Improving together : collaboration needs to start with regulators

The regulatory landscape in the UK is changing again. From 1 April 2019 NHS England and NHS Improvement became what is effectively a single organisation with far reaching responsibility for the oversight of the system. The structural features of this change, which will eventually require legislative reform, have been widely debated, not least by those affected by plans for a collaborative approach to improvement in the NHS.12 But there has been less discussion about the style and approach to regulation that might be best suited to drive improvement in the NHS as set out in the long term plan.3 We contend that a major change is required in the way the system interacts with service providers if we are to be successful in developing a new service model for the 21st century