Since its founding in 1948, the National Health Service (NHS) has been a cornerstone of British society — free at the point of use, publicly funded, and based on need rather than ability to pay. Yet behind the enduring principles lies a system that has undergone near-constant reformation. These reforms have reshaped the organisation, funding, and commissioning of health services across the decades.
As the NHS enters another period of structural reform, the re-imagination of Integrated Care Boards (ICBs) presents both risk and opportunity. One of the most critical decisions ICBs will face is whom they treat as partners in shaping services and policy. In particular, it is time to recognise the central and irreplaceable role of local negotiating committees
The news that NHS England is to be disbanded has sent ripples across the healthcare sector. For years, it was the face of national healthcare management, implementing government directives and shaping policies that affected millions of patients and healthcare professionals. But as we reflect on its legacy, we must ask a difficult question: how did so many good people, dedicated professionals, become part of a system that often acted against the very principles of care and service they set out to uphold?