Health Bill 2026-27

The Health Bill (Bill 009 2026-27) is a government bill. The main purpose of the bill would be to abolish NHS England (NHSE). The government has said this is needed to reduce bureaucracy, enable local decision making and allow more resources to be delivered to frontline healthcare services. The bill would also make various reforms to the structure of the NHS. These reforms were set out in the government’s 10 Year Health Plan for England and recommendations from Dr Penelope Dash’s review of patient safety across the health and care landscape (the Dash review).

The bill was introduced in the House of Commons on 14 May 2026. It will have its second reading on 1 June 2026. Most of the provisions in the bill would extend to England and Wales only, and apply to England, as health policy is devolved. There are some provisions in the bill that would extend UK-wide.

The government has published explanatory notes to the bill (PDF). It has also published four impact assessments on:

• abolishing NHS England (PDF)
• the single patient record and information sharing (PDF) that the bill would enable
• patient safety measures (PDF) in the bill
• measures in the bill to change the structures of integrated care boards (ICBs) and foundation trusts (PDF)

The bill contains some delegated powers, meaning it would give powers to make further legislation to ministers (or other bodies) without the need for another bill. The government has published a memorandum for the Lords Delegated Powers and Regulatory Reform Committee (PDF), which explains the reasons for each case of delegated power, to assist the committee’s scrutiny of the bill.

What are the aims of the bill and what would it do?

NHSE is an executive non-departmental public body, sponsored by the Department of Health and Social Care. It has operational responsibility over the NHS in England to support the delivery of healthcare, and it has a wide range of statutory functions, responsibilities and regulatory powers.

The main purpose of the bill would be to abolish NHSE and transfer its functions to either Integrated Care Boards (ICBs) or the Department of Health and Social Care, including transferring some powers directly to the Secretary of State for Health and Social Care.

The bill would adapt NHSE’s various responsibilities for, and powers over, the NHS in England and transfer them to the Secretary of State. For example, the Secretary of State would have new general powers to direct an ICB to carry out its functions that would be broader than powers NHSE currently has to direct an ICB to carry out its functions if an ICB is failing.

Digital and data functions that are currently the responsibility of NHSE would also be transferred or adapted to the Secretary of State or discontinued.

The bill would also:

• Enable a single patient record to be created that summarises patient health information in one place. The bill would enable the Secretary of State to legally require all NHS providers (including GPs) to disclose data to allow it to be combined in a single patient record. This would be visible to patients and clinicians providing care, be subject to existing data protection legislation, and like other NHS data, have the potential to be approved for sharing with public and private researchers. The Secretary of State would have the power to set fines for non-compliance.
• Implement changes to the patient safety landscape recommended by the Dash review, including bringing the Health Services Safety Investigations Body into the Care Quality Commission.
• Make changes to the flexibility and governance of local NHS organisations.
• Abolish Healthwatch and transfer local Healthwatch functions to ICBs and local authorities.
• Change who is represented on ICBs, remove the requirement for integrated care partnerships to be set up, and reform the statutory requirements for local health and wellbeing strategy and planning.
• Remove the requirement for NHS foundation trusts to have a council of governors and members, and transfer governors’ powers to appoint foundation trust chairs to the Secretary of State.
• Make other changes to the governance of NHS trusts and foundation trusts, including a new power for the Secretary of State to “de-authorise” foundation trusts (which would revert to NHS trust status).
• Change how financial objectives are set across the system. Instead of system-wide targets, the Secretary of State would be able to set objectives for individual ICBs and specified partner trusts. The bill would give to the Secretary of State, NHS England’s current powers to set capital and revenue resource limits and issue expenditure directions for ICBs, partner trusts and foundation trusts.
• Transfer responsibility for commissioning primary care services from NHS England to ICBs. The changes would formalise arrangements already largely operating through delegation since 2022-2023.
• Introduce new powers for the Secretary of State to make regulations imposing duties on ICBs in relation to waiting times, patient choice, and appeals concerning commissioned NHS services. The measures would require ICBs to protect and promote patient choice rights and enable the Secretary of State to investigate and enforce compliance where ICBs fail to meet these obligations.

Stakeholder commentary

Various stakeholders have said the reforms to the NHS that the bill would make would be “one of the most significant NHS restructures in recent years”.

Abolition of NHSE

Stakeholders including the Nuffield Trust and the King’s Fund have said that abolishing NHSE would provide opportunities to reduce duplication and streamline priorities. However, stakeholders have also called for further details about the abolition of NHSE and raised concerns about potential disruptions to health services, slowing down the implementation of the government’s priorities in the 10 Year Health Plan and a risk of lost expertise from cutting the workforce.

Secretary of State’s powers

Various stakeholders, including members of the House of Lords, have raised concerns that the bill would give the Secretary of State more direct powers over running the health service, which they say could risk destabilising the workforce and weakening the voice of patients. Stakeholders have also said it could result in fewer devolved power for local areas, less transparency over NHS finances, and less accountability for, and public awareness of, decisions being made.

A blog from the Nuffield Trust questioned how centralising powers over NHS providers and ICBs can be reconciled with the government’s commitment to a new NHS operating model that delivers a more diverse and devolved health service.

Single patient record

There has been mixed stakeholder commentary on the provisions in the bill for a single patient record with stakeholders considering this to be a high-profile area. Some stakeholders have said the single patient record could bring a “significant and positive impact on patient care”, although others have raised concerns about privacy safeguards. Stakeholders have highlighted that the bill lacks clarity on how single patient record data would be accessed and governed, and on whether the bill would change GPs being data controllers for patients’ GP records.

Scrutiny

Health thinktanks, patient representative bodies and parliamentarians have expressed concerns about the potential loss of independent scrutiny and investigative functions if the Health Services Safety Investigations Body and Healthwatch are abolished as the bill intends.