NHS Reforms Report

A team studying the combined impact of the Department of Health’s 2005 Next Steps Reforms within local health systems has recently published its research report. The Next Steps Reforms were intended to provide a coherent and mutually supporting set of reforms that together would lead to better care, better patient experiences, and better value for money.  The study considered three different tracer conditions/services (orthopaedics, diabetes, and early intervention mental health) and six local health economies as comparative case studies.

Principal  investigator and  lead author of the independent report, HSMC’s Professor Martin Powell notes that, ‘It was clear from the research that the framework appears to have been based primarily on addressing elective conditions such as orthopaedics, with far less relevance for our other tracers. In addition, our research suggests that transactional reforms and system management and regulation had more traction than demand and supply reforms. So while there was evidence of  increased activity and reduced waits across the sites and tracers examined, there was little perceived progress towards redesigning care closer to home, enabling prevention, and promoting choice.’

The report concludes that the Next Steps Reforms do not appear to comprise a coherent and mutually supportive set of arrangements in general terms and that they appear to favour suppliers over commissioners, and while achieving much positive impact, they have not delivered their full promise.

'Comparative case studies of health reform in England - report submitted to the Department of Health Policy Research Programme (PRP) (pdf; 1.72KB; opens in new window).

This is an independent report commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department.