NHS Modernisation Bill faces scrutiny over major shake-up of health service

The government’s plans for one of the biggest reorganisations of the NHS in more than a decade are facing growing scrutiny as legislation to abolish NHS England and introduce a Single Patient Record progresses through Parliament.

The NHS Modernisation Bill, formally known as the Health Bill, would abolish NHS England and transfer many of its existing functions into the Department of Health and Social Care (DHSC), alongside wider changes to how the health service is managed nationally and locally.

The government says removing NHS England will reduce duplication and bureaucracy, clarify accountability and allow more resources and decision-making to be moved closer to frontline services.

However, The King’s Fund has warned that the legislation also centralises significant power within Whitehall and the Secretary of State for Health and Social Care, raising questions about accountability and the balance between national control and local NHS decision-making.

Among the most significant proposals is the creation of a Single Patient Record, designed to give health and care professionals a joined-up view of an individual’s medical and care history.

Under the plans, information currently held across GP practices, hospitals, community services, mental health providers and social care would be brought together so clinicians can access relevant information when treating a patient.

Patients would also be able to access their records through the NHS App.

The government says clinicians should have improved access to linked patient information from 2027, with an ambition for patients to access a core set of information through the NHS App from 2028 and their complete record by 2030.

Supporters argue the system could improve patient safety, reduce duplication and end the frustration of people repeatedly explaining their medical history as they move between different parts of health and social care.

The government has estimated that improved information sharing could contribute to 20,000 fewer A&E attendances each year, around 6,000 fewer hospital admissions and save approximately 500,000 hours of clinicians’ time.

However, significant questions remain about privacy, data security, consent and exactly how the Single Patient Record will operate.

The King’s Fund has said much of the practical detail remains unspecified within the Bill and will instead depend on subsequent regulations, technology choices and implementation decisions.

The legislation would also abolish Healthwatch England and local Healthwatch organisations, replacing them with new arrangements for representing the patient voice within DHSC and other parts of the health system.

This has prompted concerns that independent patient representation could be weakened at the same time that greater powers are being transferred to central government.

The King’s Fund has described the Single Patient Record as potentially transformative but warned that structural reorganisation alone will not improve NHS care.

MPs are expected to return to the legislation following the summer recess in September, before the Bill faces further scrutiny in the House of Lords.

With the reforms potentially reshaping NHS leadership, patient data and accountability for years to come, attention will increasingly turn to whether the legislation can deliver a more joined-up health service without creating new risks around centralisation, privacy and public trust.

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