NHS structure

Question 1

What signalled the start of the NHS?

Answer 1

A ‘National Health Service’ white paper in 1944 resulted in the NHS act 1946

Question 2

Who was the Health Secretary at the time of conception of the NHS?

Answer 2

Aneurin Bevan

Question 3

When was the NHS created?

Answer 3

4th of July 1948

Question 4

How is the NHS funded?

Answer 4

The Department of Health gets money from public funds via chancellor of the exchequer

Question 5

What are commissioners?

Answer 5

Organisations/groups that fund providers which give healthcare:

e. g.
- CCGs
- NHS england
- Local authorities
- Greater Manchester devolution

Question 6

What are providers?

Answer 6

Groups that provide a healthcare service:

• Private providers
• Voluntary sector
• GPs and other primary care
• NHS trusts and foundation trusts
• Accountable care systems

Question 7

What are regulators?

Answer 7

They regulate the providers:

• Care Quality Commission (independent regulator for quality)
• NHS improvement (brings together the functions previously undertaken by Monitor and the NHS Trust Development Authority. It is responsible for the financial regulation, performance management and governance of NHS trusts and foundation trusts, and also supports service improvement)

Question 8

What is NHS England?

Answer 8

(Now combined with NHS improvement)
It’s an independent body that controls 40% of the NHS budget.
It’s the commissioner for Primary Care in England, it plans and buys specialist services.
It is also the negotiating partner for pharmaceutical services negotiating committee (PSNC)

Question 9

What is primary care?

Answer 9

GPs, pharmacists, dentists

Question 10

How many NHS regional teams are there in England?

Answer 10

7:

• London
• Midlands
• East or England
• North East
• Yorkshire
• North West
• South East
• South West

Question 11

What are the regional teams responsible for?

Answer 11

Responsible for the quality, financial and operational performance of all NHS organisations in their region.
They develop plans for improving health services in their area and support the identity and development of sustainability and transformation partnerships and integrated care systems

Question 12

What are CCGs?

Answer 12

Clinical Commissioning Groups. Independent and accountable to the Secretary of State for Health through NHS England.
They Commission a range of services;
- planned hospital care
- emergency and out of hours care
They also have control over prescribing budgets

Question 13

What do members consist of in CCGs?

Answer 13

GP practices

Question 14

What does the CCG elected governing body do and consist of?

Answer 14

Ensures quality, appropriate commissioning. Includes at least one nurse, one hospital doctor and 2 lay persons

Question 15

What are Commissioning Support Units?

Answer 15

They provide IT, business and management support, accounting services, and information analysis. Paid for commercial service

Question 16

What are Clinical Senates?

Answer 16

Team of healthcare specialists sharing clinical knowledge to inform service commissioning and design.
Have links with professional bodies and royal colleges.
There are currently 12 clinical senates in England

Question 17

What do Local Professional Networks do?

Answer 17

Provide clinical input to local commissioning decisions. They are hosted and supported by NHS Englands regional teams.
Work with CCGs and others on medicines optimisation

Question 18

How many LPNs support localities (pharmacy, dentistry, optometry)

Answer 18

3

Question 19

What do Pharmacy LPNs support?

Answer 19

Undertaking of Pharmaceutical Needs Assessments (PNA) - PNA influences services provided by CP in a local area

Question 20

What are Local Pharmaceutical Committees?

Answer 20

They represent all NHS pharmacy contractors in a defined locality. They represent contractors’ needs and work with regional NHS teams.
LPCs are a recognised body and are consulted on local matters affecting pharmacy contractors.

Question 21

What do LPCs do?

Answer 21

Work locally with NHS England Regional Teams, CCGs, Local Authorities and other healthcare professionals to help plan services.
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
Currently around 80 LPCs in England

Question 22

What is the Care Quality Commission (CQC)?

Answer 22

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.

Question 23

What is NHS improvement?

Answer 23

(Now combined with NHS England)
• Offer support to providers need to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable.
• Hold providers to account and intervene if necessary
• Support delivery of the NHS Long Term Plan
• Provides information and support in areas such as:
o Patient safety (NRLS – reporting of patient safety incidents)
o Emergency care
o Quality improvement
o Patient experience and involvement
o Performance and finance
o Mental health
o Maternity care
o Cancer

Question 24

What is Healthwatch England?

Answer 24

Independent national champion for people who use health and social care services. Find out what matters to people and help support patients

Question 25

What Sustainability and transformation partnerships (STPs)?

Answer 25

NHS organisations and local councils have developed shared propsals to improve health are care-working in 44 areas across all of England.
Designed around the needs of whole areas not individual organisations
Some STPs have become integrated care systems (ICSs), in which NHS providers and commissioners choose to take on collective responsibility for resources and population health, often in partnership with local authorities

Question 26

What are Primary Care Networks (PCNs)?

Answer 26

• Based on GP registered lists (30,000 to 50,000 patients)
• Innovative approach to strengthening and redesigning primary care bringing together a range of health and social care professionals to provide personalised and preventative care for their local community
• Include GP practices, pharmacy, community, mental health and acute trusts, social care and the voluntary sector
• Focus on local population needs and provide care closer to patients’ homes