It will be a lot easier for NHS England and ICBs to delegate
their responsibility for commissioning services to other NHS
organisations. The Bill gives ICBs broad powers to do this, though
we are still waiting to see the draft regulations that will set out
how far these delegations can go.
There are a couple of other tools that look rather unexciting
but ultimately could be powerful ways of embedding
subsidiarity.
The first is the joint health and wellbeing strategy, produced
by HWBs that (usually) operate on a Place footprint. These
strategies have been around since 2012, sometimes languishing in a
digital bottom drawer. Under the Bill, ICBs will have to have
'due regard' to the strategies and can be reported to their
regulator if they don't. In practice this is not very different
to the current set up. The thing that may well change is the
appetite of Places to use their strategies to highlight the issues
they are facing that need input (resource, co-ordination)
