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NHS Modernisation Bill

Lifecycle: Pre-Legislative Scrutiny Care Quality Commission · Department of Health and Social Care · NHS England Last regenerated 45 minutes ago

Summary

What this is

The NHS Modernisation Bill — announced in the King's Speech 2026 — is the Department of Health and Social Care's primary legislative vehicle to abolish NHS England, restructure Integrated Care Boards (ICBs), reform foundation trusts, transfer the Health Services Safety Investigations Body (HSSIB) and Healthwatch England functions into DHSC/CQC, and create a statutory Single Patient Record building on the 10 Year Health Plan.

Why it matters

It rewires national accountability for the NHS, ending the post-2012 'two centres' model by reintegrating NHS England into DHSC (forecast £1bn p.a. saving by end of Parliament) and shifting commissioning power (including primary care, dentistry, ophthalmology and pharmacy) from the national centre to ICBs, while extending CQC enforcement reach.

Current status

Pre-legislative scrutiny is underway: the Bill package was announced in the King's Speech (May 2026) with equality and impact assessments published on 14 May 2026, and the Health and Social Care Committee is taking oral evidence from DHSC across May–June 2026. The transitional NHS England abolition is already being delivered administratively, with structural SIs in 2025 and 2026 already amending CQC regulated-activities scope and standing rules.

What changed recently

  • 11 Jun 2026 — Health and Social Care Committee took further oral evidence from DHSC during pre-legislative scrutiny of the Bill. →
  • 14 May 2026 — DHSC published the full suite of impact and equality impact assessments covering Single Patient Record, NHS England abolition, ICB strategic commissioner role, foundation trust reform, HSSIB→CQC transfer and Healthwatch abolition. →
  • 13 May 2026 — King's Speech 2026 Background Briefing Notes confirmed NHS Modernisation Bill as a flagship public services reform measure. →
  • 8 May 2026 — SI 2026/495 amended the Health and Social Care Act 2008 Regulated Activities Regulations 2014 to bring sports-ground and event medical treatment within CQC regulatory scope. →
  • 12 Nov 2025 — Secretary of State Wes Streeting issued WMS 'Transforming our health service' updating the House on plans to reform the health system in England. →

Key documents

Framework

Statutory basis

Operationalising

Scrutiny

Evidence

Review

Consultations

Stakeholders

Grouped by role with evidence. Long groups scroll inside their column.

Sponsoring department 1

  • Department of Health and Social Care → src
    Sponsoring department for the NHS Modernisation Bill; published the 10 Year Health Plan (Jul 2025) and the full suite of impact/equality impact assessments (14 May 2026).

Sponsoring minister 3

  • Wes Streeting → src
    Secretary of State for Health and Social Care when HCWS1051 'Transforming our health service' was issued on 12 Nov 2025 and the King's Speech 2026 measures were announced; also gave the 3 July 2025 'Fit for the Future' oral statement launching the 10 Year Health Plan.
  • Baroness Merron → src
    Parliamentary Under-Secretary of State (Lords) for Women's Health and Mental Health; issued the mirror Lords WMS HLWS1049 on 12 Nov 2025 and HLWS145 in Oct 2024 announcing the 10 Year Health Plan engagement.
  • Zubir Ahmed → src
    Parliamentary Under-Secretary of State at DHSC who signed SI 2026/495 (Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026) on 29 April 2026.

Lead committee 2

  • House of Commons Health and Social Care Committee → src
    Conducting pre-legislative scrutiny: took oral evidence from DHSC on 14 May, 18 May, 21 May, 8 June and 11 June 2026.
  • House of Commons Public Accounts Committee → src
    Published report (Nov 2025) on the abolition of NHS England following the Government's 13 March 2025 announcement.

Regulator / delivery programme 5

  • NHS England → src
    Body to be abolished by the Bill; functions transferring to DHSC and the wider system; currently still exercises s.14Z61 intervention powers and s.7A public health commissioning.
  • Care Quality Commission → src
    Receiving HSSIB functions and an extended limitation period for enforcement actions; SI 2026/495 expands the scope of regulated activities subject to CQC oversight.
  • Health Services Safety Investigations Body (HSSIB) → src
    Functions being transferred into the CQC under the Bill.
  • Healthwatch England → src
    To be abolished and its functions transferred to a new DHSC Patient Experience Directorate; local Healthwatch functions split between ICBs and local authorities.
  • Integrated Care Boards (ICBs) → src
    Becoming strategic commissioners for primary care, dentistry, ophthalmology and pharmacy; board membership to be refined and mayoral nominees required.

Witnesses & evidence-givers 3

  • Lord Darzi → src
    Author of the 2024 Independent Investigation of the NHS in England relied on by the Bill's case-for-change narrative.
  • Patricia Hewitt → src
    Author of the April 2023 Hewitt Review of integrated care systems cited in the briefing notes on duplicative DHSC/NHSE data requests.
  • Dr Penny Dash → src
    Author of the Dash Review of patient safety across the health and care landscape referenced in the King's Speech briefing notes.

Commentator 1

  • Sir Keir Starmer → src
    Prime Minister; delivered launch speech for the 10 Year Health Plan on 3 July 2025.

Political commitments

What parties and ministers have promised — manifesto pledges, King's Speech announcements, ministerial statements. Each card shows what was said, by whom, and when, with a link to the original source.

  • commitment King's Speech announcement Labour · 2026

    Significant reforms to the National Health Service via the NHS Modernisation Bill

    My Ministers will push forward with significant reforms to the police, the National Health Service, and to the criminal justice system to help them deliver services the British people expect.

    Why linked: Names the Bill as part of the 2026 legislative programme.

    Source: https://www.gov.uk/government/speeches/the-kings-speech-2026 ↗
  • commitment King's Speech announcement Labour · 2026 · King's Speech announces NHS Modernisation Bill

    Abolish NHS England and build the Single Patient Record

    It will enhance patient safety and experience through a new Single Patient Record … The Bill puts power and resources in the hands of frontline NHS organisations by abolishing NHS England and stripping back national bureaucracy.

    Why linked: Operative legislative commitment underpinning the Bill's design.

    Source: King's Speech announces NHS Modernisation Bill · Original ↗
  • commitment Ministerial statement Labour · 2025 · Fit for the Future: Health and Social Care Secretary's statement

    10 Year Health Plan delivers three shifts: hospital→community, analogue→digital, sickness→prevention

    Why linked: Streeting's 3 July 2025 oral statement embeds the 10 Year Health Plan as the policy foundation the Bill enacts.

    Source: Fit for the Future: Health and Social Care Secretary's statement · Original ↗
  • commitment Ministerial statement Labour · 2025 · On 13 March 2025, the Government announced that NHSE would be abolished within …

    NHS England to be abolished within two years

    On 13 March 2025, the Government announced that NHSE would be abolished within two years and that the Department would put in place arrangements to deliver the change.

    Why linked: PAC record of the formal abolition commitment that the Bill puts on a statutory footing.

    Source: On 13 March 2025, the Government announced that NHSE would be abolished within two years … · Original ↗

Open questions & gaps

Known gaps in the evidence base and what's still pending.

Pending in the lifecycle

  • Bill introduction date and parliamentary timetable — King's Speech 2026 names the Bill but no Bill text has yet been laid in Parliament's catalogue.
  • Statutory transfer scheme for NHS England's s.7A and s.14Z61 functions to DHSC or successor bodies.
  • Detailed clauses governing Single Patient Record consent architecture, opt-outs and the legal basis (currently flagged in PQ 128022 regarding the Federated Data Platform direction under s.254 of the 2012 Act).
  • Approach to mayoral nominees on ICBs and how this interacts with English devolution settlements.

Beyond the corpus

Confidence gaps

  • Scope of the post-abolition 'wider system' destination for NHS England functions (DHSC arm vs new ALB) is not fully specified in the public briefing.
  • Interaction between Bill measures and the Health and Care Act 2022's notifiable-reconfiguration regime under Schedule 10A is unclear.
  • Whether Foundation Trust deauthorisation power (returning to Ministers) will be subject to procedural safeguards or independent panel review.