Policy briefing: Health Bill

What has been announced?

The Health Bill was introduced by the Government to Parliament on 13 May 2026. The Bill aims to follow through on the Government’s commitment to abolish NHS England and represents the largest restructure of the NHS since the Health and Social Care Act 2012.

The Bill has several important themes:

• The Bill sets out that “NHS England is abolished” and transfers functions, staff, property and liabilities to the Secretary of State (SoS), ICBs and other public bodies. The timeline for the abolition has been previously indicated to be April 2027
• Primary care services including General Ophthalmic Services (GOS) transfer directly to Integrated Care Boards (ICBs). This sees a change in the legal status but does not grant any new powers. Since April 2023 ICBs have commissioned GOS but have done so under delegated authority from NHS England. The Bill removes the delegation aspect and each ICB is now responsible directly. The changes in this regard are largely administrative
• There is now a requirement for an ICB to have at least one member nominated by the mayor of any mayoral strategic authority and the Bill now provides additional powers to the Secretary of State (SoS). These powers include the ability for the SoS to direct an ICB CEO to cease performing some functions and in extreme cases to remove the CEO of an ICB 
• Joint local health and wellbeing strategies will be replaced by Neighbourhood Health Plans. These will be produced in conjunction with local authorities and ICBs. ICBs must have regard to these plans in carrying out their duties. This places neighbourhood health plans into legislation
• The Bill empowers the SoS to establish a single patient record (SPR) making patient information available to patients and those involved in health or social care. The SoS, Care Quality Commission (CQC) or a Special Health Authority will be able to impose financial penalties for failing to comply. Regulations around the SPR are subject to consultation
• There is a new requirement on ICBs around waiting times and patient choice. The SoS is granted powers to investigate ICB compliance with patient choice obligations and to act if ICBs do not comply. The SoS will be required to publish guidance around how these powers will be used. Patient choice, a reduction in inequalities and workforce planning also feature within other sections of the Bill
• Healthwatch is abolished and a new patient voice function within the Department of Health and Social Care (DHSC) is intended to replace national and local bodies. Detail about this new body has not been included.

What do we say?

The Government’s Health Bill 2026 begins to fill in some of the detail from the many NHS policy documents that have been published in recent months. However, there are still many areas that are unclear and it will be important to see how the gaps are filled following the recent departure of Wes Streeting from the Secretary of State role.

Looking at the commissioning changes with ICBs formally becoming the commissioners of GOS, some business owners will understandably be concerned. However, as currently set out, this is a simple administrative tidying. Some members will remember the precursors to NHS England and that GOS contracts were previously held by Primary Care Trusts (PCTs). In some ways the Bill unwinds the last 14 years and reverts to the pre-2012 reforms. GOS is expected to remain a national service with a national pricing structure, albeit now once again commissioned locally.

The formalisation of Neighbourhood Health Plans presents an opportunity to ensure optometry services are recognised, but as we have expressed previously, the failure to explicitly include optometry in the early phases of the model framework is disappointing. However, in response to parliamentary questions, the Minister for Care, Stephen Kinnock, has been clear that ICBs can include optometry in these early plans if they wish.

The formal basis for the SPR is a welcome announcement and in our view one of the most important ways to join up care, prevent avoidable referrals and ensure patients don’t fall through the gaps in the system. However, it is not yet clear how or when this new record will be implemented. There are already several competing products in this space, from Local Shared Care Records, to the National Care Records Service and the Summary Care Record. Each of these products has previously been heralded as the solution to siloed patient records, but each time they have failed to deliver.

From an optometry perspective, this is because time and again the systems have been designed without considering those services that sit outside of the hospital and GP sectors. Our view is that they have been based on the assumptions that what works for general practice will also work for optometry, dentistry and pharmacy. If we are to break this cycle and achieve real transformation, systems that will be used by, or rely upon, optometry must be co-designed with the optometry profession.