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The bill gives effect to policies set out as part of NHS England’s recommendations for legislative reform following the Long Term Plan and the Integration and Innovation white paper. It would abolish clinical commissioning groups and replace them with integrated care boards (ICBs) to commission hospital and other health services. It would establish integrated care partnerships (ICPs) to bring together ICBs and local authorities to produce an integrated care strategy for their area. NHS England and NHS Improvement would be merged. New powers would be given to the secretary of state, including the power to direct NHS England, to intervene earlier in the reconfiguration of local NHS services, and to transfer functions between NHS bodies. The NHS would no longer be subject to competitive tendering requirements and enforced competition between NHS providers.

The bill contains many other measures, including: setting mandatory information standards for data across the health and adult social care system; establishing the Health Services Safety Investigations Board as a statutory body; making virginity testing an offence; and restricting the advertising of less healthy food and drinks on television, on-demand programme services and online. 

Following a government amendment to the bill at report stage in the House of Commons, means-tested financial support provided by a local authority towards an individual’s personal care costs would not count towards the new £86,000 cap on care costs. This amendment to the bill was controversial.

Other concerns raised about the bill have centred on the level of involvement that private healthcare companies would be able to have in ICBs and the level of transparency in awarding contracts under a new procurement regime. The bill has also been criticised for introducing a major reorganisation of the NHS while it is still dealing with the effects of the coronavirus pandemic, and for not doing enough to address staffing shortfalls in the NHS and the social care sector. The Government sought to address some concerns about the bill through amendments during its passage through the House of Commons, but the Labour Party and others argue these amendments did not go far enough.

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