7: NHS structure and management Flashcards
When was the welfare state established?
1948
How is the NHS funded?
General taxation
What are the three core principles of the NHS?
Universal
Comprehensive
Free at the point of delivery
Who is responsible for the NHS?
Secretary of state for health
Describe the result of the funding crisis in the 1950s and 1960s
Opticians, dental care and prescriptions were means tested
How has the NHS changed since it began?
Give 3
Increasing role for managers
Increased marketisation of provision
Separation of commissioners and providers
What is the role of commissioners?
They choose between care providers on patient’s behalf
Chosen on basis of patient needs, cost and quality
Describe the Health and Social Care Act of 2012
Devolves power - commissioning - to GPs and other primary care
Increased use of markets
Efficacy savings
Many contracts now to private providers rather than NHS providers
What is the role of the department of health?
- Sets national standards
- Sets national tariffs - charge from service providers to CCGs. Set fee for most procedures, regardless of who provides it, so must compete based on quality. Reinvest any profit
What is the role of NHS England?
Authorises CCGs - manages commissioning
Commissions specialist services, primary care
Describe the role of clinical commissioning groups?
Commission the care of local populations. Bring together nurses, GPs, specialists etc
Commission secondary services, hospital, mental health, community - responsible for much of NHS budget
Account for NICE guidance in decisions
Where is most of hospital income from?
Commissioning services
Provision of undergraduate and postgraduate training
What is a foundation trust?
High performing trusts - gain more financial and managerial autonomy
What is a Clinical director
Overall responsibility for a directorate.
Medical education, policies on junior doctors hours, supervision and tasks, clinical audit, guidelines for clinical procedures, induction of new doctors
What is a directorate?
Similar to a uni faculty
Specialty or a group of specialties
