The UK Health and Care Act received royal assent in April 2022, establishing Integrated Care Systems in England. This legislation abolished Clinical Commissioning Groups and transferred their duties to Integrated Care Boards. While implemented in England, not Wales, the Act introduced an £86,000 cap on personal care costs and restricted unhealthy food advertising. The social care reforms were ultimately cancelled in July 2024. The Act represents significant structural changes to Britain’s healthcare system.
A sweeping overhaul of England’s healthcare system was enacted in April 2022 when the Health and Care Act received royal assent. The new law makes major changes to how healthcare is organized and delivered across the country.
The Act establishes Integrated Care Systems (ICSs) as official bodies in the NHS structure. These systems bring together hospitals, community services, and local councils to plan and deliver care. The law also creates two key parts within each ICS: Integrated Care Boards and Integrated Care Partnerships.
Clinical Commissioning Groups, which previously controlled local healthcare budgets, will be abolished. Their duties will transfer to the new Integrated Care Boards. This change aims to reduce paperwork and improve cooperation between different parts of the health system.
The law gives more power to the Health Secretary, allowing greater control over NHS England and local service changes. It also formally merges NHS England with NHS Improvement to create a single leadership organization.
For social care, the Act introduces an £86,000 cap on how much anyone will need to pay for personal care during their lifetime. The Act emphasizes the importance of early planning for end-of-life care, particularly for those with dementia and other progressive conditions. The upper limit for financial support will rise to £100,000, and the lower limit to £20,000. However, the government has delayed these changes until 2025. These social care reforms were ultimately cancelled in July 2024.
The legislation includes several public health measures too. It restricts advertising of unhealthy foods high in fat, salt, and sugar. It also bans “virginity testing” and makes it illegal to perform hymenoplasty operations.
Critics worry about increased political control over the NHS and potential privatization of services. There are also concerns about delayed implementation of the social care cost cap and whether workforce planning measures go far enough.
Most parts of the Act took effect from July 2022, with full implementation of Integrated Care Systems expected by April 2023. The Royal College of General Practitioners (RCGP) was actively involved in influencing the Bill’s provisions throughout its development. The changes represent the biggest restructuring of the NHS in a decade, aiming to create a more joined-up health and care system.
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