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Local autonomy is being “steadily eroded” by central control


8 February 2016

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The autonomy of local providers and professionals, which was key to the Health and Social Care Act 2012, is being “steadily eroded”, a think-tank has warned.

A key focus of the 2012 Act was the ‘liberation’ of the NHS from central command, empowering local providers and professionals.

The autonomy of local providers and professionals, which was key to the Health and Social Care Act 2012, is being “steadily eroded”, a think-tank has warned.

A key focus of the 2012 Act was the ‘liberation’ of the NHS from central command, empowering local providers and professionals.

However, The King’s Fund stated in a new report: “These aims have been steadily eroded over time, culminating in planning guidance, which significantly extends central controls over local decision-making.”

The report, What the planning guidance means to the NHS, analyses the latest planning guidance and said that financial control of the NHS is now more of a priority than upholding autonomy.

Gone “are core elements of the Health and Social Care Act 2012, in particular, the emphasis on competition and the principle of autonomy, with national bodies (including the Department of Health and, increasingly, HM Treasury) re-asserting control – for example, through the introduction of financial control totals for all providers in 2016/17 – in order to get a strong grip on finances and performance.”

Moreover, the think-tank points out the friction between funding for sustainability and transformation, as the £2.1 billion budget for 2016/17 is currently for both tasks and has not been divided yet.

It is “inconceivable” that the NHS can achieve both financial sustainability and large-scale transformation within the financial constraints and “national bodies should be clear about the most important priorities, recognising that not everything can be delivered within the funding available and that difficult choices must be made,” it stated.

 

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