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    This could be the greatest shake-up in the 65-year history of the NHS

    The greatest impact may come from the decision to publish data on safety

    . Some 160 NHS organisations are being abolished and well over 400 new

    ones are being created - including NHS England, the biggest quango of them

    all and until now known as the NHS Commissioning Board.

    Patients, of course, will notice no immediate difference. Not tomorrow, not next

    month. Doctors will still go on doctoring, nurses nursing. Your local GP surgery

    and local hospital is not going to be revolutionised overnight.

    But the decision to hand over the commissioning of the bulk of NHS care to GP-led

    organisations - the clinical commissioning groups - with the more specialised

    care commissioned by NHS England, with local government taking responsibility

    for public health, and with EU procurement law more clearly enshrined in the NHS

    than in the past may, over time, prove to be the most significant change in the way

    the NHS works in its 65-year history.

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