Strategic Health Authorities replace existing health authorities

'Devolution Day' occurred on 1 April 2002 (so named after the initiative's stated intentions to devolve central power over the NHS to a local level). The eight regional offices of the department, 95 health authorities and 400 or more primary care groups were abolished, to be replaced by 28 new, larger and more strategic health authorities and some 300 primary care trusts (PCTs).

Many changes took place in advance of legislation. The process was often unclear, as responsibilities were reallocated and there was little clear guidance. 20,000 staff changed their jobs.

The names of the 28 strategic health authorities (SHAs) in England had been announced on 18 December 2001. This followed 22 public consultation exercises on the boundaries of the proposed new health authorities, in line with the announcement in the Shifting the Balance white paper.

The 28 new bodies operated in shadow form following the abolition of the 'old' health authorities, until section 1 of the NHS Reform and Health Care Professions Act came into force on 1 October 2002, and they were formally renamed SHAs.