NHS 1974 Project

Project Background

The NHS 1974 Project examines the major restructuring of the National Health Service in England and Wales, the first since its creation in 1948. The reform replaced 15 Regional Health Authorities with 98 Area Health Authorities, aiming to deliver more equitable, locally aligned healthcare. Our research focuses on how these structural changes impacted variation in clinical practice and patient outcomes for the baby boomer generation.

Before 1974, access to specialist care in the NHS varied widely depending on geography and socioeconomic status. The reform was designed to unify service delivery and eliminate these inequalities by introducing co-terminous Area Health Authorities. This restructuring laid the foundation for more consistent access to care across the population. Using rich administrative and survey data, we examine how the reform influenced health outcomes.

Research Methodology

Our approach combines historical administrative records with longitudinal cohort data to evaluate the long-term effects of the 1974 NHS reorganisation. Key elements include:

• Mapping health authority boundaries before and after the reform
• Linking area-level changes to individual patient data
• Comparing treatment patterns across regions with differing clinical norms
• Assessing whether access equalisation weakens the link between socioeconomic status and treatment decisions