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NHS overhaul sees sweeping structural changes take effect

On 1 April the huge wave of structural changes planned for the NHS in England officially takes effect. 

The massive overhaul is part the government’s Health and Social Care Act, a controversial piece of legislation generally regarded as the most radical NHS reform plan ever.

The reforms are partly designed to encourage greater involvement from the private sector and charities – something that continues to prove extremely controversial.

The regulator Monitor will ensure that there is a level playing field for private companies and charities to compete against NHS organisations to provide care.

Monitor will also regulate providers of health and adult social care services.

Meanwhile, local councils will control public health budgets.

New health and wellbeing boards will help link this work with that of the new clinical commissioning groups, encouraging integrated working across health, social care, public health, and children’s services.

Key structural changes to the NHS:

Primary care trusts (PCTs), which currently control most NHS spending, will be replaced by more than 200 clinical commissioning groups (CCGs).

  • GPs, hospital doctors and nurses will be involved in these
  • PCTs and regional strategic health authorities are phased out
  • Most hospitals and trusts are expected to become foundation trusts by 2014
  • A new NHS Commissioning Board, with four regional and 50 local offices, will oversee the health service from 1 April, charged with improving health outcomes for people in England. It will also ensure CCGs do not overspend
  • A new national body, Healthwatch, is being set up as an independent consumer champion for health and social care services in England

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