6) NHS Structure and Management

Question 1

When was the NHS created?

Answer 1

1948 as part of the welfare state

Question 2

What are the three core principles of the NHS?

Answer 2

• Universal (covering everyone)
• Comprehensive (covering all health needs)
• Free at point of delivery

Question 3

Why is the NHS not wholy free at point of service as was originally planned?

Answer 3

In the 1950s/1960s more people came forward with health care needs as they could afford it now. (it was free now)

Question 4

Describe how commissioning occurs in this current government (2014)

Answer 4

• There are clinical commissioning groups (made up of GPs) which pick different providers to treat patients. There is a set amount of money a procedure can cost (national tariff), if the group you choose can provide it cheaper that group get to pocket the profit. However, they also have to take any loss if it’s more expensive than tariff.
• However, the GPs can’t comission there own services as the CCG don’t control this type of comissioning this is the national board (NHS England)

Question 5

Describe the central differences between medical and clinical directors.

Answer 5

• Medical directors are higher up, they are responsible for quality who sits on the board of directors. They communicate between the board and medical staff and lead those staff.
• Clinical directors have overall responsibility for a speciality (with many different departments in it) - they are responsible for decinding medical education/training and carry out audits and design/implement policy.

Question 6

Describe the different levels that oversee CCGs.

Answer 6

• CCGs are overseen by the national board (split into regional hubs and local offices)
• This national board (called NHS England) is then overseen by the Department of Health
• The DoH itself is overseen by the Secretary of Health

Question 7

Describe the main changes introduced by the “Health and Social Care Act of 2012”

Answer 7

• Devolves power (especially commissioning) to GPs and others in primary care
• Shakes up NHS originsaitonal structure significantly
• Secretary of State must attempt to secure continuous improvement in the quality of services provided to individuals.