Category Archives: Health

What does Andy Burnham’s social care announcement mean for providers?

On Tuesday 29 July, Prime Minister Andy Burnham, Louise Casey and Health Secretary Yvette Cooper outlined the government’s approach to adult social care reform. Burnham said it was ‘shameful’ that decades of political point-scoring had come at the expense of meaningful reform and argued that he is prepared to spend political capital to deliver lasting change. The prime minister used the speech to make three key announcements.

First, Burnham confirmed that Louise Casey’s independent review of adult social care will be accelerated by a year, with final recommendations now expected by summer 2027. He said Casey had been asked to consider how the government could deliver a National Care Service, arguing that social care should become more preventative, person-centred and better integrated with the NHS.

Second, Burnham announced a renewed focus on the social care workforce. Building on the government’s plans to introduce a Fair Pay Agreement for care workers from 2028/29, he said ministers would explore wider reforms to improve pay, training and career progression. He also proposed creating clearer pathways between social care and NHS roles to help professionalise the workforce and improve recruitment and retention.

Third, Burnham announced the launch of cross-party talks on social care reform involving the Conservatives and Liberal Democrats. He argued that lasting reform would require political consensus and described the discussions as the first test of his commitment to a less adversarial style of politics. Burnham said common ground must be found if policymakers are to address challenges that have remained unresolved for decades.

Both Andy Burnham and Louise Casey signalled that future reform would involve greater scrutiny of private providers. Casey argued that there remains an important role for a mixed market in adult social care, but criticised providers perceived to be “profiteering” from care services. Burnham echoed these concerns, arguing that some parts of the sector have prioritised profit and cost-cutting over the quality of care and outcomes for vulnerable people. However, Burnham has historically adopted a pragmatic rather than an ideological approach to public service reform. As health secretary in the Brown-led government, he recognised the role that independent providers could play in increasing NHS capacity and reducing waiting times where they delivered value for patients and taxpayers.

As a result, he is unlikely to pursue reforms that materially reduce the private sector’s role in adult social care. Given the significant share of care capacity and expertise provided by independent providers, the prime minister is likely to be mindful of avoiding reforms that could destabilise the market by causing market exits and place further pressure on already stretched services. Instead, providers should expect a greater focus on accountability and transparency, clearer standards to improve the quality and consistency of care, and enhanced scrutiny of how public funding and provider profits are used. The NHS Modernisation Bill currently going through the Commons is one key place to watch if any substantive change is to come forward.

On funding, Burnham argued that significant improvements could be achieved through more effective use of existing resources before tax rises are considered. He highlighted the costs associated with avoidable hospital admissions and delayed discharges caused by inadequate social care provision, suggesting that greater investment in prevention could deliver substantial savings across the wider health system. However, significant questions remain about the long-term funding model for a National Care Service. Reports suggest officials are exploring options ranging from social insurance-style contributions to inheritance-based levies, although ministers have stressed that no decisions will be taken until Casey’s review is complete and the new prime minister remains constrained to some extent by Labour’s 2024 manifesto commitments on tax.

Phil Hope, GK’s Strategic Adviser and former care services minister under Andy Burnham at the Department for Health, who was directly referenced in the prime minister’s speech said: ‘The prime minister was clear that he wants to build a broad consensus around social care reform and move the debate beyond the political point-scoring that has hindered progress in the past. Bringing forward the Louise Casey review to 2027 creates an opportunity for that conversation to take place away from the pressures of a forthcoming general election. While concerns about profiteering were raised, there was little detail on the scale of the issue or how ministers might address it, making this an area the Casey review is likely to explore further.’

Steve Brine, GK’s Strategic Advisor and former health minister as well as chair of the cross-party Health and Social Care Select Committee said: ‘It was a hugely impressive performance from Andy Burnham with what was more a political than a policy announcement but his authenticity on the subject is welcome and important. It was really about creating the political conditions for reform rather than announcing the detail, but that day will come – along with who pays – and that is the next big moment. Casey’s challenge is to define what ministers actually mean by ‘National Care Service’ – is it about standards, funding, eligibility – and for the PM it’s how will someone’s experience be different in two, three or five years’ time? That’s ultimately how people will judge success.’

Sajid Javid- Five priorities of the new Health Secretary

Capital isn’t glamorous, but it’s where health reform succeeds or fails

Drawing on his experience as a Health Minister and Chair of the Health and Social Care Select Committee, GK’s strategic advisor Steve Brine argues the real challenge is delivering, not announcing, NHS infrastructure investment.

There is an old saying in politics that ministers like cutting ribbons more than fixing roofs. Reading the Government’s new 10-Year Capital Plan for Health and Social Care, I was reminded just how true that is.

Having served as a Health Minister and later as chair of the cross-party Health and Social Care Select Committee, I’ve learned that while politicians understandably focus on services, patients and waiting lists, none of those can be credibly improved without investing in the infrastructure that underpins them.

Estates, equipment and digital capability are not simply operational issues; capital isn’t glamorous – but it’s where health reform succeeds or fails

That is why I think this document matters, even if it contains fewer headline announcements than some may have wanted. It’s more of a capital investment framework than a capital spending announcement and while it is important because it starts to join together a series of previously announced commitments into one strategy, if you’re looking for lots of new money or major projects, you’ll likely be disappointed.

For investors, suppliers and those looking to support the transformation of health and care, this is best understood therefore as a statement of strategic direction. The Government is attempting to provide something the NHS has too often lacked: a long-term framework that links capital investment directly to service reform.

The themes will be familiar and re-enforce the view many of us held that the capital plan would essentially be the infrastructure companion to the 10-Year Health Plan which is now just over one year old.

Investment in neighbourhood health centres, modern diagnostic equipment (see my last piece), digital infrastructure, community facilities and the maintenance of the existing estate have all featured in previous announcements.

What is new is the attempt to bring those priorities together and explicitly align them with the Government’s ambition to shift care from hospitals into communities, from analogue to digital, and from sickness towards prevention.

As a minister, I learned very quickly that capital policy is health policy. You can’t expect clinicians to embrace new models of care if they are working in buildings designed before England last won the World Cup, nor can you promise a digital NHS without investing in the infrastructure that powers it. Too often, capital has been treated as something separate from healthcare delivery whereas in reality, it is one of its principal enablers.

That lesson stayed with me when I chaired the Health and Social Care Select Committee. Alongside colleagues on the Public Accounts Committee, we scrutinised the New Hospital Programme, asking not simply whether Boris Johnson’s ambitions were right, but whether they were deliverable.

That experience reinforced a rather obvious point: announcing infrastructure programmes is relatively straightforward; delivering them consistently over a decade, through changing political and economic circumstances, is considerably more challenging!

That is why I think investors should read this document with cautious optimism. The opportunities are clear. If the Government is serious about expanding community-based care, modernising diagnostics, digitising the NHS and addressing the maintenance backlog, there will inevitably be demand for expertise, technology, construction, data, equipment and innovative delivery models.

The direction of travel is now clearer than it has been for some time. The question not answered is pace. The plan sets out the destination far more clearly than the route to get there. There is relatively little detail about sequencing, procurement, prioritisation or delivery milestones.

History also provides a note of caution. During my time in government, I saw how easily capital budgets could come under pressure when day-to-day NHS spending became squeezed. Every government says it will protect long-term investment; not every government manages to do so.

And I note how one of the strongest themes is ‘repair first’ as large sums are earmarked for tackling the maintenance backlog, replacing obsolete equipment and of course removing RAAC. £6.75bn for hospital repairs over nine years and £2bn to remove reinforced autoclaved aerated concrete.

Overall, I see this as a welcome piece of strategic thinking. It provides a clearer signal than we have had for many years that infrastructure is no longer being viewed as an afterthought but as a prerequisite for NHS reform. For those looking to invest, that matters.

The real test, however, will not be whether the strategy is well written, but whether successive governments (including the new one about to start work) have the discipline to stick to it.

Community pharmacy settlement brings stability, but long-term challenges remain

As a former Pharmacy Minister, I watch the annual community pharmacy contract negotiations with interest because I know how important they are. This year’s settlement is notable for one reason above many in that it was agreed! That may sound like a low bar, but in today’s NHS it is anything but.

At a time when ministers find themselves in dispute with almost every part of the health workforce, the fact that Government and Community Pharmacy England have reached an agreement matters.

Negotiation remains preferable to imposition. It provides stability, certainty and, perhaps most importantly, a platform for future reform. The settlement itself is better than many in the sector (including me) were expecting. Indeed, compared with the rest of primary care, community pharmacy has secured one of the stronger funding settlements available anywhere in the NHS.

Minister Stephen Kinnock deserve praise for recognising that pharmacies cannot carry on indefinitely with rising costs. The increase in funding, the uplift in retained medicines margin and the write-off of historic over-delivery all sit on the positive side of the ledger.

But we should be honest about what this settlement is – and what it is not.

It is not a recovery plan. The uncomfortable truth is that a decade long funding gap – which I absolutely take my share of responsibility for – has not been closed. The additional investment announced for 2026/27 is largely consumed by increased activity levels and of course inflation. This matters because while the settlement should help stabilise the sector, I suspect it will not halt pharmacy closures.

There is another challenge too. I have great respect for Community Pharmacy England but there will come a point where it must decide whether it believes a deal is acceptable or not.

Last year, and now this, we hear of an agreement reached quickly followed by explanations setting out why the agreement is not good enough. I understand why this occurs, but it is not a position that can be sustained indefinitely and many in the sector will feel that. Ministers won’t much care so long as it’s done and they will come to rely on that.

At some point, the sector, government and negotiators alike need true alignment on what success actually looks like. The government’s clear priority in this settlement is independent prescribing. As a manifesto commitment and a central part of the neighbourhood health agenda, it is easy to see why ministers are keen to deliver here.

The principle is absolutely right. For years I have argued that community pharmacy is one of the NHS’ most underused assets. Everyone should want pharmacists diagnosing, prescribing and managing more patients – ‘hospital to community’ as they say.

My concern is whether the funding stamped on this settlement will be enough to deliver independent prescribing at a meaningful scale. Training people is vital. Creating the capacity, infrastructure and incentives to make independent prescribing a systemic part of community pharmacy practice is another challenge.

My verdict? This is a better deal than many anticipated and best in class in primary care. It provides some level of stability and demonstrates that constructive negotiation is still possible with this government.

But stability is not transformation.

The question facing us all is whether the settlement represents the first step towards a realised clinical future for community pharmacy – or merely another year spent managing decline, albeit a little more slowly.

This article from Steve Brine also appears at the Chemist + Druggist online magazine.

Treasury to Treatment: James Murray Appointed Health Secretary

As predicted, England has a new Health Secretary – James Murray.

Above all else, he deserves the goodwill that comes with inheriting one of the best jobs in government.

The Department of Health and Social Care is unlike any other brief. It combines immense public affection for the NHS with relentless operational pressure, difficult fiscal realities and an almost impossible expectation that Ministers can ‘fix’ deep-rooted problems decades in the making.

So my advice to James above all else would be this; you inherit a Ten Year Plan (and numerous other strategies) so don’t waste time and try the patience of the sector by re-writing them.

Focus on operationalising them and give your civil servants (as well as Jim Mackie who I suspect will be feeling deflated right now) a very clear steer from day one on your top three policy areas. Not the infamous three ‘shifts’ – they’re the means to the end – but the areas they know you personally will never drift from.

James takes office with a formidable in-tray. NHS waiting lists still high and a media (as well as a sector) that is sceptical recent falls weren’t more about politics than clinical reality.

Access to primary care continues to define the ‘retail offer’ in health, while care reform of course remains the great unresolved question of British domestic policy.

Not to mention a Ten Year Workforce Plan that remains illusive, medicine shortages (which I predict will grow as an issue in 2026) and rising demand because we are living longer, but often not healthier, lives.

And hanging over all of this is perhaps the biggest challenge of all; how we finally move from a sickness service to a genuine health service.

That is why the NHS Modernisation Bill he inherits matters. Much of the early discussion around it has understandably focused on the proposed Single Patient Record — a potentially transformative attempt to join up fragmented patient information across the NHS.

Done properly, this could save lives, reduce duplication, improve productivity and finally give clinicians the information they need at the point of care. Done badly, it risks becoming another expensive digital programme which loses public trust before it delivers meaningful change. The new Secretary of State will need Number 10 (whoever occupies it) to back him fully when the going gets tough.

But the Bill goes wider than that. It is likely to include measures aimed at modernising NHS structures, expanding the use of technology and AI, improving data sharing, reforming procurement and accelerating innovation adoption. And that’s before Labour MPs, increasingly keen to reject incrementalism, get their hands on amendments come the Bill Committee stage.

The challenge, of course, is delivery. Every Health Secretary arrives in office promising reform. Most discover the system is better at absorbing change than enabling it.

The NHS is enormous, complex and deeply institutionalised. Structural reform alone rarely changes outcomes unless accompanied by cultural change, workforce support and political honesty about priorities.

And that brings me to Wes Streeting. I know how hard it is to leave that Department so it can’t have been easy.

Politics is often too tribal to acknowledge effort when people leave office or move on from major briefs. But it is right to recognise the energy, seriousness and determination Wes brought to the health debate.

Whatever one’s politics, he helped force difficult conversations into the open — about productivity, reform, prevention and the need for the NHS to modernise if it is to remain sustainable.

Wes deserves credit for that as well as the HIV Plan, the Men’s Health Strategy and some lesser noticed progress around things like the Rare Diseases Plan or England (finally) testing newborns for Spinal Muscular Atrophy as a result of his work with Jessy from Little Mix.

The new Health Secretary will quickly discover there are a thousand competing voices telling him what matters most.

My hope is that, amid the noise, he keeps sight of a simple truth: the future sustainability of the NHS will depend not only on how we treat illness, but on how seriously we take the business of creating a healthier society in every sense of the word. We should all wish him nothing but success.

Steve Brine, consultant, podcaster, trustee, former MP for Winchester & Chair of the Health Select Committee

Prevention is the new cure podcast – all things health and politics

Portrait of Stephen Brine - Uk Parliament Official

The Rare Diseases Action Plan: A refreshing focus on implementation

GK Strategic Adviser and former health minister Steve Brine examines the government’s new Rare Diseases Action Plan and its impact on people living with rare diseases. 

As someone who has spent many years engaged with health policy, both inside and outside government, I was genuinely heartened to see the England’s Rare Diseases Action Plan published to mark Rare Disease Day last month.

This fifth annual plan builds on the UK Rare Diseases Framework and sets out clearly how we intend to turn the strategic priorities I first produced as the minister into real improvements in people’s lives.

Rare diseases may, individually and as the name suggest, be uncommon – but collectively they affect a significant number of people – and even more indirectly via family members.

I have always been acutely aware how too many families face what is heartbreakingly called a ‘diagnostic odyssey’; years of uncertainty, multiple referrals, and repeated explanations before a condition is recognised and understood.

This isn’t just about medicine; it’s about dignity, continuity of care, and basic fairness across the NHS.

The new 2026 Action Plan wisely positions itself as a practical implementation of the Rare Diseases Framework’s four core priorities:

  • helping patients get a final diagnosis faster
  • increasing awareness of rare diseases among healthcare professionals
  • better coordination of care; and
  • improving access to specialist care, treatment and drugs.

But it does much more than repeat them, it brings them to life in the context of the Government’s 10 Year Plan for the NHS in England.

At its core, the plan seeks to show how system-wide reform – from digital transformation to community-based care – can make a real difference for people living with rare conditions.

One of the most meaningful aspects of this year’s plan is its emphasis on health equity, something ministers often say is central to their health mission.

For too long, people living with rare diseases have experienced variation in the care they receive, depending on where they live or what their condition is.

This is not unique to this cohort of patients of course but, for the first time in an action plan of this kind, the system explicitly recognises rare disease as a health inequality, and commits to addressing this through better data, targeted improvement work, and integration with NHS England’s longstanding approach to tackling inequalities.

This marks an important shift – one that sits right at the heart of a modern health service, and was important to me when drawing together the original priorities.

On the diagnostic front, progress is evident but needs to go further and faster.

The NHS Genomic Medicine Service now delivers genomic testing for more than 7,000 rare conditions, and there’s a renewed focus on significantly shortening that ‘odyssey’.

The re-procurement of the NHS Genomic Medicine Service (GMS) from April 2026 is welcome as is the suggestion, something I wish I had been able to do, the new contracts will give certainty and run for ten years from this spring.

What this renewed GMS should deliver is a forward-looking contract which embeds genomic technology into standard clinical pathways and, in-turn, makes a positive impact on diagnosis delays.

Last year also saw the establishment of pilot clinics for people with undiagnosed rare diseases that bring many more services ‘under one roof’.

Two of these pilot centres – one in the north and one in the south of England – are expected to be operational by autumn 2026. Their purpose is simple but should make a big difference; to give people who have exhausted standard lines of diagnosis a new path to understanding what’s wrong. This brings vital hope.

Coordination of care remains a longstanding challenge for people with rare conditions, for whom the term comorbidity was coined. This requires input from a range of specialists and can be very challenging for a health system such as the NHS.

To answer this, NHS England is looking at models of care that support rare disease collaborative networks (28 of which now exist) to join things up and bring that consistency across services.

Another significant advance is the work being done on so-called ‘novel’ therapies.

Regulators like the Medicines and Healthcare products Regulatory Agency have made commitments to change how rare therapies are treated, with a view to facilitating more timely access to the latest treatments.

These are the sorts of advances that not only push scientific boundaries, but also give real hope to individuals and families living with rare conditions. We need to see, soon, the first patient treated by one of these therapies to keep momentum in this space.

Of course, none of this has happened by accident. Central to the 2026 Action Plan’s development and delivery has been the voice of the rare disease community.

I launched the ‘National conversation on rare diseases’ in 2019 which gathered over 6,000 responses across the UK and directly informed the four priorities being settled upon.

This time, patient organisations, clinical experts and charities seem to have again provided insight, and lived experience, ensuring the new plan lands with the credibility it must have to be successful.

I have tried to be positive in this piece – and there is much to be positive about – but we shouldn’t fool ourselves there isn’t a LOT of work to be done.

Today, only around 5 % of rare conditions have an approved and effective treatment, and for too many people the journey towards diagnosis is more long wandering road than ‘odyssey’ which suggests an adventure eventually leading somewhere good.

This plan isn’t the endpoint – and it’s not meant to be. It is the next part of a long-term commitment which builds on the work I did, which in itself built on the 2013 UK Strategy for Rare Diseases.

Credit to the current team of health ministers, across the UK, who have agreed to further extend that work giving us further chances to address unmet need and prepare for the future.

As someone who has seen both the frustrations and the progress in this policy area over many years, I welcome the clarity, ambition and practical focus of the 2026 Action Plan.

At a time when Ministers in this government are (rightly) criticised for producing grand plans without much of a nod to implementation, it is refreshing indeed.