Nicholas Timmins’ case study of the National Health Service (NHS) reforms draws out 10 specific lessons from the story of the Health and Social Care Act.

1. Have a story to tell
2. Beware lack of internal challenge
3. Don’t go quiet on plans ahead of an election; or misrepresent them. Do recognise that the
world can change.
4. The coalition negotiations; take more time, involve some expertise
5. The need for a strong centre
6. The role of the Civil Service: recognise the weakness of the Civil Service in the face of a
determined minister; weigh up sound advice.
7. Legislation should be an accurately targeted rifle shot, not a carpet bombing
8. Revolution v. Evolution
9. Don’t overestimate how far key arguments over reform have already been won
10. Build a consensus, or at least some support

In this separate commentary, we link those lessons to earlier work that the Institute for Government has done on:
1. policy making in opposition
2. making coalition government work
3. transitions to government
4. the role of the centre of government
5. being an effective minister
6. better policy making.

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