I see it as a case of forced decentralisation leading to bad incentives. When you had few NHS trusts covering entire UK, you could easily handle common issues b

I see it as a case of forced decentralisation leading to bad incentives. When you had few NHS trusts covering entire UK, you could easily handle common issues because their scale matched close enough to cover entire vertical slice. Now you have trusts cut in size creating incentives against cooperation if only because of how funding is going to be arranged, and even if there's centralised service like NHS Digital... it's not the entity that is going to fight for budget for trust-local employee training and support needs.