A system is “a group of interacting, interrelated, or interdependent elements forming a complex whole.”

The measures in this bill will help NHS organisations join up, to provide better care for the public and to plan services. None of the measures here will erode the protection of personal information. Patient choiceWe are also bringing forward several measures to improve accountability in the system in a way that will empower organisations and give the public the confidence that they are receiving the best care from their health and care system, every time they interact with it. The de facto development in recent years of a strongly supportive national NHS body in the form of a merged NHS England and NHS Improvement will be placed on a statutory footing and will be designated as NHS England. This will be complemented by enhanced powers of direction for the government over the newly merged body which will support great collaboration, information sharing and aligned responsibility and accountability. In addition, we will legislate to further ensure the NHS is able to respond to changes and external challenges with agility as needed. Measures will include reforms to the mandate to NHS England to allow for more flexibility of timing; the power to transfer functions between arm’s length bodies and the removal of time limits on special health authorities. An improved level of accountability will also be introduced within social care, with a new assurance framework allowing greater oversight of local authority delivery of care, and improved data collection allowing us to better understand capacity and risk in the social care system. Our measures recognise this, and we therefore plan to introduce greater clarity in the responsibility for workforce planning and a clear line of accountability for service reconfigurations with a power for ministers to determine service reconfigurations earlier in the process than is presently possible. Additional measures The pandemic saw the suspension of certain data collection requests from government and national bodies such as NHS England, NHS Digital and the Care Quality Commission. Where data collection was vital to the pandemic response, existing powers were used to publish notices requiring health and care bodies to share data to help manage and control the spread of COVID-19 within local systems. We will build on this approach and make changes to the regulations governing the sharing of data to enable more effective use of data for the benefit of individuals and the health and care system as a whole. allow ICSs to enter into collaborative arrangements for the exercise of functions that are delegated to them, enabling a ‘double-delegation’

The powers within the bill are intended to enable us to develop a new provider selection regime which will provide a framework for NHS bodies and local authorities to follow when deciding who should provide healthcare services. The provider selection regime will be informed by NHS England’s public consultation , and aims to enable collaboration and collective decision-making, recognising that competition is not the only way of driving service improvement, reduce bureaucracy on commissioners and providers alike, and eliminate the need for competitive tendering where it adds limited or no value. Commissioners will be under duties to act in the best interests of patients, taxpayers, and the local population when making decisions about arranging healthcare services. A growing and ageing population. Over the next 20 years the population in England is expected to grow by almost 10%. The number of people aged 75+ is expected to grow by almost 60% – an additional 2.7 million peopleWe want to support the health and care system to work collaboratively and flexibly across different footprints. Many local areas have been exploring ways of working more collaboratively and are seeking to align decisions and pool budgets between CCGs and NHS England, across CCGs, and between CCGs and local authorities (LAs). I’m going to put the new software update on the system. (This means that I will use the system to install the update.) On safety and quality: we will bring forward measures to put the Healthcare Safety Investigation Branch (HSIB) on a statutory footing; to enable us to improve the current regulatory landscape for healthcare professionals as needed; to establish a statutory medical examiner system within the NHS for the purpose of scrutinising all deaths which do not involve a coroner and increase transparency for the bereaved, and to allow the Medicines and Healthcare products Regulatory Agency ( MHRA) to develop and maintain publicly funded and operated medicine registries so that we can provide patients and their prescribers, as well as regulators and the NHS, with the evidence they need to make evidence-based decisions. We will also be bringing forward measures to enable the Secretary of State to set requirements in relation to hospital food. And finally, we will take powers to implement comprehensive reciprocal healthcare agreements with countries outside the EEA and Switzerland (‘Rest of World countries’) – expanding our ability to support the health of our citizens when they travel abroad, subject to bilateral agreements. Delivering for patients, citizens and local populations – supporting implementation and innovation

remove NHS Improvement’s specific competition functions and its general duty to prevent anti-competitive behaviour We will also work closely with the NHS to reduce the health inequalities currently experienced in the area of choice, by helping to increase clarity and awareness of patient choice rights within systems and of the range of choices available. Reducing bureaucracy proposals We make things worse in the long term by violating systems in the short term, as we ignore the simple truth that disruption of an efficient system always has its price.”Happiness is not found in the control we have over others. It’s found in the control we have over the moment-to-moment trajectory of our own lives, and more exactly—here we get to the root of things—the control of the personal systems that are ours to adjust and maintain.” (Sam: much of Carpenter’s thinking is influenced by Stoicism and echoes what William B. Irvine writes in A Guide to The Good Life : ““There are things over which we have complete control, things over which we have no control at all, and things over which we have some but not complete control.”)