Members of Curiaโs Health, Care, and Life Sciences Research Group speaking included
- Fatima Kamara, Senior Executive, NHS England (Chair)
- Rt Hon Andrew Stephenson CBE, former Minister of State, Department of Health and Social Care
- Paula Sheriff, former Shadow Minister for Mental Health and Social Care
- Dr Nick White, former Chief Medical Officer, NHS Shropshire, Telford and Wrekin Integrated Care System
A moment of reckoning
The UKโs health and social care systems are at a critical crossroads. Mounting waiting lists, workforce pressures, and the persistent disconnect between healthโฏand social care have underscored the need for bold reforms.
In a recent Curia webinar, a panel of healthcare experts, including Fatima Kamara (chair), a nurse with over two decades of experience in the NHS; Paula Sheriff, former Shadow Minister for Mental Health and Social Care; Dr Nick White, an experienced medical director; and Andrew Stephenson, former Minister of State for Secondary Care, met before the announcement to scrap NHS England to explore the impact of recent government announcements.
Their discussion covered key policy developments, including an inquiry led by Baroness Casey, an elective recovery plan, and Wes Streetingโs new productivity reforms, which aim to expand patient choice and introduce a system where funding follows the patient.
Now, with Sir Keir Starmerโs announcement to abolish NHS England in an effort to cut bureaucracy and improve efficiency, the question remains: will this move resolve the systemic challenges identified by experts, or does it risk raising more questions than it answers?
โThereโs no health without social care. Integration is the key to unlocking system-wide efficiencies.โ โ Fatima Kamara, Senior Executive, NHS England
The discussion revealed cautious optimism but emphasised the urgent need for implementation. As Kamara noted, โThe future of health and social care depends on moving beyond announcements to meaningful, systemic change.โย
Waiting lists: A system under strain
The announcement of NHS England’s abolishment is largely driven by the urgent need to address hospital waiting lists, one of the biggest concerns facing our healthcare system today. Reducing these waiting lists was a central theme in the webinar, underscoring the recognition that current backlogs have created a domino effect throughout the NHS. Patients face significant barriers to timely care, causing GP practices and A&E departments to become overwhelmed.
Dr White explained the scale of the problem, โThirty per cent of same-day GP appointments and A&E visits are linked to patients whose conditions have worsened while waiting for treatment.โ Tackling these delays is essential for unlocking wider system efficiencies.
The debate now centres on whether Starmerโs plan to abolish NHS England will cut waiting lists or cause further disruption. Supporters argue that streamlining bureaucracy could improve ministerial accountability, speed up decisions, and enhance funding allocation. Critics, however, warn that restructuring alone wonโt fix systemic inefficiencies and may create short-term instability, diverting focus from frontline care.
While greater central control could improve co-ordination, it remains unclear whether this will lead to faster patient access to treatment. Without parallel investment in workforce capacity, hospital infrastructure, and social care integration, structural reform alone may not deliver meaningful improvements.
โPolitical will, not new ideas, is whatโs needed to tackle the challenges weโve known for decades.โ โ Rt Hon Andrew Stephenson CBE, Former Minister of State, Department of Health and Social Care
Workforce pressures and the path forward
Workforce shortages represent one of the greatest obstacles to achieving reform goals. Dr White highlighted the strain on healthcare professionals, noting that many are working in environments that are neither sustainable nor efficient.
โReforms can only succeed if they are built on collaboration and respect for the people delivering care.โ โ Paula Sheriff, former Shadow Minister for Mental Health and Social Care
Abolishing NHS England presents an opportunity to tackle productivity challenges โ particularly by reducing duplication of services between the Department of Health and Social Care and NHS England. Our panel emphasised that streamlining responsibilities could cut inefficiencies and free up resources, but warned that without proper implementation, restructuring alone will not solve workforce pressures or improve patient care.
The role of technology
The panel also explored the transformative potential of technology in health and social care. Stephenson highlighted artificial intelligence (AI) as a tool for streamlining operations, from automating routine administrative tasks to enabling faster, more accurate diagnostics.
However, Stephenson stressed that implementation must be thoughtful and strategic. โAI needs to focus on practical applications that free up cliniciansโ time and improve outcomes,โ Stephenson said. This includes areas like discharge notices, which, if handled efficiently, could significantly reduce delays in patient flow.
Alongside the push for greater integration between health and social care, the abolition of NHS England raises questions about whether this move will accelerate or hinder the uptake of innovation. A more centrally controlled system could, in theory, streamline decision-making and funding for new technologies, making adoption faster. However, there is also a risk that innovation slows if bureaucratic changes create uncertainty over leadership and strategy.
Fatima Kamara added that AI adoption requires substantial investment in training and infrastructure. Without this, she warned, technology risks adding to cliniciansโ workloads rather than alleviating them – a critical consideration as the government navigates reform.
The independent sector: Friend or foe?
The role of the independent sector in addressing NHS backlogs sparked debate among the panellists. Sheriff shared a positive experience of receiving timely care through private providers, noting that such partnerships could play a role in reducing waiting lists.
โPrioritising waiting lists isnโt just about clearing backlogs โ itโs about unblocking the entire healthcare system and improving patient outcomes.โ โ Dr Nick White, former Chief Medical Officer, NHS Shropshire, Telford and Wrekin Integrated Care System
However, she and Kamara acknowledged the public scepticism surrounding private sector involvement. โCollaboration, not competition, is the way forward,โ Sheriff argued, emphasising the importance of transparency and ensuring that public funds are used effectively.
The governmentโs latest push for competition within the NHS raises questions about how public and private sectors will coexist. Ministers argue that competition will drive up standards, but there are concerns about how it will affect service accessibility in deprived areas.
Prevention and public health: The missing piece
The discussion also highlighted the importance of prevention and addressing health inequalities as integral components of sustainable reform. Sheriff called for greater investment in public health initiatives, such as vaccination programmes and early diagnostics.
โPrevention is often overlooked in favour of reactive solutions, but itโs a crucial part of ensuring the NHSโs long-term sustainability,โ she said. Tackling disparities in access to care and outcomes must also remain a priority, the panellists agreed.
However, with the abolition of NHS England, the question arises: who will take responsibility for public health strategy and implementation? Will it fall to local authorities and mayors, or will a new, centralised approach emerge? If responsibilities are split between multiple agencies, there is a risk of fragmented leadership and inconsistent policy implementation, which could hinder progress on tackling health inequalities.
Challenges ahead and the way forward
Achieving meaningful reform will not be without its challenges. The panellists identified clear opportunities for improvement, these include:
- Streamlining pathways:โฏsharing best practices across regions to enhance efficiency
- Harnessing AI:โฏfocusing on practical applications that deliver measurable benefits
- Engaging stakeholders:โฏensuring reforms are shaped by input from staff, patients, and the wider community
- Investing in prevention:โฏaddressing the root causes of health disparities to reduce future pressures
Final thought: seizing the moment
The webinar underscored the urgent need for action to address the interconnected challenges facing health and social care. Keir Starmerโs decision to abolish NHS England has sparked a crucial debate: will this reform resolve the structural inefficiencies that have long plagued the system, or will it introduce new complexities without tackling the fundamental issues of workforce shortages, waiting lists, and public health?
As Kamara summarised, โThe future of health and social care depends on moving beyond announcements to meaningful, systemic change.โ The panel made clear that structural reorganisation alone will not deliver resultsโprogress depends on prioritising collaboration, investing in workforce capacity, integrating health and social care, and leveraging technology effectively.
Much remains uncertain about the future of healthcare governance, accountability, and delivery. However, if reforms are implemented with clear strategy, investment, and stakeholder engagement, they could provide a genuine opportunity to build a more equitable, efficient, and sustainable systemโrather than another layer of disruption.