Abolished to perfection? Building a better centre for the NHS

The abolition of NHS England and the merging of its functions in the Department of Health and Social Care is a huge undertaking. Delivering it successfully could help to simplify accountability, improve prioritisation, create savings, reset the dynamics between the centre and regions, and improve working with wider government. However, the change could also lead to increases in policy incoherence and blame culture, as well as the loss of skills, capacity and focus on areas outside the day-to-day NHS.

Drawing on past reforms, the report identifies five key factors in whether the process will be a success:

1. The government develops a clear and coherent vision for reform.
2. That vision should be sensitively and openly communicated at every level.
3. The need to move quickly must be balanced against opportunities for deeper transformation and getting the basics right.
4. Reforms inevitably cause disruption – making the pace of reform important for containing costs and uncertainty.
5. Establishing a unified culture and new ways of working should start early in the transition.

This report was published in partnership with the Nuffield Trust.