This year the UK government will introduce a new bill limiting autocracy of NHS. Prime Minister Boris Johnson plans to issue new instructions to NHS England chief executive Sir Simon Stevens.
Under the terms of Conservative health reforms, Sir Simon’s position is operationally independent, but the prime minister is said to be concerned that this arrangement makes it difficult for Downing Street to force through changes to the system.
NHS England was created as part of a widely-criticised shake-up of health service structures under then health secretary Andrew Lansley, which controversially introduced an internal market system. Stevens wants to develop an integrated care system across England, with the ability to plan collectively.
Its separation from the Department of Health was designed to keep it at arm’s length from ministers, allowing them to avoid direct blame for poor performance.
But it is understood that Mr Johnson is concerned that this gives Sir Simon too much freedom and prevents No 10 from stepping up the pace of reforms demanded by government.
Ministers have begun monthly meetings with him to demand reductions in waiting times, which hit their worst-ever levels in A&E departments in December last year.