A clean bill of health

In the biggest shake-up of the NHS since its inception, 151 primary care trusts (PCTs) and 10 strategic health authorities will go and 24,500 manager posts will be lost. The reforms are expected to cost £1.4bn to implement according to government estimates (others have said nearer £3bn), but are expected to save £5bn by the end of 2014/15, principally through a 33% saving in administrative costs. The government’s “pause and listen” exercise during June resulted in some cosmetic changes to the Bill, but the broad thrust of the proposals remains the same.

And change is already underway, even though the Bill is not expected to become law until December 2011. In future, it will be lean and nimble providers who prosper. They will need to know how to design services which appeal to new “customers”—clinical commissioning groups (CCGs) led and owned by GPs but with representation on their board from nurses, hospital doctors and lay