Watch out – more upheaval is coming to a hospital near you

This time it’s Integrated Care Systems

Cartoon of an Office Worker with Tons of PaperworkThe NHS says these are ‘new partnerships between organisations that meet health and care needs. It’s about giving people the support they need, joined up across local councils, the NHS, and other partners, and removes traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services,”  In the past, these divisions meant many people experienced bad care (their words).

Hang on a minute.  In 1998 the  NHS’s announced they were setting up “Integrated care pathways – structured multidisciplinary care plans which detail essential steps in the care of patients with a specific clinical problem.  Surely the NHS should be working this way anyway?

So what is going on?

Hasn’t the NHS had enough upheavals recently?  Will yet another re-invention of the NHS wheel solve anything, or just create yet another layer of Admin., more confusion, more paperwork, and leave less funding for patient care?

Silver Voices organisation can’t understand this either, saying “The NHS in England has inexplicably published proposals for yet another bureaucratic reshuffle of the health service, at a time when the NHS is facing its worst crisis since it was formed.” 

Apparently CCGs (Clinical commissioning groups) are going to be replaced by 42 Integrated Care Systems, , no doubt with huge organisational costs. This is not the time to be rearranging the deckchairs, when patient care should be the sole priority.

So watch out – Granny-power is about to be unleashed! Silver Voices threaten “we will press ahead with our plans to support any older person who decides to withhold their council tax (rates in Ireland) in protest at their social care needs not being met”.

They are a force to be reckoned with; their campaign against the BBC re-imposing the TV Licence Fee for over 75s, saw 3/4 million refusing to pay.

They should listen to Chris Hopson (right) CEO NHS Providers,Chris Hopson who warns against giving politicians “excessive” powers to control the service..  Until I read his comments in the papers, I thought it was just me that worries this new idea will give politicians more control over our health.

Apparently not.

Commenting on a recent White Paper, Hopson is concerned that Matt Hancock willl get greater control, and has warned againsg giving politicians “excessive” powers to control the NHS.  New schemes might strip the NHS of its independence, and there are signs of tensions between Mnisters and NHS England. . Seems I am not the only person concerned. .

British Medical Journal agrees

In January 2011 Fiona Godlee, their editor in chief, commenting on the then Health Minister (Andrew Lansley’s) plans for reform, pointedly asked “What do you call a government that embarks on the biggest upheaval of the NHS in its 63 year history, at breakneck speed, while simultaneously trying to make unprecedented financial savings? The politically correct answer has got to be: mad.”

Or as ex-MP Ann Widdicombe called it, “bonkers”.

Godlee now says “should we say the same about the government’s plans to reverse the Lansley reforms, coming as they do in the teeth of a pandemic, with hospitals at full stretch and a mass vaccination programme under way?

The details are still emerging, but the key elements are clear: the abandonment of the 2012 Health and Social Care Act’s requirements for competitive tendering for services in England, the shift of control back to Whitehall, and the establishment of new intermediate structures, the “integrated care systems,” to manage healthcare at local level.

Medical opinion says the latest plans are  “incoherent, de-regulatory, off-target, and badly timed. They will do next to nothing to remedy the serious shortcomings highlighted by the pandemic: a depleted NHS, a privatised social care system, with over-centralised, fragmented and part-privatised communicable disease control and public health systems.”


Currently, many organisations have ignored or circumvented the rules to fit local circumstances.  These are working well, but instead of leaving them in situ, NHS Management just can’t leave well alone.  Already the nice, cosy relationship many built up with consultants and nurses during lockdown is falling apart.

However,  if major reforms had ever worked in the past, now is not the right time (for change), says the BMA, when staff are physically and emotionally exhausted and when resources are needed for national recovery and tackling the backlog of non-covid care.

Also, there has been no time for a consultation process. Are we ready to put our faith in the secretary of state for health? And where is the long-awaited commitment to reform social care, which the pandemic has revealed to be the government’s Achilles heel?

La La Lansley’s reforms in 2012 were disruptive, costly, top down, rushed, ideologically driven, and ultimately deeply flawed. In seeking to reverse them, the government must not be allowed another apple cart to upset the NHS yet again.


Currently, numerous petitions are doing the rounds, set up by those concerned at the way the NHS is going.  But before you sign, make sure they aren’t leading out of the frying pan into the fire. 



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