The Health and Care Act 2022: What’s next for the future of healthcare in England?

With the passing of the Health and Care Act 2022, England’s healthcare system is set for its most comprehensive set of reforms yet, with the government planning sweeping changes to its structure and hierarchy as they plot the future of healthcare.

Care commissioning groups and other regional mechanisms will be replaced by integrated care systems (ICS), integrated care boards (ICB), and integrated care partnerships (ICP), formalising healthcare’s commitment to a more collaborative approach to health. This new, collaborative approach will involve cooperation between NHS bodies and healthcare industry organisations at the national and local level, along with residents and businesses within the area served by each ICP.

In June, the Government also published its Digital Health and Social Care plan, outlining the importance of embedding digital health solutions across the healthcare system to improve patient care, provider wellbeing, and operational efficiency.

Although these reforms have the potential to transform healthcare, they come at a precarious time for England’s healthcare system, where years of stretched budgets have combined with COVID-19 backlogs to put even more pressure on overworked clinicians.

The Health and Care Act is a real chance to make a difference for the country’s medical professionals and their patients, but the Act doesn’t include any specific provisions to help alleviate the growing staff shortage as burned-out clinicians leave their roles. That means leaders who take on the responsibility of managing the new Act’s requirements will also need to think critically about how they can make the most of this opportunity and evolve their system in a way that benefits everyone.

An opportunity for healthcare executives to collaborate

At such an important stage of England’s healthcare reform, it’s also vital that leaders are given the space they need to discuss challenges, share resources and ideas, and support each other. To this end, we’ve created the Nuance UK Healthcare Council, a regular forum of executives and experts from across England’s healthcare network, including several foundation trusts. For our inaugural meeting, we worked with the College of Healthcare Information Management (CHIME) and gave leaders from Hospital Trusts such Oxford University Hospitals, The Royal Free London, Calderdale and Huddersfield NHS Foundation Trust, Birmingham and Solihull Mental Health NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust an unprecedented opportunity to collaborate directly—in a completely open and honest environment.

Digital challenges could slow reform progress

Throughout the day’s early sessions, the Council outlined the challenges they’re seeing in their trusts and organisations, often finding that the other leaders were experiencing similar potential roadblocks to progress.

For example, many of our Council members highlighted the difficulty of effectively digitising such a complex system—and choosing the right digital solutions to facilitate that shift. Just like clinical teams, IT teams are under a lot of pressure, and our leaders have concerns that might lead to organisations simply replicating clunky paper processes in a digital environment.

“Experience” was central to all the challenges discussed during the day—both for clinical staff and their patients. Tackling burnout and improving care outcomes can only be achieved with a diverse range of inputs, so our Council members all stressed the importance of engaging everyone in major decisions, including the C-suite, clinicians, non-medical staff, and the patients themselves.

The shift from competition to collaboration

With the core challenges discussed, the Council moved on to the most important part of the day: identifying opportunities for collaboration and ideas for a seamless transition to Integrated Care.

Guided by Stephanie Lahr, MD, a guest speaker from our US Healthcare Council, the panel reflected on how this structural reform signalled a shift from competition to collaboration. Many care providers are used to collaborating within their local area, but there’s been little interaction beyond that, as many regions take different approaches to care delivery. With everyone following the ICS/ICB/ICP structure, there’s much more opportunity to share best practices as they’re discovered—so everyone benefits.

Four best practices for effective reform

Inspired by Dr Lahr’s session, the latter part of the meeting was dedicated to outlining some key takeaways that our Council members will use to guide their decisions as they plan their trusts’ first steps into the new ICS structure.

The Council agreed on four recommendations:

  1. Partnership is vital for faster, more effective progress
  2. Diverse experience is needed to inform major decisions
  3. Digital solutions will be a key enabler
  4. Success will likely be achieved using iterative processes

As an observer of the day’s sessions, I’d like to add a further lesson I learned: be hopeful. There’s no question that this reform will be a dramatic shift for the NHS and other care providers in England, and there’s much work ahead of us. But this energetic, collaborative Council gave me real hope that we can all work together to make meaningful changes in English healthcare, supporting our staff more effectively and providing even better standards of care for our patients.

To explore each session in more detail—and get the full rundown of the Council’s insights from the day—read our white paper summarising the whole meeting.

Join us to create the future of healthcare in England

The Nuance UK Healthcare Council provides a unique opportunity for senior executives from across the healthcare system to collaborate and share best practices and experiences to drive successful reform. And by having direct access to Nuance leaders, Council members will help shape the direction of future digital healthcare innovations. The Council is scheduled to meet again in the autumn, and we’re keen to add more leadership perspectives to the discussion. So, if you’re a healthcare leader who’s interested in adding their voice to the mix, you’ll find details on how to contact the Council in the white paper too, and I encourage you to get involved.

Read the white paper

Explore key takeaways from the day’s sessions in our summary white paper, where we’ve collected the experts’ views on collaboration, investment, and digital initiatives.

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Dr Simon Wallace
About Dr Simon Wallace

Dr Simon Wallace is the Chief Clinical Information Officer (CCIO) of Nuance’s Healthcare division in the UK and Ireland. Simon has worked as a GP, hospital and public health doctor in Brighton and London. His interest in health informatics began in the 90s when he spent a year at the King's Fund investigating the impact of the internet on shared decision making between patients and their healthcare professional. For the past 15 years, he has worked for a range of organisations including Bupa, Dr Foster, Cerner Corporation and GSK across a range of technologies which include electronic patient records, telemedicine, mobile health and lifestyle devices. Simon has a keen interest in the voluntary sector, recently completing a 7 year term as a Trustee for Fitzrovia Youth in Action, a children and young people’s charity based in London.