Following the most radical health shake-up since the birth of the NHS, reporter SARAH TROTTER finds out what the changes will mean for local patients.

A NEW era of health care landed in the UK when the aims of the Health and Social Care Act came into force on April 1.

One of the biggest changes is the scrapping of PCTs for Clinical Commissioning Groups (CCGs) - a group of doctors, nurses and other medical professionals - who will buy services for patients in their areas.

They will handle around 60 per cent of the health budget and supporters say this is a positive move as doctors are best placed to understand their patients’ needs and shape medical care locally.

But critics say the scheme marks "the end" of the NHS as we know it, with fears of privatisation through the back-door and large companies ‘cherry-picking’ the best services.

Other reforms include councils picking up responsibility for protecting the health of the community - tackling issues such as smoking, alcohol, drugs and obesity - with a ring-fenced budget of around £3billion.

A new national board NHS England has also come into play which will oversee the day-to-day running of these services and will be in charge of dentistry and specialist hospital care.

Patients will not notice any major overhaul overnight as the new system creeps in slowly. GPs say the next 12 months will reveal the full extent of the changes.


Critics say opening CCGs up to bids from private sector companies will mean large corporations can cherry-pick services - destabilising the NHS financially, splintering services, and exposing CCGs to expensive law suits.

They also fear it will break the bond of trust between GPs and patients as doctors are forced to consider financial targets as well as care.

Amersham Vale Practice GP, Dr Louise Irvine, says the changes will be a "slow strangulation" of the NHS with increased waiting times and a reduction in patient services.

The GP-of-25-years and chair of Save Lewisham Hospital said: "I personally don’t think any of the changes are positive.

"It is going to be a slow strangulation, not an overnight change.

"There will be longer waiting lists, people finding services are no longer available, a lack of transparency.

"Those people who can afford it will more and more go private to top up. "We will end up with a two tier system.

"That is why we talk about it being the end of the NHS as we know it."


Supporters say the changes mean improved services with more joined up local care as GPs and councils link together to target the area's needs.

They say the rise of the private sector is being overplayed - some NHS services are already open to private bids - and benefits include more choice and providers competing to drive up better services.

Chairman of NHS Bromley CCG Dr Andrew Parson said: "As local GPs in Bromley, we are very well positioned to understand local needs and know from our patients what works well for them and where we need to focus on making things better."

Chairwoman of Lewisham CCG Dr Helen Tattersfield says the changes are positive but that time will tell how much authority GPs will be given in practice from central authorities.

She said: "Obviously I think the changes are good. The reason I think it potentially can make a difference is that it allows us to work much closer with local authorities. "We can work closely and influence things more quickly.

"Why I say potentially is because we are not clear how much say we will have. The whole thing around the TSA - that was a big blow. The next 12 months will be crucial in seeing how much can we influence. At the moment we don’t know the answer to that."

Other changes

Health and wellbeing boards - made up of community organisations and elected reps - will be set up in each area to make sure services work together to respond to a community's needs.

Local Healthwatch, which are represented on health and wellbeing boards, will give patients and communities a voice in decisions that affect them and will report any issues at a national level to Healthwatch England.