This Library briefing has been prepared ahead of the forthcoming debate on the impact of the Health and Social Care Act 2012 on the current performance of the National Health Service and its future sustainability. It provides a summary of the changes brought in by the Health and Social Care Act 2012, presents statistics on NHS performance and provides information on recent developments in regard to the issue of the NHS’s finances and its sustainability.
Health and Social Care Act 2012: Performance and Sustainability of the NHS (512 KB , PDF)
On 8 September 2016, the House of Lords will debate the motion “that this House takes note of the impact of the Health and Social Care Act 2012 on the current performance of the National Health Service and its future sustainability”.
The Health and Social Care Act 2012 received royal assent on 27 March 2012, with many of its provisions coming into force on 1 April 2013. It introduced significant structural changes to the NHS, including the establishment of clinical commissioning groups, replacing the previous primary care trusts.
Since the passage of the Act, the NHS has continued to see increasing demand in a challenging economic environment. NHS Improvement—a body established on 1 April 2016 by bringing together existing organisations including Monitor and the NHS Trust Development Authority—has stated that:
Sustained operational and financial challenges continued to affect adversely the performance of the NHS provider sector in 2015/16. Providers faced record high demand and increased cost pressures. Throughout the year, providers worked hard to improve services for patients, reduce costs and maximise resources. Despite these efforts, the sector as a whole continued to underperform against a number of national healthcare standards, and the year-end deficit was almost three times larger than position reported in 2014/15.
On 16 December 2015, the Government established the Sustainability and Transformation Fund (STF), providing £1.8 billion to “help challenged hospitals to achieve financial balance while focusing on changing the way they provide high quality care for patients”.
Health and Social Care Act 2012: Performance and Sustainability of the NHS (512 KB , PDF)
While handling record demand, the social care sector in England is facing workforce, resource and funding pressures. There are also millions of people providing unpaid care. The new Labour government has announced an intention to create a ‘National Care Service’, and to improve NHS and social care integration as part of a 10-year plan for reform.
Between 1970 and the early 1990s, over 30,000 NHS patients were given blood transfusions, or treatments made using blood products, which were contaminated with hepatitis C or HIV. Over 3,000 people have since died, and thousands more live with health conditions. The infected blood inquiry called for immediate compensation, public memorials, and for lessons to be learned in medicine, government and the civil service. In August 2024 the government set out plans for compensation.
Vaginal mesh implants are used to repair damaged internal tissue. However, many women receiving these implants have experienced severe complications. In 2020, an independent review recommended establishing a compensation scheme for the women affected. The Conservative government rejected this recommendation, saying its focus would be on improving product safety. However, calls for redress have continued, with a subsequent review in 2024 also recommending the establishment of a compensation scheme.
