NHS Flashcards
When was the NHS founded?
1948 under the reforming post-war Labour Government
What was it designed to do?
Important plank of welfare designed to care for the sick and vulnerable from “cradle to grave”
What is so good about NHS
Available throughout UK “free at point of need” regardless of ability to pay.
What charges had already been introduced by 1951?
Charges for prescriptions, spectacles and dental visits
Affordability has always been an issue and in modern UK, an ageing population and the increasing costs of sophisticated medical techniques, have increased these pressures.
How much of public money does the NHS recive?
How many people does it employ?
130bn and UK health spending is about 9.8% of GDP
1.1m people making it one of the largest employers in the WRLD
How many doctors, nurses, GPS, clinical commission groups and hospital trusts does the NHS have?
Doctors = 112,000
Nurses = 311,000
GPS = 8000
CCG = 191
Hospital trusts = 233
Where does NHS funding come from?
80% comes from general taxation
20% from National Insurance Contributions, land sales and charges to patients
What did Tory gov under Maggie introduce idea of in 1990!
The internal market in 1990 NHS and Community Care Act and this remained a controversial part of the NHS ever since
What is a internal market in 1990 NHS and Community Care Act
Splits NHS into purchasers or commissioners that buy NHS services on behalf of patients and providers, such as NHS hospital trusts that supply these services
The theory is the discipline of the market will drive efficiencies and improvements in service in the similar way as the open market
What happened to NHS under Labour Government Tony Blair?
Increased funding for NHS (from 6.7% in 1997 to 9.7% in 2010) but kept the idea of the internal market largely intact
What were established in 2002
Primary Care trusts which commissioned health care from the providers - ie the NHS Trusts. Some NHS trusts were given self-governing status and became foundation Trusts and 28 Strategic Health Authorities were set up to work with PCTa to buy health care
What is the 2003 Health and Social Care Act and why did it prove so controversial?
It allowed PCTs purchase care form private providers, or even abroad, to reduce waiting lists
What were the Cameron reforms?
2010 coalition governemnt wanted to cut red tape and hand money directly from the governemnt to GPs who provided most of the health care to its patients
What act abolished PCTs and handed commissioning over to consortia of GPS, nurses, hospital doctors and the public. They were called Clinical Commissining Groups (CCG)
2012 Health and Social Care Act
What did all NHS trust become in 2012?
Foundation trust encouraged to become not-for-profit mutual style companies that could generate their own income from selling private treatment. Hospitals could go bust, just like private companies
What do NHS trusts have to with CCG to purchase from any ‘qualified provider’
They have to compete for business in the voluntary or private sector
What do CCGs do?
Buy in patient care on behalf of patients
Due to some clinical decisions requiring specialist knowledge who are CCGs advised by
Commissioning Support Units - these do number crunching and analysis that CCGs can use
Clinical Senates - offer expertise in particular areas of patient care that GPS may not know much about
What are NHS foundation trusts and what do they do?
Hospitals, Ambulance services and mental health units
Provide patient care to CCGs in competition with qualified providers in voluntary and private sector
Who are NHS England and what do they do?
Gives a wider view than the CCGs and oversees budget planning, delivery and day to day operation of the NHS
Who is Monitor?
Health care regulator that licenses health care providers, regulates prices and makes sure essential services continue if a provider runs into trouble
Who is the Care Quality Commission?
Regulator than inspects hospitals, care homes, dental and GP surgeries and issues reports
Who is Health watch?
Represents the view of patients
Who are the Parliamentary and Health Service Ombudsman?
Deals with complaints
Who are the National Institute for Health and Care Excellence (NICE)
Provides national guidance and advice to improve health and social care including approving new drugs
What did the 2012 Health and Social Care Act do to responsibility of public health (like smoking and health eating)
Used to be run by NHS
Now handed control over to local authorities and new national body Public Health England
What have Local governments been tasked with doing?
Establishing Health and Well being Boards bringing together key players in the health and social care system, including local councillors to improve care in a joined up way across health, social care and other public services
How many areas of England have STPs been set up and who do they involve
44
Involving NHS groups such as CCGs and Foundation Trusts as well as local authorities and charities
What are STPs tasked with?
Developing 5 year plan (2016-2021) to improve health services
What do STPs aim to do?
Improve quality and develop new models of care
Improve health and well being
Improve efficiency
Improve integration with social care and other local authority services
