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The Pharmacist > NHS Structure > Flashcards

NHS Structure Flashcards

1
Q

What does the NHS do?

A

Commission services and provide healthcare

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2
Q

How did the NHS start?

A

Sickness was a post war priority.
a white paper in 1944 was developed, which resulted in the NHS Act 1946. First country in the world to provide free healthcare

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3
Q

When did the NHS start?

A

created on 4th July 1946

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4
Q

Who was Aneurin Bevan?

A

The health secretary at the time of the NHS conception.. Officially inaugrated the NHS on July 5th by receiving the keys to Trafford General

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5
Q

Role of the Department of Health in the NHS today?

A

Gets money from public funds via the Chancellor of the Exchequer to fund the NHS

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6
Q

Who holds responsibility for NHS Scotland, Wales and NI?

A

Devolved administrations - each territory has its own legislation

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7
Q

Who is responsible for NHS policy?

A

Ministers (politicians), headed by the secretary of state. . The DoH leaders are responsible for setting policy and strategy for health/social care and assuring delivery. aslo responsible for resources. no longer directly managing NHS organisation

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8
Q

Who funds the local authorities?

A

Public Health England

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9
Q

Who funds the CCGs?

A

NHS England and regional teams

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10
Q

Examples of service providers?

A

GPs, private providers, voluntary sector, NHS trusts, foundation trusts

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11
Q

What is the NHS TDA?

A

Trust development authority. Responsible for overseeing performance management and governance of NHS trusts

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12
Q

What is NHS improvement?

A

Brings together NHSTDA and monitor, along with NHS england patient safety team, advancing change team, NHS interim management, Support two’s intensive support team, and the National Reporting and Learning Team

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13
Q

What is monitor?

A

Financial regulator of NHS trusts

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14
Q

Role of NHS improvement?

A

Oversee foundation trusts, NHS trusts and independent providers
Support providers and local health systems to improve
Holds providers and boards to account and intervenes where necessary

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15
Q

Who funds community pharmacies?

A

NHS England for essential and advanced services, NHS England area teams for enhanced services

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16
Q

Who are NHS England?

A

Independent body
Controls approx. 40% NHS budget (100bn)
Sets strategies and priorities of the NHS
Is the commissioner for Primary Care in England (GPs, pharmacists, dentists)
Plans and buys specialist services
Negotiating partner for Pharmaceutical Services Negotiating Committee (PSNC)

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17
Q

What are the 5 regional teams in England?

A

London, Midlands and East, North, South East and South West

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18
Q

What do the regional teams do?

A

Develop plans for improving health services in their area
Cover healthcare commissioning and delivery in their areaand provide professional leadership on issues such as finance, human resources, organisational development etc
Work closely with NHS Clinical Commissioning Groups (CCGs) , local authorities, health and wellbeing boards

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19
Q

What are CCGs?

A
  • members consist of GP practices

- independent and accountable to SoS for health through NHS england

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20
Q

CCG Governing bodies - what do they do and what do they consist of?

A
  • ensure quality and appropriate commissioning for money being well spent and improved outocmes
  • always at least one nurse, one hospital doctor and one layperson
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21
Q

What is the budget of CCGs?

A

Control about 2/3 of the total NHS budget, 76b in 2018/19 - have control over the prescribing budgets

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22
Q

How many CCGs are there in England?

A

currently 195 - median population of 250,000 covered

23
Q

What are CSUs?

A

Commissioning support units - Provide IT, business and management support, accounting services, information analysis
Paid for commercial service
No model structure- can set up as see necessary

24
Q

What are clinical senates?

A

Team of healthcare specialists sharing clinical knowledge to inform service commissioning and design
Have links with professional bodies and Royal Colleges
Currently 12 clinical senates in England

25
Q

What are LPNs?

A
  • provide clinical input to local commissioning decisions, hosted and supported by the regional teams
  • each locality is supported by three LPNs (pharmacy, dentistry, optometry)
  • needed as commissioning decisions cover a wide area and various professional groups
26
Q

Whatdo pharmacy LPNs do?

A

support undertaking of the PNA (which influences the commissioning decisions)
work with CCGs and others on medicines optimisation

27
Q

What are LPCs?

A

Local pharmaceutical committee - represent all NHS pharmacy contractors in a defined locality. A recognised body and are consulted on local matters affecting pharmacy contractors

28
Q

What is the role of LPCs?

A

Negotiates and discusses pharmacy services with commissioners, available to give advice to CP contractors and others wanting to know more about local pharmacy.
LPCs liaise with the LMCs, LDCs and LOCs

29
Q

How many LPCs in England?

A

80

30
Q

What is the CQC?

A

Care Quality Commission - Independent regulator of health and adult social care services in England. Ensure care provided by hospitals, dentists, ambulances, care homes and home care agencies meets the Government standards of quality and safety.
Board is accountable to the public, Parliament and the Secretary of State for Health

31
Q

Start of NHS improvement?

A

April 2016 - brought together monitor (finances), NHS trust development authority, patient satefy (including national reporting and learning system), advancing change team, intensive support teams

32
Q

What is healthwatch england?

A

an independent consumer champion that gathers and represents the public’s views on health and social care services in England

33
Q

What are STPs?

A

Sustainability and transformation parterships: NHS organisations and local councils have developed shared proposals to improve health and care- working in 44 areas across all of England.
Designed around the needs of whole areas not individual organisations.
Proposals compiled by senior figures from various parts of the local health and care system after discussions with staff, patients and others.

34
Q

Possible progressions for STP?

A

Some STPs will become integrated care systems, in which NHS providers and commissioners choose to take on collective responsibility for resources and population health, often in partnership with local authorities.

35
Q

What are vanguards?

A

A group of people leading the way in new developments or ideas

36
Q

Function of vanguards?

A

Set out in the 5YFV (NHS England’s 5 year strategy) was the need to transform service delivery
(overcome and breakdown barriers and divides between primary care, community services and hospitals)
They provide co-ordinated and personalised health services
Each vanguard site takes the lead on the development of a new care model – act as ‘blueprints’

37
Q

Outcomes of vanguards?

A

currently 50 Vanguard sites in England

Ambition - by 2020 that 50% of the population will be covered by new models of care

38
Q

What are the 5 different types of vanguard sites?

A
  • Integrated primary and acute care systems (PACS)
  • Multispecialty community providers (MCPs)
  • Enhanced health in care homes
  • Urgent and emergency vanguards
  • Acute care collaborations
39
Q

What do integrated PACS vanguards do?

A

joining up GP, hospital, community and mental health services

40
Q

What do MCP vanguards do?

A

moving specialist care out of hospitals into the community

41
Q

What do Enhanced health in care homes vanguards do?

A

offering older people better, joined up health, care and rehabilitation services

42
Q

What do Urgent and Emergency vanguards do?

A

new approaches to improve the coordination of services and reduce pressure on A&E departments

43
Q

What do acute care and collaboration vanguards do?

A

linking local hospitals together to improve their clinical and financial viability, reducing variation in care and efficiency

44
Q

Example of a local PACS?

A

Salford together: integrates salford CCG, salford royal foundation trust, GMMH, salford primary care and the city council. use itnegrated care records online

45
Q

What are the 4 levels of the PACS care model? Bottom to top

A
  • Whole population
  • Urgent Care needs
  • Ongoing care needs
  • Highest Needs
46
Q

What are the whole population needs/requirements according to PACS?

A
  • building business intelligence systems and shared care records
  • tailoring services based on population
  • community engagement
  • supporting self care and patient activation
  • linking people to comunity assets and services
47
Q

What are urgent care needs/requirements according to PACS?

A
  • proactive approach, joined up crisis response services

- integrated access to unplanned, urgent and emergency care services

48
Q

What are ongoing care needs/requirements according to PACS?

A
  • scaled up and enhanced primary and community care teams
  • MDTs for complex service users
  • integrated access to specialist advice and treatment
  • ongoing care in the community, enabled by technology
49
Q

What are highest needs/requirements according to PACS?

A
  • co-ordinated care for those with most complex needs
  • new model of co-ordinated inpatient care
  • rapid discharge and integration with community based care
50
Q

Example of MCP vangaurd?

A

Stockport together - Linking up Stockport CCG, mental health services, Stockport Council, GP federation, voluntary organisations

51
Q

Examples of teams in the core MDT?

A

Doctors, nurses, GP/consultant, community based specialists, friends and family, social care, dieticians, pharmacists

52
Q

Role of the care co-ordinator?

A

navigate issues around the persons care, completely centreted around the patient

53
Q

Similarities between PACS and MCPs?

A
  • Both population-based new care models that aim to improve the physical, mental and social health and wellbeing of their local population.
  • Both are based around the GP registered list
  • Both encourage communities to look after themselves by supporting self-care and connecting people to community assets and resources.
  • Both support staff to work in different ways using team-based care and digital technology
54
Q

Differences between PACS and MCPs?

A
  • Both models include primary, community, mental health and social care services but PACS also provides most or all local hospital services.
  • Scale - MCP smaller population, a PACS will provide care for all the population served by its acute trust, generally at least 250,000.

The Pharmacist (9 decks)

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