Title

HEALTH

Devolve NHS England's £168bn budget to local government, says report

NHS England’s £168bn budget should be handed to local government in a radical restructure, the Reform think-tank has suggested in a report today.

NHS England's £168bn budget should be handed to local government in a radical restructure, the Reform think-tank has suggested in a report today.

The report proposed ‘all but a few specialist NHS services' be devolved to local government, which would offer core hospital services and be able to spend the money as it wished provided it met minimum standards of care agreed by the Department of Health and Social Care (DHSC).

It argued this would end the current system of fragmented funding streams between hospitals, community care, GPs and social care, and allow more joined-up care, incentivising prevention.

The report admitted a new localised health system would require a huge increase in the size of local government.

Last month's The MJ Future Forum heard the relationship between local government leaders and the NHS was ‘immature at best and dysfunctional at worst'.

Senior well-placed sources have privately warned ‘something was starting to go wrong' in Integrated Care Systems as planned cuts to Integrated Care Board (ICB) staffing levels threaten to land councils with an increased burden.

The Local Government Association is understood to have reported a host of issues being raised about ICBs amid fears DHSC and NHS England will pull back up to the centre.

Head of health at Reform, Rosie Beacon, said: ‘New locally-tailored approaches to health are needed which are rooted in specific community need; that's impossible if NHS activity is dictated by a remote national body.'

Speaking at the Future Forum session in Hertfordshire, chief strategy officer at NHS England, Chris Hopson, underlined his support for the current structure of ICB and Integrated Care Partnerships.

Hopson added: ‘I genuinely believe we have the right statutory structure to make these relationships work.'

HEALTH

The route out of EFS

By Owen Mapley | 15 October 2026

Exceptional financial support to councils must become a bridge back to sustainability, says Owen Mapley.

HEALTH

EXCLUSIVE: Chiefs push for councils to be viewed equally as Government seeks to rewire the state

By Dan Peters | 14 October 2026

Council chief executives have warned Whitehall that local authorities must be treated as equal partners as the Government plans to rewire the state.

HEALTH

Autumn Budget: Funding counties' growth

By Steve Broadbent | 14 October 2026

Counties hold the key to growth and public service reform, but the Budget must match ambition with investment, says Steve Broadbent.

HEALTH

First, rewire the place, then turn the lights on

By Rob Huntington | 14 October 2026

From Trumpton’s tangled wires to today’s fragmented public services, local government must join up devolution, funding and reform to improve residents’ lives...

Dan Peters

Popular articles by Dan Peters

-->