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‘NHS should decentralise for a more localised healthcare delivery,’ new Reform report suggests


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Reform’s proposal introduces a model in which the centre of gravity in the health system is radically shifted to local decision-makers

In a bid to bolster healthcare provision and alleviate the strain on the National Health Service (NHS), Reform, a prominent think tank, has unveiled a groundbreaking proposal titled “Reimagining Health: a framing paper”.

This report, dubbed “Close Enough to Care,” advocates for a significant overhaul within the NHS in England (NHSE), with the aim of fostering improved healthcare delivery nationwide. One of the central tenets of the proposal is the dissolution of NHS England, in favour of transferring fiscal oversight responsibilities to the Department of Health and Social Care (DHSC).

Highlighting the drawbacks of centralisation within the healthcare system, the report stresses the need for a more localised approach to healthcare delivery. It suggests that empowering local authorities could lead to more tailored care solutions, particularly in terms of preventive healthcare measures.

Despite efforts to promote integrated care systems (ICS), the report identifies persistent inefficiencies including “lack control overbudgets and resource allocation”.

Currently, an average of 250 people are likely to have died each week in 2023 while waiting in emergency departments according to a study by Royal College of Emergency Medicine (RCEM).

To address the current issues faced by the healthcare landscape, the proposal recommends delegating greater authority to city mayors and regional leaders, enabling them to make informed decisions about resource allocation and healthcare governance.

Moreover, the report advocates for the redistribution of financial resources to ensure that local communities have the necessary support to meet their healthcare needs. This could involve exploring alternative treatment modalities and innovative approaches to healthcare delivery.

However, the report acknowledges that restructuring alone may not be sufficient to address the systemic challenges facing the NHS. Urgent action is needed to safeguard the sustainability of the healthcare system and ensure its ability to meet the evolving demands of the population.

Overall, “Reimagining Health: a framing paper” underscores the pressing need for substantive reforms within the NHS. It calls on policymakers to take decisive action to address existing inefficiencies and strengthen the resilience of the healthcare system for the benefit of all.


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