Government reforms risk reducing accountability in the health system and potentially undermining the performance of key NHS organisations as a result, according to a new report.
The Kings Fund study concludes that the reforms are likely to meet the government's aim of reducing centralised control but will fail to deliver on its commitment to improve local accountability, a key pledge in the coalition agreement.
It warned that the weakness of governance arrangements for GP consortia and health and wellbeing boards may result in the new NHS Commissioning Board intervening in the work of consortia to drive performance, undermining the government's aim of reducing top- down management.
Instead more robust governance arrangements for GP consortia including a properly constituted board and stronger powers for health and wellbeing boards should be introduced.
This should be added alongside measures to strengthen foundation trust boards and support governors in overseeing the performance of hospitals senior staff.
The charity concluded that: ‘with the reforms introducing far-reaching changes to the health landscape, much will depend on how relationships develop between the various bodies in the system.
‘And it may be more difficult for parliament to hold different parts of the NHS to account in future. Ironically, this could lead to pressure for a return to greater political intervention in the future.'
Anna Dixon, director of policy at The King's Fund and one of the report's authors, said: "This report highlights weaknesses in the accountability arrangements set out in the Health and Social Care Bill.
"The pause in the legislative process provides an opportunity to look again at these issues and strengthen accountability in the health system to drive improvements in performance and ensure that public money is well spent."
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