Following the Government’s announcement that NHS England will be abolished, we look through the Pulse archives to trace NHSE’s history since it was established
2012
March: Following several amendments, the Health and Social Care Bill is passed, putting in motion a major reform of the NHS that would lead to the launch of NHS England and CCGs, led by health secretary Andrew Lansley.
GP leaders argue that the bill is ‘irreversibly damaging’ to the NHS and is a waste of taxpayers money, and the GPC calls on the Government to withdraw it and begin drawing up a ‘sensible alternative’ that maintains GP commissioning without the need for legislation in Parliament.
September: Andrew Lansley gets replaced with Jeremy Hunt as part of David Cameron’s cabinet reshuffle.
2013
April: NHS England is introduced, with Sir David Nicholson as first chief executive. Through the newly formed CCGs, GPs take on statutory stewardship of more than £60bn of NHS funding.
October: Simon Stevens is appointed as the new chief executive of NHS England, after Sir David Nicholson was unable to shake off widespread criticism after a report into the failures of care at Mid Staffordshire Foundation NHS Trust and subsequently resigned.
2014
October: NHS England reveals plans for GP practices to see the majority of their funding – including global sum, QOF, enhanced services and premises – devolved to CCGs. Under the plans for co-commissioning primary care, CCGs are able to apply to take on added responsibility.
November: CCGs struggle with controversies and conflict of interests as some request new powers to performance manage the GP contract and take contractual action against their member practices.
2015
April: The first set of GP-led CCGs take on responsibility for commissioning the majority of GP services. And practices are contractually required to introduce ‘named GPs’ for every patient, in the new GP contract for 2015/16.
2016
April: NHS England announces the General Practice Forward View, including an investment of £2.4 billion a year. GP leaders welcome the package, saying it would ‘reverse the unacceptable decline in general practice funding’. It included a range of measures, such as:
- Investment in specialist services for GPs suffering from burnout;
- 3,000 fully funded mental health workers to be placed in general practice;
- A range of measures to stop secondary care dumping workload on primary care;
- CQC scaling back GP inspections;
- Recruiting more than 500 overseas GPs
2017
February: The 2017/18 GP contract deal is agreed, and overwhelmingly welcomed by the BMA as it binned paperwork and moved funding into the core contract.
2018
June: Prime Minister Theresa May commits to an additional £20.5bn a year to the NHS by 2023, which she says will be used to implement what NHS England is calling its 10-year plan.
August: Dr Arvind Madan, NHS England director of primary care, suggested that GPs should be ‘pleased’ when small practices close while posting provocative comments under the pseudonym ’Devil’s Advocate’ on the Pulse website. He resigned from his role at NHS England shortly after.
2019
January: A new five-year contract for general practice is agreed between the BMA and NHS England, and it’s the most significant contract since 2004, with £405m of funding confirmed for 2019/20 that will in part be used to support practices to join networks. Some of the main headlines from the new contract are:
- Billions to be invested in practice funding through five-year GP contract.
- Guaranteed increase in global sum
- NHS to fund all staff indemnity on top of global sum increase.
- The introduction of PCNs: Practices given £2 per patient to join networks under new DES.
- ARRS: NHS England to fund 22,000 practice staff to support GPs.
In the same month, the NHS long-term plan pledges digital GP appointments for everyone who wants them.
2020
March: NHS England issues advice for practices to move to a ‘total triage’ services, as LMCs and CCGs implement radical changes to GP access at the beginning of the Covid pandemic.
November: Pulse reveals in a world exclusive that the NHS was expecting to start vaccinating against Covid by the end of the year, and had already developed a DES.
July: The NHS People Plan says that GP should be able to make use of salaried GPs who work flexibly across local areas via new ‘banks’ of doctors.
2021
April: Simon Stevens announces he will step down from his chief executive post at NHS England.
May: NHS England issues a letter to practices saying that GP patients needed to be offered face-to-face appointments if that was their preference. The infamous letter causes a storm rarely seen in general practice, and gets branded ‘tone deaf’ by the BMA and dismissed as a ‘memento to incompetence’ and ‘ridiculous’ by LMCs.
July: Amanda Pritchard becomes the new chief executive of NHS England.
2022
March: A contract deal was imposed on GPs for 2022/23, including the extended access element of the Network DES requiring practices to offer the full range of ‘routine’ services such as screening and vaccinations on Saturdays.
July: The Health and Care Act 2022 establishes 42 ICS assuming commissioning functions from CCGs.
2023
March: Once again, the GP contract deal for 2023/24 gets imposed on GPs by NHS England without the backing of the BMA. Practices are now contractually bound to offer patients a needs assessment on first contact or to signpost other ‘appropriate services’, prohibiting practices from asking patients to come back another time.
2024
February: NHS England announces it will increase funding for general practice by 2.23% as part of what it calls ‘final arrangements’ for the 2024/25 GP contract – which was imposed, rather than agreed with the BMA.
March: 99% of GPs vote down the contract in a referendum organised by the BMA. GP leaders have express ‘profound concern’ after NHSE said discussions around the 2024/25 contract in England were a ‘consultation’ with various groups, and not a ‘negotiation’ with the BMA.
April: The BMA writes to NHS England to state that they are ‘now in dispute’ over the imposed GP contract.
May: Health Education England, NHS Digital and NHS England merge into a single organisation.
August: GP collective action protesting the deal starts, with NHS England saying that ICBs should continue to make sure that practices fulfil their contractual duties.
2025
January: Amanda Pritchard and NHSE chief financial officer Julian Kelly are grilled by MPs about their response to a report from the Public Accounts Committee which concluded there had been a lack of ‘fresh thinking’ and ‘decisive action’ from NHS England to meet policy ambitions to shift funding away from hospital to the community.
February: The BMA agrees to a deal ‘in principle’ with NHS England for the 2025/26 contract. It’s the first agreed – rather than imposed – contract deal in England in four years. It prompted NHS England to hail the negotiations a success, while the BMA said that this is ‘the first step on the road to recovery’ for general practice. NHS England’s chief executive Amanda Pritchard resigns and announces she will step down from the role at the end of March.
March: NHS England announces plans to reduce its workforce by ‘around half’. Three leading board members also step down. The Government announces it will abolish NHS England in a bid to ‘reduce duplication’ with the Department of Health and Social Care.
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