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Think tank calls for NHS ‘devolution revolution’ framework


2 August 2016

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The NHS needs a framework for a “devolution revolution”, according to a report from think tank Localis.

The report, Local empowerment: How to achieve a sustainable health and care service, makes the case for a greater use of devolution within the NHS.

Much more NHS funding should be raised and controlled locally with local NHS and local government leaders given total control of their entire local health budget, the report argues.

The NHS needs a framework for a “devolution revolution”, according to a report from think tank Localis.

The report, Local empowerment: How to achieve a sustainable health and care service, makes the case for a greater use of devolution within the NHS.

Much more NHS funding should be raised and controlled locally with local NHS and local government leaders given total control of their entire local health budget, the report argues.

The report also says that local areas should be increasingly free of central government control and direction, with greater local flexibilities.

Localis, a think tank for issues relating to devolution, recommends that local areas negotiate health devolution deals with the Government that empower local leaders to drive integration, transformation and financial sustainability.  

Following in the footsteps of Greater Manchester and building on sustainability and transformation plans, it is recommended that as part of these deals local leaders are fully accountable for the health budget with a commitment to transparent accounting between providers and commissioners.

The report also includes a survey of over 100 key NHS and local government stakeholders, which found that 78% said devolving control of the total local health budget would help create a sustainable and integrated local healthcare economy.

Sadiq Khan, the Mayor of London, said the report is further evidence that devolution is “crucial for London”.

He said: “Providing NHS leaders with greater flexibility and ownership over their services will help them to better meet local demands and manage the health of their communities.

“London has become the main tax generator for the whole country, and putting this money back into the capital’s health services and giving them better powers will help create an integrated, sustainable NHS to be proud of.”

Stephen Dorrell, chair of NHS Confederation said: “By taking the opportunity to embed the NHS more closely in the full range of local public services, and harnessing the natural impatience of voters, the report sets out an agenda which provides a key response to the health policy challenges we face.

“The report is also extremely timely. At a time when it seems that discussion about the implications of Brexit borders on an obsession. 

“The message is clear. Civic leaders should not wait for permission; they should act now and seek forgiveness later – in the unlikely event that it proves necessary.”

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