Hospital boards not ready to run population health, says government adviser

Hospital trust boards are not currently in a position to run population health and “very few” acute chief executives “truly understand” primary care, government’s neighbourhood health adviser has told HSJ.

Sir John Oldham, A former GP and a senior adviser to Wes Streeting, told HSJ in an interview: “You can’t just take a hospital trust board and management and think that it will be able to run population health, because the skill set and knowledge set is really quite different.”

The 10-Year Health Plan, published last week, said high-performing trusts would be encouraged to evolve into “integrated health organisations”. Similar to accountable care organisations in the USA, they would take on a population-based budget to run – and commission – a wide range of acute, community, primary and social care services. Some will begin in 2026, and the plan says IHOs will “over time… become the norm”.

There are questions about how it will fit with the planned expansion of primary care-led neighbourhood health work, including two proposed new “neighbourhood provider” contracts.

Sir John, who is leading a new programme implementing neighbourhood health, said “deepening the connectivity with local authorities” was particularly important “when you’re developing IHOs, because if they just become hospital services being delivered in the same way in the community, then it will fail”. 

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Source: HSJ, 9 July 2025