The Health Act 1999 has received Royal Assent. Its measures to foster modernisation of the health service include partnership working, moving decisions about treatment to the local level and provisions for raising quality standards.

The Act provides for new ways of joint working between the NHS and local councils. This will allow closer partnership working between health and social services professionals and include joint projects and budgets.

GP Fundholding will be ended and replaced by Primary Care Trusts. They will go live in April 2000. The Trusts will shape new primary and community care services. Developments will include more use of day surgery in health centres close to home, joined up healthcare offering treatment, advice, physiotherapy and chiropody; and wider health partnerships with GPs teaming up with dentists, opticians and pharmacists to provide a complete package of health services.

The NHS will be subject to the first ever Duty of Quality. The Act provides that through Clinical Governance provisions Health Authorities, NHS Trusts and Primary Care Trusts must strive to improve the health care they provide. The new system of clinical governance will ensure that hospitals and other NHS organisations have adequate processes in place to identify and deal with shortcomings and weaknesses. There are also provisions for the Commission for Health Improvement which will start its work programme in April 2000. It will monitor the NHS to ensure that arrangements to improve and assure quality of patient care are effective and make sure that the Duty of Quality is adhered to.