NHS England faces legal challenges over proposed changes to services

Dyer, Clare

doi:10.1136/bmj.k328

Cited by 9 publications

(6 citation statements)

References 1 publication

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“…However, the British Medical Association expressed concern about 'the lack of clarity and accountability surrounding their development so far' (British Medical Association 2018), clearly illustrating the issues that we have raised with the ambiguities surrounding NHSE's accountability for its actions. Concerns among sections of the public about the potential for ACOs to increase privatization and care rationing resulted in two High Court challenges, one of which names the Secretary of State for Health and NHS England as joint defendants, and the other, which names only NHS England (Dyer 2018).…”

Section: The Five Year Forward View and Nhs England As Primary Policymentioning

confidence: 99%

Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England

Hammond

Speed

Allen

et al. 2018

Public Management Review

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Meta-governance involves orchestrating the 'rules of the game' in public management. Arm's-length bodies are particularly important vehicles for this. We consider the case of an arm's-length body (NHS England) created to oversee the English NHS' day-to-day operation, and remove 'political interference'. Although mandated by the Department of Health it has increasingly operated as policy-maker, developing policies in tension with existing legislation, while Ministers have faded from public-facing accounts of service operation. This suggests NHS England operates as a meta-governor, insulating government whilst pursuing its own agenda, and raises crucial questions about governmental accountability whilst simultaneously making answers harder to obtain.

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Section: The Five Year Forward View and Nhs England As Primary Policymentioning

confidence: 99%

Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England

Hammond

Speed

Allen

et al. 2018

Public Management Review

View full text Add to dashboard Cite

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“…In any case, following a legal challenge from opponents to the introduction of accountable care, NHS England has announced that it will pause the introduction of the proposed contract for accountable care organizations until it has completed a consultation exercise. 21,22 An alternative narrative exists that explains the rise of accountable care in terms of an increasing privatization of publicly funded and provided health care services in England. Proponents of this narrative suggest that accountable care will lead to greater involvement of private sector companies in commissioning and providing services and that services are likely to become more fragmented rather than more integrated.…”

Section: Beyond Competition?mentioning

confidence: 99%

More Reform of the English National Health Service: From Competition Back to Planning?

Lewis

2018

Int J Health Serv

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The period of sustained financial austerity since 2009 has led to a shift in competition policy within the English National Health Service. Policymakers have directed their attention away from the preexisting priority to support quicker access to routine and planned hospital care and have focused instead on improving emergency, cancer, and general practitioner services. This has prompted the development of a new policy framework and, in particular, a desire to create collaborative health systems focused on specific populations. In addition, previous policy initiatives to engage the leadership of general practitioners in planning services have been revisited. The overall effect has been to shift emphasis away from competitive markets and back toward a planning approach.

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“…Media coverage informing the public of these changes has also been sparse. A lack of parliamentary scrutiny on many of these large structural changes has also been raised as lacking, so much so that NHS England now faces a legal challenge from academics and campaign groups [ 57 ] with concerns raised that these changes may compromise the principles of equitable and high quality care delivery for the population. [ 58 ] The question of accountability is raised in the very first line of the NHS constitution, the premise on which the UK health service was created in 1948.…”

Section: How Can Key Decisions Be Influenced?mentioning

confidence: 99%

Accountability in the NHS: the impact on cancer care

Macklin-Doherty

2018

ecancer

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Accountability of service delivery is becoming increasingly complex and never has this been more apparent than in the field of Oncology. Cancer care has an unrivalled level of complexity not only in the heterogeneity of management of the disease itself but increasingly in the myriad of service providers, specialities, policymakers and regulatory bodies overseeing its delivery. The stepwise series of changes to NHS structures over recent decades has had an enormous impact on our ability to answer key questions which lie at the heart of accountability: who is making the key decisions about changes to cancer care delivery? What are these reforms achieving? How can they be influenced?It is only through clear and transparent decision-making that we may have any hope of implementing, monitoring and influencing the effects of evidence-based change.However, with growing complexity of service structures and an increasing number of bodies developing ambitious and complex strategies, in a context of resource restraint and system pressures, it has become very difficult to answer these questions clearly. This increasing lack of clarity and transparency around such fundamental questions may mean that, despite there being such a pressing need and apparent desire for accountability in cancer care, paradoxically we may actually be deviating further and further away from this. Perhaps it is time for less complexity and for the decision-makers to get back to some fundamental principles which clinicians have embraced in evidence-based medicine: what is being done and by whom? Is this change beneficial and if not how can we influence change?

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NHS England faces legal challenges over proposed changes to services

Cited by 9 publications

References 1 publication

Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England

Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England

More Reform of the English National Health Service: From Competition Back to Planning?

Accountability in the NHS: the impact on cancer care

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