Stevens targets April 2022 for NHS reorganisation

Speaking at an NHS Confederation conference today, NHS England’s chief executive said: “We want everyone to be working as an ICS… from April 2021. If we get legislation in the first part of next year, we expect to be able to put those on a statutory basis by April 2022.”

The government has also recommitted to legislation in its “bureaucracy busting” document published earlier today (see box below). 

Sir Simon told HSJ in September NHSE was expecting legislation in the first half of 2021 which should give ICS a “legal form” — an apparent shift from NHSE’s position a year ago when it said ICS should continue as partnerships rather than new organisations. Creating them as new organisations is highly likely to involve the abolition of clinical commissioning groups, created in 2013.

Sir Simon said “evolved” proposals for legislation would soon be published for engagement.

He said place based relationships, as opposed to the wider system level, are a “foundational building block for joint working” at a local level but there are also “other bigger judgements and partnerships that need to take place”. There has been some concern that local “place” based working, where local authorities, providers and commissioners work more closely together on a smaller patch with more local identity, could be jeopardised by making ICS statutory.

Any legislation is also expected to include a dramatic reversal of competition rules and regulation, as proposed by NHSE last year. Its timing will remain uncertain and subject to political distuption, however, with rumours of a cabinet reshuffle, which could hold it up, and local elections in May.

Sir Simon used the same conference to confirm the government’s spending review on Wednesday would include funding for “extra health needs that have arisen due to the pandemic” such as elective backlogs; but said it would not cover direct covid costs in 2021-22 costs. He said: “What we have agreed with the government is that they are putting in funding for extra health needs and they will continue to work with us about [covering] extra covid costs going into 2021-22. We agree it makes more sense to answer that question early in the new year.”

He also confirmed a further £20m was being made available to primary care networks this week to fund local vaccinination centre as the response from PCNs had been “so strong”.