The NHS is about to undergo more big changes, shifting care away from hospitals, investing more powers in the Secretary of State for Health and replacing clinical commissioning groups (CCGs) with new, larger integrated care boards (ICBs) as part of wider changes to the function of integrated care systems (ICSs).

The proposals in the Health and Care Bill – which received its second reading in the House of Commons in July – represent a major redirection away from the foregrounding of competition in the Coalition Government’s Health and Social Care Act 2012 towards more collaboration, partnership and integration. So is this good or bad? The bill contains plans to dismantle some of the existing rules on procurement and competition, and allows the NHS and its partners the flexibility to deliver more joined-up care. But it also gives greater powers to politicians to appoint supporters and control how healthcare is run, and could potentially lead to less transparency because tendering processes will no longer be compulsory.