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Health Bill 2026-27: Progress of the bill

The briefing attached to this page was published on 1 September 2026. It provides an overview of the progress of the health bill through the House of Commons prior to report stage. The page below additionally provides an overview of how the bill was amended at report stage in the Commons.

The Health Bill (Bill 009 2026-27) is a government bill. The main purpose of the bill is to abolish NHS England (NHSE). The government has said this is needed to reduce bureaucracy, enable local decision making and allow more resources to be delivered to frontline healthcare services. The bill would also make various reforms to the structure of the NHS. These reforms were set out in the government’s 10 Year Health Plan for England and recommendations from Dr Penelope Dash’s review of patient safety across the health and care landscape (the Dash review).

The bill was introduced in the House of Commons on 14 May 2026. The Library briefing on the Health Bill 2026-27 (May 2026) has further background information on the bill, a clause-by-clause analysis of the bill as introduced in the Commons, and a summary of key stakeholder commentary.

The bill had its second reading on 1 June 2026. It finished its committee stage on 16 July 2026, and it will have its report stage on 7 September 2026.

Most of the provisions in the bill would extend to England and Wales only, and apply to England, as health policy is devolved. There are some provisions in the bill that would extend UK-wide.

The government has published explanatory notes to the bill (PDF). It has also published four impact assessments on:

• abolishing NHS England (PDF)
• the single patient record and information sharing (PDF) that the bill would enable
• patient safety measures (PDF) in the bill
• measures in the bill to change the structures of integrated care boards (ICBs) and foundation trusts (PDF)

The bill contains some delegated powers, meaning it would give powers to make further legislation to ministers (or other bodies) without the need for another bill. The government has published a memorandum for the Lords Delegated Powers and Regulatory Reform Committee (PDF), which explains the reasons for each case of delegated power, to assist the committee’s scrutiny of the bill.

What are the aims of the bill and what would it do?

The main purpose of the bill would be to abolish NHSE and transfer its functions to either integrated care boards (ICBs) or the Department of Health and Social Care.

NHSE is an executive non-departmental public body, sponsored by the Department of Health and Social Care. It has operational responsibility for the NHS in England to support the delivery of healthcare, and it has a wide range of statutory functions, responsibilities and regulatory powers.

The bill would also:

• Adapt NHSE’s various responsibilities for, and powers over, the NHS in England and transfer them to the Secretary of State.
• Enable a single patient record to be created that summarises patient health information in one place.
• Implement changes to patient safety bodies recommended by the Dash review, including bringing the Health Services Safety Investigations Body into the Care Quality Commission.
• Make changes to the governance of local NHS organisations to increase their flexibility.
• Abolish Healthwatch England and transfer local Healthwatch functions to ICBs and local authorities. Healthwatch England collects views of people who use health and social care services, provides information, advice and signposting services, and can escalate concerns about health and social care services to the Care Quality Commission.
• Remove the requirement for integrated care partnerships (groups of organisations involved in care, including the NHS, local authorities, and other local organisations like voluntary groups), and reform the statutory requirements for local health and wellbeing strategy and planning.
• Remove the requirement for NHS foundation trusts to have a council of governors and members and transfer governors’ powers to appoint foundation trust chairs to the Secretary of State.
• Change how financial objectives are set across the system.
• Transfer responsibility for commissioning primary care services from NHS England to ICBs. The changes would formalise arrangements already largely operating through delegation since 2022/23.

What are the timelines for implementation?

Following Royal Assent, most provisions would come into force on the day or days specified by the Secretary of State in regulations.

The government has given the following information about timelines for the implementation for various aspects of the bill.

Abolition of NHS England

On 13 March 2025, the government announced plans to abolish NHS England and merge its functions into the Department of Health and Social Care (DHSC) by March 2027, subject to parliamentary approval. The government also announced plans to reduce the combined headcount of staff across both organisations and across ICBs by 50% by March 2028.

Single patient record

Subject to parliamentary time, the government aims to introduce the single patient record via the NHS App from 2028. This would give all patients in England access to a core set of their data, to facilitate more coordinated, personalised and predictive care. The single patient record would initially be rolled out in two priority pathways of maternity care and frailty, which will initially be developed through local arrangements.

Changes to the patient safety landscape

The DHSC has said that investigative functions would not be transferred to the Care Quality Commission (CQC) until the “CQC has improved and… is being supported and held to account to recover its effectiveness”.

If a provider of health and social care does not register with the CQC when delivering a regulated activity (as defined in the Health and Social Care Act 2008), the CQC can bring legal proceedings within three years. The bill would extend this to five years for offences committed after relevant provisions come into force, two months after the bill receives Royal Assent.

What was debated during the second reading of the bill?

The second reading of the Health Bill (Bill 009 2026-27) took place in the House of Commons on 1 June 2026. The bill received cross-party support overall. Key themes from second reading include:

• The abolition of NHS England. MPs debated if the abolition of NHS England would reduce bureaucracy and deliver frontline improvements to patients and staff or distract from service delivery and be too difficult to implement in practice.
• The Secretary of State’s powers. MPs debated if the bill would improve accountability and local devolution in the NHS or centralise too much power to the Secretary of State.
• The single patient record. While MPs supported the concept of a single patient record and its potential to improve patients’ experience of care, they highlighted the importance of adequate privacy safeguards for patients’ data.
• Scrutiny, accountability and patient voice. MPs discussed if various aspects of the bill would diminish patient voices and reduce independent scrutiny and investigatory functions, including the bill’s provisions to abolish Healthwatch and merge the Health Services Safety Investigations Body with the Care Quality Commission.
• Social care. MPs debated if there was adequate consideration of it in the bill.
• Health inequalities. MPs discussed if and how the bill should go further to address them.

How was the bill amended during its Commons committee stage?

The debate in the public bill committee focused on similar themes as in the second reading of the bill. All changes made to the bill by the public bill committee were government changes.

New clauses and schedule

Nine new government clauses and one new schedule were added to the bill.

One new clause about collaborative working arrangements between local authorities and the NHS

New clause 20 (clause 40 in the bill as amended by the public bill committee (PDF)) would enable combined authorities, combined county authorities and the Greater London Authority to enter into arrangements with NHS bodies about their functions, increasing their ability to cooperate.

The minister said the new clause would better enable collaborative working and local partnerships between NHS bodies and local authorities.

Three new clauses and one new schedule about pharmaceutical services

New clause 21 (clause 41 in the bill as amended by the public bill committee (PDF)) is a technical clause that would update legislative terminology around how doctors dispense medicines. Minister Karin Smyth said the clause would not affect current practice but rather update legislation in line with the way services are already commissioned and delivered.

New clause 22 (clause 42 in the bill as amended by the public bill committee (PDF)) amends how the Secretary of State can make arrangements for pharmaceutical services or relax requirements for pharmaceutical provision where they consider that there is inadequate provision of service.

New clause 23 would introduce a new schedule 1 (clause 43 and schedule 7 in the bill as amended by the public bill committee (PDF)). The new schedule would mean that all appeals made by pharmacy contractors, against decisions made by ICBs, would go to a single appeal body rather than a range of bodies as is currently the case. The minister said the change would simplify the appeal framework for NHS pharmaceutical services.

Five new clauses about the regulation of medical devices

New clauses 91 to 95 (numbered 70 to 74 in the bill as amended by the public bill committee) relate to the regulation of medical devices. Minister Karin Smyth said the regulatory framework for medicines and medical devices was complicated and difficult to navigate, and that this was delaying innovation, delaying patients being able to access new healthcare products, and creating a barrier for small and medium companies to enter the UK market. She said the five new clauses were intended to make the medicines and medical devices regulatory system more flexible, quicker to update, and easier to navigate.

The clauses would:

• amend the Medicines and Medical Devices Act 2021 so it refers to international and UK standards
• amend the definition of “mutual recognition agreement” in the Medical Devices Regulations 2002
• amend duties to consult with the public for organisations making regulations about human medicines and medical devices (such as the Medicines and Healthcare products Regulatory Agency and DHSC)
• change the parliamentary procedure for certain regulations about medicines from the affirmative procedure to the negative procedure
• allow regulations altering certain fees about medical devices to be made subject to the negative procedure rather than affirmative procedure

Changes to existing clauses and schedules

Reinstating requirements for foundation trust directors to include a registered doctor or dentist

Government amendment 19 was made to schedule 3, introduced by clause 29. Currently, foundation trusts (FTs) are required by law to have at least one executive director who is a registered medical practitioner or a registered dentist and another who is a registered nurse or a registered midwife. When the bill was first introduced to the Commons, schedule 3 as it was drafted would remove this requirement. Government amendment 19 amends schedule 3 to reinstate it.

Minister Karin Smyth explained in the public bill committee that the government never intended to change the policy on who is a clinical member of NHS foundation trust boards or deprioritise clinicians by removing the requirement about executive directions from law.

How was the bill amended during its Commons report stage?

All changes made to the bill at report stage were government changes.

New clauses

Eight new government clauses were added to the bill.

Two new clauses about opportunities for patients to receive visitors

Under new clause 96 (clause 19 in the bill as amended in the Commons (PDF)):

• when an ICB arranges accommodation for a patient, it would also need to help promote opportunities for the patient to receive visitors.
• ICBs would also need to promote the option of a patient being able to have a companion during treatment in a hospital or hospice (that does not require an overnight stay).

Under section 1 of the Care Act 2014, when carrying out adult social care functions, local authorities have a general duty to promote a person’s wellbeing. This includes the person’s wellbeing in relation to, among other things, their physical and mental health, their participation in recreation, and their domestic, family and personal relationships.  New clause 97 (clause 57 in the bill as amended in the Commons (PDF)), would amend the Care Act 2014 to require local authorities, when carrying out this duty, to consider:

• the importance of enabling individuals to involve other people in decisions about their care and support, and ensuring those people receive sufficient information and support to participate effectively
• the importance of individuals being able to receive visitors
• the importance of care home residents having opportunities to take trips outside the care home

Minister Karin Smyth said the two new clauses would strengthen the duties of ICBs and local authorities to support visiting opportunities for patients. She said the clauses would help patients to receive additional support and help family members, friends and carers to be involved in decisions about their care.

Four new clauses about a new power for the Secretary of State to create a framework to regulate medical devices

New clause 94 (numbered 79 in the bill as amended in the Commons (PDF)) would give the Secretary of State a new power to make regulations to introduce a licensing scheme for medical devices, which would replace the current arrangements for the conformity assessment and registration of medical devices in England, Scotland and Wales.

New clauses 99, 100 and 101 (numbered 82, 81 and 80 respectively in the bill as amended in the Commons (PDF)) are consequential to new clause 94.

Minister Karin Smyth said the current framework for regulating medical devices was not designed to keep pace with how fast medical technologies were evolving, such as software and AI being used in healthcare. She said new clause 94 (and consequential new clauses 99, 100 and 101) would enable the government to work with patients, healthcare professionals and the medical devices sector to create a framework that can stay up to date with emerging medical technologies and would help to protect patients, support innovation and strengthen the UK’s life sciences sector.

The minister confirmed that EU medical devices legislation would continue to apply in Northern Ireland.

Two new clauses on sharing information about medicines and medical devices

New clause 95 (numbered 74 in the bill as amended in the Commons (PDF)) would allow the Secretary of State and the Department of Health in Northern Ireland to share information about human medicines.

New clause 98 (numbered 75 in the bill as amended in the Commons (PDF)) outlines when the Secretary of State would be able to share information about medical devices, such as to warn the public about safety issues affecting a particular medical device.

Changes to existing clauses

This section does not discuss all amendments made to existing clauses, but only ones that were substantially debated.

Restoring the requirement for Integrated Care Boards to have a member nominated by local authorities

The bill, as first introduced to the Commons, would amend who would be required to be represented on each ICB. It would have added requirements for ICBs to have a member nominated by the mayors of mayoral strategic authorities and it would have removed requirements for ICBs to have at least one member jointly nominated by local authorities. MPs, including those on the Commons Health and Social Care Committee, raised concerns about how the removal of an ICB member jointly nominated by local authorities would affect joint working between the NHS and local authorities and the provision of integrated health and social care.

During report stage of the bill, government amendments 60 to 62 were made to the bill to restore the requirement for each ICB to have at least one member jointly nominated by local authorities, alongside any mayoral-nominated member.

What did the government say during Commons report stage about what it would do next?

Create a statutory maternity commissioner

During report stage, the Secretary of State Yvette Cooper said the government would bring forward amendments to the bill in the Lords to establish a statutory maternity commissioner for England.

Set out what abolition of NHS England would look like

The Secretary of State said she would “update the House and the NHS shortly” on the future operating arrangements of the abolition of NHSE and its merger with the DHSC. She said it would mean returning to some of the arrangements in place before 2012 (before NHSE was created) when she said the government had “strong national NHS leadership”. However, she also said there would be greater partnership between the NHS and the DHSC, accountability and less duplication than we have today.

Review the bill’s provisions on Healthwatch

In response to MPs’ concerns that the abolition of Healthwatch could result in a loss of independent scrutiny and diminish patient voice, minister Karin Smyth said:

I can commit to working closely with colleagues across this House and in the other place in order to review these provisions and ensure that our approach sufficiently empowers and devolves to local populations. We all want to ensure that the changes deliver for patients and service users, building public trust and ensuring that their voice is embedded in the care they receive.