{"id":48124,"date":"2020-07-23T09:41:45","date_gmt":"2020-07-23T08:41:45","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=48124"},"modified":"2020-07-23T09:43:29","modified_gmt":"2020-07-23T08:43:29","slug":"anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/","title":{"rendered":"Anna Charles: This is not the right time for a wholesale NHS reorganisation"},"content":{"rendered":"<p><span style=\"font-weight: 400\">You might expect, in the midst of a global pandemic, that unpicking the inner workings of the organisations that run and oversee the national health service would be far from front of ministers\u2019 minds. But recent reports would indicate this is not the case. The question of a large-scale NHS reorganisation\u2014which seems to tempt governments of all colours with remarkable regularity\u2014is once again being mooted.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">If <\/span><a href=\"https:\/\/www.theguardian.com\/society\/2020\/jul\/10\/boris-johnson-plans-radical-shake-up-of-nhs-in-bid-to-regain-more-direct-control\"><span style=\"font-weight: 400\">reports in the media<\/span><\/a><span style=\"font-weight: 400\"> are to be believed, parts of government have set their sights on a radical shake up of NHS structures, including an attempt to restore minsters\u2019 direct control over the NHS by restricting the operational independence of NHS England created under the 2012 Health and Social Care Act. Quite why this is deemed necessary at this moment in time is unclear. There are reports of ministerial frustration at the role some health agencies have played during the pandemic, but some of the areas of greatest concern\u2014such as the faltering start to the Test and Trace programme, and the provision of personal protective equipment (PPE)\u2014were the responsibility of agencies already under the direct control of ministers (Public Health England is an executive agency of the Department of Health and Social Care while the NHS supply chain is set up as a limited company, wholly owned by the Secretary of State for Health and Social Care). Restricting the independence of NHS England is therefore <\/span><a href=\"https:\/\/www.instituteforgovernment.org.uk\/blog\/prime-minister-plan-radical-shake-nhs-not-right-prescription\"><span style=\"font-weight: 400\">not a logical response<\/span><\/a><span style=\"font-weight: 400\"> to these concerns.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Reportedly also under consideration is the option of turning integrated care systems\u2014which are currently voluntary local partnerships bringing together providers and commissioners of NHS services with local authorities and other partners to collectively plan and integrate care\u2014into legal entities with budgets and statutory responsibilities. There are legitimate questions about how to ensure appropriate transparency and accountability for Integrated Care Systems if they are to have greater responsibility for planning services and managing resources, but setting them up as a new legal entities would have far reaching implications for the governance and accountabilities of existing organisations such as clinical commissioning groups and NHS Trusts and Foundation Trusts.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">If there is one lesson from the history books of NHS reform, it is that attempts at large-scale reorganisations should be approached with considerable caution. In 2015, The King\u2019s Fund concluded that the last, and possibly largest, set of organisational reforms (the coalition government\u2019s 2012 Health and Social Care Act) had been &#8220;<\/span><a href=\"https:\/\/www.kingsfund.org.uk\/publications\/nhs-under-coalition-government\"><span style=\"font-weight: 400\">distracting and damaging&#8221;<\/span><\/a><span style=\"font-weight: 400\">. With the benefit of hindsight, an even less favourable conclusion might now be reached. NHS leaders have spent the years that followed having to <\/span><a href=\"https:\/\/www.kingsfund.org.uk\/publications\/amending-2012-act-can-it-be-done\"><span style=\"font-weight: 400\">unpick and work around<\/span><\/a><span style=\"font-weight: 400\"> many of its core features as the strategic focus of the NHS has shifted away from the world of competition enshrined in the Act, in favour of collaboration and integration in response to changing population need.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Structural reorganisations consume significant time and resource, distract leaders and staff from other priorities, and often fail to deliver intended benefits. The system can ill afford such upheaval at the same time as facing potential further waves of covid-19 and dealing with the complexities of restoring and renewing services.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">So, what is the alternative? A focus on improving collaborative behaviours between NHS organisations, and between the NHS and local government, would likely deliver more positive impact more quickly than an extensive reorganisation. Targeted changes to support the integration of services would be preferable to wholesale changes to structures. This includes changes to end the forced competitive procurement of some services and remove some of the blockages that make it harder for NHS providers and commissioners to work together. <\/span><a href=\"https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2019\/09\/BM1917-NHS-recommendations-Government-Parliament-for-an-NHS-Bill.pdf\"><span style=\"font-weight: 400\">Proposals for just such a limited set of changes<\/span><\/a><span style=\"font-weight: 400\"> have already been put forward by NHS England, <\/span><a href=\"https:\/\/richmondgroupofcharities.org.uk\/sites\/default\/files\/support_letter_nhs_legislation_proposals_final.pdf\"><span style=\"font-weight: 400\">supported by stakeholders<\/span><\/a><span style=\"font-weight: 400\"> across the health and care system, including The King\u2019s Fund.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Instead of allowing a reorganisation of NHS structures to consume valuable energy and political capital, the government would do better to direct its attention to social care. The impact of covid-19 on people who rely on social care has provided more evidence (if more was needed) that the sector has been overlooked for too long and is in desperate <\/span><a href=\"https:\/\/www.kingsfund.org.uk\/publications\/whats-your-problem-social-care\"><span style=\"font-weight: 400\">need of attention, investment and reform<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The <\/span><a href=\"https:\/\/www.conservatives.com\/our-plan\"><span style=\"font-weight: 400\">Conservative Party manifesto<\/span><\/a><span style=\"font-weight: 400\"> made the NHS a key priority, making a series of commitments to grow and support the NHS workforce. It also promised to solve the problems in social care to give every person the dignity and security that they deserve, and to &#8220;level up&#8221; every part of the country by addressing deep-rooted economic and social inequalities. While it is easy to assume that the coronavirus has changed everything, the pandemic has underlined that these priorities\u2014supporting the workforce, reforming social care, and tackling inequalities in health\u2014are now more important than ever. Entering into yet another attempt to rearrange the NHS deckchairs will not solve these problems and risks distracting attention from making the changes that would.\u00a0\u00a0<\/span><\/p>\n<p style=\"font-weight: 400\"><em><strong>Anna Charles<\/strong>, Senior Policy Adviser, The King\u2019s Fund<\/em><\/p>\n<p style=\"font-weight: 400\"><em><strong>Competing interests<\/strong>: None declared<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>You might expect, in the midst of a global pandemic, that unpicking the inner workings of the organisations that run and oversee the national health service would be far from [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":45210,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236,2148],"tags":[],"class_list":["post-48124","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs","category-kings-fund"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Anna Charles: This is not the right time for a wholesale NHS reorganisation - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Anna Charles: This is not the right time for a wholesale NHS reorganisation - The BMJ\" \/>\n<meta property=\"og:description\" content=\"You might expect, in the midst of a global pandemic, that unpicking the inner workings of the organisations that run and oversee the national health service would be far from [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-07-23T08:41:45+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-07-23T08:43:29+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/07\/nhs_parliament.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"4096\" \/>\n\t<meta property=\"og:image:height\" content=\"2731\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Anna Charles: This is not the right time for a wholesale NHS reorganisation\",\"datePublished\":\"2020-07-23T08:41:45+00:00\",\"dateModified\":\"2020-07-23T08:43:29+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/\"},\"wordCount\":838,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2019\\\/07\\\/nhs_parliament.jpg\",\"articleSection\":[\"NHS\",\"The King's fund\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/\",\"name\":\"Anna Charles: This is not the right time for a wholesale NHS reorganisation - The BMJ\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2019\\\/07\\\/nhs_parliament.jpg\",\"datePublished\":\"2020-07-23T08:41:45+00:00\",\"dateModified\":\"2020-07-23T08:43:29+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#primaryimage\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2019\\\/07\\\/nhs_parliament.jpg\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2019\\\/07\\\/nhs_parliament.jpg\",\"width\":4096,\"height\":2731,\"caption\":\"An NHS sign at St Thomas' Hospital, with Big Ben in the background, in Westminster, central London\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2020\\\/07\\\/23\\\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Anna Charles: This is not the right time for a wholesale NHS reorganisation\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\",\"name\":\"The BMJ\",\"description\":\"Helping doctors make better decisions.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\",\"name\":\"The BMJ\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2018\\\/05\\\/The-BMJ-logo.jpg\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2018\\\/05\\\/The-BMJ-logo.jpg\",\"width\":852,\"height\":568,\"caption\":\"The BMJ\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/bmjdotcom\\\/\",\"https:\\\/\\\/x.com\\\/bmj_latest\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Anna Charles: This is not the right time for a wholesale NHS reorganisation - The BMJ","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/","og_locale":"en_US","og_type":"article","og_title":"Anna Charles: This is not the right time for a wholesale NHS reorganisation - The BMJ","og_description":"You might expect, in the midst of a global pandemic, that unpicking the inner workings of the organisations that run and oversee the national health service would be far from [...]More...","og_url":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/","og_site_name":"The BMJ","article_publisher":"https:\/\/www.facebook.com\/bmjdotcom\/","article_published_time":"2020-07-23T08:41:45+00:00","article_modified_time":"2020-07-23T08:43:29+00:00","og_image":[{"width":4096,"height":2731,"url":"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/07\/nhs_parliament.jpg","type":"image\/jpeg"}],"author":"BMJ","twitter_card":"summary_large_image","twitter_creator":"@bmj_latest","twitter_site":"@bmj_latest","twitter_misc":{"Written by":"BMJ","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"Anna Charles: This is not the right time for a wholesale NHS reorganisation","datePublished":"2020-07-23T08:41:45+00:00","dateModified":"2020-07-23T08:43:29+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/"},"wordCount":838,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#organization"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/07\/nhs_parliament.jpg","articleSection":["NHS","The King's fund"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/","url":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/","name":"Anna Charles: This is not the right time for a wholesale NHS reorganisation - The BMJ","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#website"},"primaryImageOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#primaryimage"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/07\/nhs_parliament.jpg","datePublished":"2020-07-23T08:41:45+00:00","dateModified":"2020-07-23T08:43:29+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#primaryimage","url":"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/07\/nhs_parliament.jpg","contentUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/07\/nhs_parliament.jpg","width":4096,"height":2731,"caption":"An NHS sign at St Thomas' Hospital, with Big Ben in the background, in Westminster, central London"},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/23\/anna-charles-this-is-not-the-right-time-for-a-wholesale-nhs-reorganisation\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/bmj\/"},{"@type":"ListItem","position":2,"name":"Anna Charles: This is not the right time for a wholesale NHS reorganisation"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/bmj\/#website","url":"https:\/\/blogs.bmj.com\/bmj\/","name":"The BMJ","description":"Helping doctors make better decisions.","publisher":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/bmj\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/bmj\/#organization","name":"The BMJ","url":"https:\/\/blogs.bmj.com\/bmj\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/05\/The-BMJ-logo.jpg","contentUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/05\/The-BMJ-logo.jpg","width":852,"height":568,"caption":"The BMJ"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/bmjdotcom\/","https:\/\/x.com\/bmj_latest"]},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/bmj\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/48124","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=48124"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/48124\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media\/45210"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=48124"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=48124"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=48124"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}