Briefing on the Health and Care Bill: House of Lords Second Reading Our briefing for the House of Lords on the Health and Care Bill 2021/22

The Health and Care Bill 2021/22 outlines major changes to NHS rules and structures in England. The Bill is the largest legislative shake-up of the NHS in a decade and undoes many of the changes introduced by the Coalition government in the last round of major NHS legislation back in 2012.

The Health Foundation has welcomed the Bill’s broad emphasis on increasing collaboration between different parts of the health and care system. However, opportunities have been missed to support the NHS to recover from the impact of the pandemic and improve productivity; and several aspects of the Bill require closer scrutiny.

This briefing explores the potential implications of the Bill, providing recommendations for how the Bill could be improved as it enters the House of Lords and how it can be effectively implemented in the context of wider reform. It covers:

• the Bill’s proposals to improve integration and collaboration – and the potential barriers to realising these in practice

• our proposal for how the Bill could be strengthened to tackle workforce shortages – by publishing independently verified assessments of future need every two years

• further action the Bill could take to reduce health inequalities, including improved reporting and amending NHS’s ‘triple aim’

• the importance of better data sharing, to improve outcomes and patient experience

• how increased powers for the Secretary of State could threaten the speed and effectiveness of decision-making in the NHS

• government’s last-minute change to the £86k cap on social care costs and how it will disproportionately impact people with lower assets.