Accelerating the Uptake of Value-Based Reforms in NHS England

New report provides perspective on current health policies and offers recommendations for improving care integration in England

The Duke-Margolis Center for Health Policy’s new report on value-based care reforms in England highlights a strong commitment to develop new care models and identifies regulatory ambiguities and gaps in system capacity which may hinder further progress. To accelerate the uptake of reforms for the English National Health Service (NHS), the Duke-Margolis team proposes 14 policy recommendations, which include the creation of a “care system integrator” function and the development of new infrastructure for health information technology.

This two-year project was funded by the London-based Health Foundation, with the report’s findings based on dozens of interviews with health system leaders and government officials, including two in-person roundtables held in England in 2017 and 2018. The team used the accountable care framework to analyze the organizational competencies of new care models. Conversations with innovators and site visits to delivery system pilots also provided on-the-ground perspective of how the NHS’s layered strategy of care integration is operating in practice.

Health system leaders emphasized a disconnect between top-level policies and frontline care experiences. In the report, researchers from Duke-Margolis describe how a “care system integrator” – defined as a  designated   entity  that  takes responsibility  for  specific  steps  toward  achieving  the  Triple  Aim  for  a  defined  population – could bridge this disconnect, aligning national policy objectives with local efforts. The team also identify a series of recommendations for NHS England, ranging from improved communications to new standards for data sharing.

As English policymakers prepare to issue new health care reforms for the 70th anniversary of NHS England, the report from Duke-Margolis may provide valuable insight and perspective to help systems reduce fragmentation of health and social services and increase progress towards population health.