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HEALTH BILL TO ABOLISH NHS ENGLAND FACES COMMONS SECOND READING
By Martin Foskett, Reporter
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UNITED KINGDOM, London. The Government’s 2026 Health Bill, introduced in the House of Commons, would abolish NHS England and transfer many of its functions to the Secretary of State, alongside new powers to direct integrated care boards, a statutory framework for a single patient record, and changes to patient voice and safety oversight bodies.
Parliament’s bill page lists the legislation as a government bill originating in the House of Commons in the 2026- 27 session, with first reading recorded on 14 May 2026 and second reading scheduled for 1 June 2026. The same page lists motions on a Ways and Means resolution, a money resolution and a programme motion for 1 June 2026.
The bill’s long title is short and broad, describing a measure “to make provision about health and social care”, sponsored by the Department of Health and Social Care. The bill page also identifies the Health Secretary, Wes Streeting, as the member associated with the measure.
At the centre of the text is a direct clause stating that “NHS England is abolished”. That line is followed by a detailed set of transfer powers allowing the Secretary of State to make one or more schemes for moving property, rights and liabilities from NHS England to a range of recipients, including the Department, integrated care boards, NHS trusts, NHS foundation trusts, Special Health Authorities and other public bodies. The drafting is designed to make reorganisation legally workable, including provisions for the continuity of documents and proceedings, shared ownership or use of property, and staff protections resembling TUPE-style arrangements.
The Treasury is also given scope, through regulations, to vary how certain taxes apply to transfers carried out under the schemes, including stamp duty and VAT. The provisions appear aimed at preventing the abolition and transfer process from creating unintended tax consequences, although the bill leaves the details to secondary legislation.
Taken together, the abolition and transfer sections remove an arm’s-length national management body that previously sat between ministers and day-to-day system management. NHS England has acted as a national commissioner for certain services and as a key conduit for national priorities. Under the bill, many references in existing legislation are amended to transfer responsibilities previously assigned to NHS England to the Secretary of State.
The bill then expands ministerial direction powers over integrated care boards, the organisations responsible for commissioning most NHS services in England. A new direction of power would allow the Secretary of State to give boards instructions on whether to exercise a power, when and how to exercise functions, the conditions that must be met before action is taken, and the matters a board must consider in decision-making. The bill requires directions to be published as soon as reasonably practicable.
In a further provision, where legislation makes action contingent on an integrated care board having formed an opinion, the bill would allow the Secretary of State to form that opinion and then direct the board to act without forming its own. Supporters may argue that the mechanism could speed up decision-making. Critics may see it as a route to bypass local judgment. The bill includes some limits, including restrictions on directions relating to the appointment or employment of a particular individual, and on directions about services to be provided to a particular patient. It also bars directions that conflict with NICE guidance or recommendations in specified circumstances.
The bill sets out a stronger intervention regime for what it calls “performance: significant failure”. Where the Secretary of State considers an integrated care board is failing, has failed, or is at significant risk of failing to discharge functions in a way judged significant, ministers could direct a board to cease performing some or all functions for set periods. Ministers could then discharge those functions themselves, arrange for another person to do so, or direct another integrated care board to perform them.
Separate powers relate to the chief executive of an integrated care board. The bill would allow the Secretary of State to direct a chief executive to cease performing functions for specified periods and, in the most severe cases, to terminate the chief executive’s appointment and direct the chair to appoint a replacement on the set terms. The Secretary of State would be required to publish reasons when using the powers, and to consult before directing another board to take on functions.
Alongside governance, the bill amends a set of statutory duties, including on inequalities, patient involvement, innovation and patient choice. It would update the Secretary of State’s duty to have regard to the need to reduce inequalities in access to services and inequalities in outcomes. It would introduce a duty to promote involvement of each patient, including their carers and representatives, in decisions about prevention, diagnosis, care and treatment. It would also place a duty on the Secretary of State to act with a view to enabling patients to make choices about aspects of health services provided to them.
On innovation, the bill would create a duty to promote innovation in the provision of health services, including in the arrangements for their provision. It also includes the power to make prize payments to promote innovation, including for work at any stage, including research.
The commissioning sections include new regulation-making powers on waiting times and on patient choice. The bill provides for regulations that may impose duties on integrated care boards regarding waiting times for treatments or other services they arrange, including requirements to address cases where services are not provided within a specified period.
On patient choice, the bill says that regulations must provide arrangements enabling choice for specified treatments or services. It also sets out an enforcement route allowing the Secretary of State to investigate potential failures to comply and to accept undertakings from boards to remedy problems within a set period, supported by published guidance on how the powers will be used.
In planning and local partnership structures, the bill would remove integrated care partnerships and integrated care strategies from the existing legal framework, and replace the concept of joint local health and wellbeing strategies with “neighbourhood health plans”. Under the proposed changes, a responsible local authority and each of its partner integrated care boards would be required to prepare a plan setting out how assessed needs are to be met through the exercise of their functions. The bill requires those preparing plans to have regard to guidance issued by the Secretary of State and to involve people who live or work in the area.
The bill also changes the membership requirements for the integrated care board. It would require ICB constitutions to include at least one member nominated by the mayor of each mayoral strategic authority whose area coincides with, or overlaps, the ICB’s area. It requires the constitution to set out the nomination process. It says nominating mayors must have regard to any guidance published by the Secretary of State on the selection of candidates.
The legislation extends into provider governance, including NHS trusts and NHS foundation trusts. It contains amendments to accounting and audit, and provisions affecting foundation trust constitutional arrangements, including the removal of the roles of members and councils of governors, as well as new powers relating to board governance and the potential suspension of directors. It also gives the Secretary of State the power to impose expenditure limits on an NHS foundation trust by order, subject to consultation and publication requirements.
In oversight and patient voice, the bill would abolish Healthwatch England and remove statutory arrangements with Local Healthwatch organisations. Supporters may argue that existing structures have not delivered consistent influence. Critics may argue that the change removes a recognisable route for patients to escalate their concerns through an independent channel. The bill does not provide a like-for-like replacement body, relying instead on consultation duties elsewhere in the legislation.
On patient safety, the bill would transfer the functions of the Health Services Safety Investigations Body to the Care Quality Commission, with accompanying transfer scheme provisions. The shift would move a national safety investigations function into the same organisation that regulates and inspects providers, raising questions about how investigative work and regulatory enforcement would sit alongside each other in practice.
A further significant plank is the creation of a legal framework for a national “single patient record”, within a broader set of provisions on health and social care information systems and information sharing. The detail is largely enabled through regulation-making powers, meaning key decisions on the design, scope and safeguards would be set later through secondary legislation.
Parliament’s publications list shows a range of supporting documents already lodged alongside the bill, including explanatory notes dated 14 May 2026 and a delegated powers memorandum, as well as impact assessments covering abolishing NHS England, patient safety measures, structural measures affecting integrated care boards and foundation trusts, and a single patient record and information sharing. A Regulatory Policy Committee opinion is also listed regarding the single patient record and information sharing.
The presence of multiple impact assessments suggests the government expects scrutiny not only of the governance changes but also of delivery risks, particularly in data and digital infrastructure. The bill itself is largely structural, setting out powers, duties and institutional changes rather than announcing a costed service expansion. The practical effects would depend on how the Department uses the new direction and intervention powers, how quickly transfer schemes can be implemented without disruption, and how the information sections of secondary legislation are drafted.
The bill arrives against a backdrop of continued pressure on NHS performance measures, with ministers frequently judged by waiting lists, access and outcomes regardless of where formal accountability sits. By abolishing NHS England and strengthening ministerial authority over integrated care boards, the legislation appears to align political responsibility with clearer statutory control. That alignment could provide a more direct line of accountability, while also concentrating responsibility for delivery failures closer to ministers.
For now, the bill remains in its early stages. Second reading is scheduled for 1 June 2026, when MPs are expected to debate the legislation’s principles and vote on whether it should proceed to detailed scrutiny in its early stages
