GPs to commission all local care. A separate commissioning board – now called NHS England – to do the specialist stuff and hold the GPs’ contracts. A more formal recognition of the role of choice and competition. New Health and Wellbeing Boards to bring health and social care more closely together, etc, etc So how is it all going? It is early days. The best of the clinical commissioning groups are doing some interesting things. Health and Well-Being Boards – an after-thought to Lansley’s own reforms – are emerging as some people’s favourite to be the dark horse of the changes. If genuinely joined up commissioning of health and social care is to occur – and increasingly it seems to be the received wisdom that that is needed – it just might be that they will be the bodies that evolve to do it. Although it is worth noting that that, in itself, would need another reorganisation. Competition is not working quite as intended. The intention, the politicians said and still say, was that commissioners should be able to choose when to use competition. But the lawyers have got their hands on this. Some clinical commissioning groups are succumbing to […]

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