Reforming the NHS from within: beyond hierarchy, inspection and markets – King’s Fund – 11 June 2014
“Politicians’ role in the running of the National Health Service (NHS) needs to be better defined to counter interventionist and centralising tendencies that have hampered effective reform to date, says a new report published today by The King’s Fund.
The report, Reforming the NHS from within: beyond hierarchy, inspection and markets, argues that a new political settlement is needed that clarifies the strategic role of ministers in determining funding, establishing priorities and providing accountability to Parliament, and leaves local NHS leaders with the space to innovate and lead service change. This settlement should reflect lessons learnt from the experience of the present government’s health reforms, which have failed to distance ministers from the operational management of the NHS as originally intended.
The report challenges the dominant approaches to NHS reform over the past 20 years – targets and performance management; inspection and regulation; and competition and choice. It argues for a fundamental shift in how the NHS is reformed. The NHS needs to move on from prescriptive, top-down approaches to change by progressing from:”
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