10) NHS Structure and Management

Question 1

When was the NHS created?

Answer 1

1948

Question 2

What are the 3 core principles of the NHS?

Answer 2

Universal, comprehensive and free at point of delivery

Question 3

What changes were made to the NHS due to the Griffiths report (1980s)?

Answer 3

Increased accountability
Increase roles of mangers
increased marketisation of provision - competition between hospitals

Question 4

What are the changes made to the NHS due to more current reforms?

Answer 4

Commissioning - budget given based on population needs

Health and Social Care Act - devolves commissioning power to GPs, increased use of markets

Question 5

Describe the current structure of NHS (hierarchy):

Answer 5

Health Secretary -> Department of Health -> NHS England -> CCGs -> Provider organisations (hospitals and GPs)

Question 6

What is the role of the Secretary of State for Health?

Answer 6

Overall accountability of NHS

Question 7

What are the roles of the Department of Health?

Answer 7

Sets national standards, shapes direction of services and sets national tariff

Question 8

What are the roles of NHS England?

Answer 8

Authorises CCGs
Supports, develops and performance manages commissioning
Commissions specialist services e.g. primary care

Question 9

What are the roles of CCGs?

Answer 9

Work with HCP, patients and public to commission healthcare services, accounting for NICE guidelines

Question 10

How do NHS trust gain income?

Answer 10

Services that CCGs commission for them

Undergraduate and postgraduate training

Question 11

What are national tariffs?

Answer 11

Fee for services charged by service providers e.g. set price for procedure

Question 12

What is the function of Monitor?

Answer 12

Financial and corporate governance of NHS trusts

Question 13

What is the function of Care Quality Commission?

Answer 13

Quality of care to patients

Question 14

What is the function of NICE?

Answer 14

Commissioning guidance and quality standards

Question 15

What are the managerial roles that clinicians can take on?

Answer 15

Clinical and medical directors

Question 16

What are some of the clinical director’s roles?

Answer 16

Provide medical education
Implement audits and policies
Develop guidelines and protocols
Induction of new doctors

Question 17

How are hospital trusts organised?

Answer 17

Into clinical directorates based on speciality and each led by a clinical director and general manager

Question 18

What are some of the medical director’s roles?

Answer 18

Responsible for quality of care
Link between board and medical staff
Approving job descriptions and interviewing
Disciplinary process

Question 19

What are the difficulties associated with non-clinical management?

Answer 19

Medical culture hostile to non-clinical managers
Imposing authority
Changing power relationships