Having worked in both local government and the NHS it has been interesting to compare the Scottish and English approaches to health and social care.
In England, the NHS has become more fragmented and less coherent since the Lansley reforms in 2013. The NHS is still trying to recover. This major structural change created an unhelpful distraction, combined with a real reduction in management capacity, meaning that trying to move the NHS in England from an inherently competitive system to a collaborative one, is taking longer to deliver positive outcomes.
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