OBJECTIVES: The UK NHS is currently undergoing the most significant reforms to its structure possibly since the NHS was formed. There are many questions at all levels regarding the reforms, and this research aimed to address some of them The objectives were – 1) To assess how the reforms were proceeding and what issues they had been encountered, and 2) To determine how the delivery of care has been impacted at a grassroots level METHODS: We adopted a two phased approach. The first phase involved extensive literature review in order to assess how the reforms were expected to proceed, what the outcomes were likely/expected to be and when key milestones were expected to be met. The second phase was centred on primary research carried out by Double Helix personnel. Key stakeholders in the reforming NHS at all levels were approached and data was collected using a combination of qualitative and quantitative methodologies.  RESULTS: While the vision of the NHS reforms was very clear from the outset, the actual progression on the ground has been met with considerable challenges. Even while CCGs in the first wave were in the process of undergoing assessment, changes to the overall architecture of the reforms were continuous. Key personnel at all levels lacked a clear grasp of what the following 12 months would bring, and various influencer and guideline bodies faced uncertain futures or lacked a clear remit. At the stage of writing there was no clear evidence either way to suggest that the reforms were having an impact on frontline healthcare delivery CONCLUSIONS: The UK NHS Reforms were always going to be challenging due to their scale and complexity. However there has been a clear lack of direction at various levels leading to uncertainty and fears for the short and medium term future