NHS changes proposed following five year plan

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Changes to the commissioning and regulation of health services are needed following the NHS five year forward view.

The proposals are discussed in the Implementing the NHS Five Year Forward View: aligning policies with the plan report from The King's Fund.

The potential for single organisations to take care of all the healthcare needs of "defined populations" with a budget was explored.

There was also a warning that proposed changes to the structure of the NHS in the five year plan could "could fall foul of the competition regulators if they emerge as monopoly integrated providers of NHS care in their area."

The report recommends that rules on procurement and tendering, designed to encourage new providers to enter the market, be waived "where appropriate".

The NHS' first contract with a private provider to run a Hinchingbrooke Hospital recently ended with the company, Circle, handing the hospital back to the NHS.

The report also warns that inspections by the Care Quality Commission may be holding back integrated care by focusing on the performance of one organisation, "almost regardless of the impact on other providers in their area."

One of the factors highlighted in Circle's announcement of its withdrawal from the contract for Hinchingbrooke was an inspection from the CQC.

Chris Ham, chief executive of The King's Fund and lead author of the report, said: "The NHS five year forward view offers a compelling vision for how NHS services need to change but risks gathering dust on the shelf unless fundamental changes are made to the way health services are commissioned, paid for and regulated.

"While NHS leaders will understandably be tempted to focus on dealing with short-term pressures, the reality is that improving operational performance and implementing the changes to services outlined in the Forward View are two sides of the same coin - both must be priorities if the NHS is to confront the challenges it faces."

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