The Health Service and NHS England As a result of the new government’s focus on economic growth and narrative around public spending, we can expect – at a minimum – increased pressure on NHS finances and changes to priorities for commissioning. At this point it seems unlikely that we will have a Lansley-style repeal and reform of the NHS in the coming years – although this may be something that the initial set of reviews and assessments contributes to. At an abortion service level, we would anticipate an increased focus in how to avoid increased spending – so an increased focus on contraception and STI testing, incentive-based funding and commissioning, and renewed focus on how to reduce ‘repeat’ abortions. On the positive side, there will be increased appetite for innovation and spreading of the care burden which is currently limited by the law, such as primary care provision of EMA services, nurse and midwife provision of surgical care, and contraceptive alternatives. Because of the increased pressure on the health service, for which there is no apparent solution in the medium term, we can expect that there is little opportunity for the government to undertake action around bringing abortion provision ‘in-house’ to the NHS. The blunt fact is that we are expecting close to 300,000 abortions to be provided in 2024, and the NH currently provides fewer than 50,000. NHSE has a dedicated team leading on abortion work currently, and they remain committed to this work going forward. The NHS has published its objectives and vision for abortion services. This sets out the need for improved access and care through greater collaboration between the independent sector and the NHS, sustainable funding arrangements, integrated commissioning practices and greater NHS surgical provision. This vision was first published as part of a letter to systems in March 2024 setting out the pressures facing the sector and asking integrated care boards to take forward a small number of key actions to help support services locally and nationally. Integrated Care Boards are asked to commission services in line with this vision. The letter set out a clear objective and vision for abortion services: Improved access and care for all those who need abortion services. • A more managed and collaborative approach between independent sector providers and the NHS to meet and manage demand, including coordination of provision at the most appropriate geographies to bring wait times in line with National Institute for Health and Care Excellence standards, expanding training to ensure we grow surgical skills and improve access to services. • Appropriately funded, financially sustainable services supported by an NHS Payment Scheme that promotes sustainability for both independent and NHS providers. • Commissioning practices that support sector resilience and development, promote quality and collaboration, and take a whole-pathway approach to sexual health and abortion services. • Enhanced NHS provision, workforce training and support, particularly in relation to surgical abortions, to create additional capacity within the system and meet patient needs. 11
RkJQdWJsaXNoZXIy NTI5NzM=