Health England which became UKHSA and OHID in 2021.

  • Mandating CCGs to make funds available for treatments recommended by NICE.

2014 Five Year Forward View

This report highlighted some key initiatives and changes to the NHS to take place from 2014-2019. Its main aims included:

  • Working with community and care services to free up beds for A&E and ambulances by reducing bed blocking.

  • Increase the number of GPs, pharmacists and mental health therapists.

  • Open Rapid Diagnostic and Assessment Centres to screen more of the public against cancers.

  • Invest more into community care to increase elderly independence.

  • Form 24 Hour Liaison Mental Health teams in A&E in an initiative to equate the care given to both physical and mental health.

  • Increase and improve the use of technology in the NHS.

  • Increase staff employment and retention to reduce locum staff.

  • Assess the necessity of treatments given by the NHS (e.g determining the cost per QALY) in order to invest more money into other parts of the NHS.

2019 NHS Long Term Plan

This is a plan which sets out the key aims for the NHS over the next 10 years. This plan was created after the NHS secured funding with an average increase of 3.4% year on year for the next 5 years (a £20.5bn increase over the period). Some of the key initiatives include:

  • Chapter 1: Supporting and integrating care:

    • Increasing the number of digital GP consultations to reduce waiting times, reduce commuting, and save money.

    • Encourage the formation of Primary Care Networks (PCNs) to increase communication between different primary care providers (e.g GPs, pharmacists, local authorities etc.).

    • Increase funding into primary care by £4.5bn.

    • Form Urgent Treatment Centres (which you can be referred to by GPs or NHS 111) to relieve the growing pressure on A&E. These are centres to treat urgent minor injuries and illnesses which cannot be treated by GPs.

  • Chapter 2: Reducing healthcare inequalities:

    • Prevention programs and campaigns against smoking, obesity and alcohol consumption (e.g the “Healthier You” programme against diabetes).

    • Local CCGs (now ICSs - see: “Structure of the NHS”) must set out their plans to improve local public health.

  • Chapter 3: Increasing care quality:

    • Increase funding into reducing waiting times.

    • Investing £2.3bn into local mental health investments.

    • Increase local centres to screen for cancers to promote earlier cancer diagnoses.

  • Chapter 4: Supporting staff and reducing workforce pressures:

    • Increase the number of medical and nursing school places.

    • New routes for doctors and nurses via apprenticeships.

    • More flexible leave to improve staff retention.

  • Chapter 5: Improving technology in healthcare:

    • Investments into better data management systems.

    • Increase use of AI in documenting patient notes, diagnosing cancers, and calculating doses for treatments.

    • Potential use of AI to answer NHS 111 calls in the future.