Reforming the NHS in England: opportunities and challenges.

This paper reviews the main challenges facing the NHS in England. It assesses the radical reforms proposed by the coalition government and the financial pressures facing the NHS. The paper argues that much more emphasis needs to be given to integrated care in future in the context of an ageing population and the increased prevalence of chronic diseases. The importance of effective leadership in the NHS must be recognised and supported and is likely to be one of the issues highlighted in the Francis Inquiry report into Mid Staffordshire NHS Foundation Trust. There is also a need to look beyond current debates on reform and funding and ask what kind of health and social care system is required in the future. The King's Fund's programme of work on the future system will be raising major questions about the current emphasis on hospital based care and the need to reorient towards supporting people in their own homes and in community settings.