The Royal College of Physicians (RCP) has issued a briefing to peers ahead of the House of Lords second reading of the Health Bill.
The Bill proposes substantial changes to NHS leadership, accountability and service planning. It would abolish NHS England, transfer functions to the secretary of state for health and social care and integrated care boards, establish a framework for a single patient record, change responsibility for specialised commissioning and move national patient-safety investigation functions into the Care Quality Commission.
The RCP supports the ambition to modernise the NHS and broadly welcomes the introduction of a single patient record. However, ministers must provide stronger assurances about clinical leadership, patient safety, health inequalities, environmental sustainability and the resources needed to implement the reforms safely.
The briefing to peers highlights:
- The need to deliver the single patient record safely and effectively: A joined-up record could give clinicians a more complete picture of a patient’s health, reduce repetition and make better use of staff time. Its success will depend on interoperability with existing systems, meaningful clinical and patient involvement, support for people who are digitally excluded, and robust arrangements for privacy, data governance and accountability.
- The importance of protecting clinical leadership: The abolition of NHS England must not result in the loss or fragmentation of clinical expertise. The government should confirm which national clinical leadership roles and functions will be retained, where they will sit and how independent clinical advice will continue to shape policy, service planning and commissioning.
- The need for stronger action on health inequalities: The Bill would require the secretary of state to consider inequalities in access to services and health outcomes. The RCP believes that this should be strengthened to a duty to act to reduce health inequalities, supported by coordinated action across government and transparent reporting on progress.
- The need to maintain accountability for environmental sustainability: The abolition of NHS England risks creating a gap in system-wide responsibility for the NHS’s environmental impact. The RCP supports a statutory duty requiring the secretary of state to report annually to Parliament on the health service’s progress on emissions and environmental sustainability.
- The importance of clinical expertise in specialised commissioning: Integrated care boards will take on responsibility for commissioning most specialised services. The government should ensure that these arrangements include meaningful clinical representation, consistent national standards and safeguards against unjustified variation in access to specialised care.
- The case for retaining independent patient-safety investigation: The Bill would abolish the Health Services Safety Investigations Body and transfer its investigative functions to the Care Quality Commission. The RCP is calling for an independent national patient-safety investigation body to be retained, with its operational independence, specialist expertise and confidential safe-space protections preserved.