Initiated by previous Health Secretary Andrew Lansley and more than two years in gestation, the new NHS puts around £65bn of taxpayers’ money directly into the hands of GPs.
Working together in Clinical Commissioning Groups, they will buy services for local patients based on what’s best for the individual and using published performance data from providers of care.
The idea is that patients are at the heart of it, transparent data will drive up quality and drive out poor performance.
For those the NHS is communicating with – patients in hospital, frontline nurses – April will probably feel the same as any other month.
Many will dismiss it as just another shuffling of the deckchairs - same red-tape but different dispenser. But the impact will be profound – and will need to be communicated as such.
This is an entirely new system, the largest restructure since the NHS was formed in 1948.
In London, the number of organisations involved in how NHS money is spent will increase tenfold - from seven to more than seventy.
There is a regional office for London, but on paper it does not have the authority to implement London-wide changes which the strategic health authority had.
Yes, there is real opportunity here for increased localism, but there is also a real risk. A risk that decisions that need to be taken and taken quickly - to improve patient care, to tackle poor performance or finances - will be hampered by the complexity of the new arrangements. It is always hard to get quick decisions from a committee.
Media coverage of the reforms has put the NHS back on the national agenda again after years of relative quiet.
Doctors and managers set out a case for change based on quality gains, but the public hear ‘cuts’ and campaigners cry ‘privatisation’.
The furore over the Francis report into Mid-Staffordshire hospital and whistleblowing has done real damage to the NHS’s reputation of - it is eating away at our trust in the country’s best loved institution and its workforce.
A recent ComRes poll clearly highlights a growing public concern about the quality of care and compassion the NHS is providing.
Although most (55%) still believe that the NHS provides a high standard of care to patients, more than half (54%) believe that patient care is worse today than it was ten years ago and one in three people (36%) say they have personally encountered unacceptably poor standards of care in the NHS. This equates to more than 17 million adults whose experiences have been negative.
The NHS will continue to deliver great care to millions this month and next. But it also needs to repair bridges internally and externally and be more honest about its shortcomings.
The NHS works best when its relationships are strong and to maintain these, motivate staff and rebuild public trust, communication is more important than it ever was.
Stephen Webb is a director at London Communications Agency