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National Health Service History

Geoffrey Rivett

home inheritance1948-19571958-19671968-1977 1978-1987  1988-19971998-2007 2008-20172018 - 2027envoishort history London's hospitals


Chapter 8

2018 to 2027

The eighth decade.

Background - UK and World Events Year NHS Event
Migrant crisis with any deaths from drowning in the Mediterranean  2018 Jeremy Hunt remains Secretary of State for Health and Social Care and is then replaced by Matt Hancock.
NHS Long Term finance settlement
Resignation of Theresa May over Brexit 2019 NHS Long Term Plan

Basic NHS Statistics (from the NHS Confederation)

Organisational change
Finance and the emerging crisis
Medical progress
General Practice and primary care
Hospital Services
Medical Education and Staffing



In the UK politican sphere, the decision of the electorate to leave the European Union, engulfed the administration with such a workload that the impression was gained that little else was possible. Within the NHS, however, the combination of the worst its of Andrew Lansley's reforms and the limited growth possible within a programme of austerity, led to widespread dismay. The decision of the Prime Minist to retain Jeremy Hunt as Health Secretary and then appoint Matt Hancock provided a measure of sstability. Neither was seen as a radical reformer, and both proved able to work with Simon Stevens, the Chief Executive of NHS England.

Aa birthday present on the 70th anniversary, the NHS received a long term financial settlement. Although less than think tanks such as the King's Fund felt was necessary, 3.4% real terms increase in England, it was only the second long term settlement in the history of the NHS. The need for security of resources had long been maintained. Here was something significant. As Gordon Brown, the then Chancellor of the Exchequer, was angry when Tony Blair made a committment, so was Philip Hammond irritated by this new one.

Organisational change

In the previous decade, on an essentially voluntary basis,  Trusts, Clinical Commisioning Groups (CCGs) and local authorities had been encluraged to form Sustainability and Transformation Partnerships (STPs).  STPs were encouraged to develop further into Integrated Care Systems/partnerships (ICSs). Progressively the number of the latter increased, and in the process their might be merger. Simon Stevens said that to deliver the long term plan every NHS organisation would need to intensify partnerhip and working with each other, including loal councils and community organisations.  One senior officer said that many performance 'challenges' could only be addressed across a larger population and 'provider footprint.'

Medical Progress




General Practice and Primary Health Care

Partly under central encouragement, the organisation of primary health care began to change. Underlain by the belief that services could be improved (and cost savings might result), practices increasingly established primary care networks. By 2019 1,300 of these had been formed across England. In general they did not affect the day to day work of a practice, but they might assist in the joint provision of more specialised services, or out of hours cover and emergency surgeries. 

home inheritance1948-19571958-19671968-1977 1978-1987 1988-1997  1998-2007 2008-2017 2018 - 2027 envoishort history London's hospitals



Geoffrey Rivett©