Yesterday’s King’s Speech (May 13, 2026) announced the government’s intention to pass the NHS Modernisation Bill in this parliamentary session, putting its plans for restructuring the health service on a legal footing.
Key features of this Bill are the abolition of NHS England, with its responsibilities going either to the Secretary of State or devolving to Integrated Care Boards (ICBs), disbanding Healthwatch England alongside the introduction of a new Patient Experience Directorate within the Department of Health and Social Care, and creating the Single Patient Record by joining up health and care records across primary and secondary care.
The Bill represents the largest reorganisation of the NHS in more than a decade, much of it focusing on how the NHS is organised rather than on care itself. Sarah Walter, Chief Executive of The NHS Alliance, describes the bill as “key to delivering the government’s vision as set out in the 10 Year Health Plan.”
Sarah adds: “The abolition of NHS England with functions transferred either to the Secretary of State or devolved to ICBs will provide an opportunity to streamline decision-making from the centre and must be accompanied by measures and ways of working which empower local leaders to design services for their communities. In doing this it is important that the government recognises the need for a decisive shift of authority from ministers and national bureaucracy to local leaders.”
Sarah Woolnough, Chief Executive of The King’s Fund cautions that there is a danger that this Bill appears to do the opposite to what it professes to achieve, in that instead of devolving power from Whitehall and giving patients more control over their care, the impression might be of a government pulling power back to the centre whilst disbanding the independent organisations set up to listen to patients and make sure their voices are heard. “Many of the Bill’s provisions won’t make much difference to patients day to day, because they focus on how the NHS is organised rather than care itself,” she says.
Single Patient Record
Historically, this has proven a tough nut to crack, with concerns around privacy and data protection. Achieving a Single Patient Record is an aspiration that health experts and patients alike would welcome, with the necessary checks and safeguarding in place. It would make disparate services work together more efficiently, and give patients more control.
Rachel Power, Chief Executive of the Patients Association says: “We welcome the proposal for a Single Patient Record, something patients have wanted for a long time. Too many people have had the experience of repeating their history at every appointment, or of vital information simply not being there when it is needed. Done well, a Single Patient Record could make a genuine difference to people's lives. But it must be designed with patients, it must work for people who find digital technology difficult, and patients must stay in control of their own information. We also note that the Bill’s initial commitment to a single patient record is limited to maternity and frailty care by 2028. Patients will want to see a clear timetable for how this is extended to all.”
The Patients Association is less keen on the plans to abolish Healthwatch England, and has expressed its deep concern. “A patient voice that sits inside government is not the same as one that can challenge it,” Rachel adds.
Will it work?
“Health legislation focused on changing NHS structures has a history of getting bogged down in parliament and burning through political capital for little gain,” warns Sarah Woolnough. “The ongoing political uncertainty – when setting out major changes to the structure of an organisation that is responsible for a budget the size of Portugal's economy – could also present difficulties for the Bill’s smooth passage.
“The test for this Bill is whether it can overcome these obstacles and help make the NHS ‘fit for the future’ in a way that is meaningful for patients.”
