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PH3611- Clinical module > NHS structure and pharmacy > Flashcards

NHS structure and pharmacy Flashcards

1
Q

Student Health Warning

A
  • It is a changing picture and there are many aspects of the new NHS structure that have not yet taken their final shape
  • Multiple graphics will be presented in this session as well as links to other content, need to take a rounded view in order to understand the NHS reforms
  • Therefore a lot to the important stuff is not on the slides
  • Expect audience participation
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2
Q

The beginning

A
  • July 5th 1948
  • Aneurin Bevan
  • Opens Park Hospital, Manchester
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3
Q

Founding principles of the NHS (1948)

A
  • Meet the needs of everyone
  • Free at the point of delivery
  • Based on clinical need, not ability to pay
  • The health service available to all and financed entirely from taxation, which means that people pay into it according to their means
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4
Q

NHS constitution

A
  • Establishes the pinciples and values of the NHS in England
  • Sets out rights to which patients, public and staff are entitled
  • Pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively
  • The secretary of state for health, All NHS bodies, private and voluntary sactor providers supplying NHS services and local authorities in the exercise of their public health function are required by law to take account of this constitution in their decision and actions
  • Renewed every 10 years. Handbook every 3
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5
Q

Principles in the NHS constitution (2013)

A
  1. The NHS provides a comprehensive service available to all
  2. Access to NHS services is based on clinical need, not an individual’s ability to pay
  3. The NHS aspires to the highest standards of excellence and professionalism
  4. The NHS aspires to put patients at the heart of everything it does
  5. The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and wider populations
  6. The NHS is committed to providing the best value for taxpayers money and the most effective, fair and sustainable use of finite resources
  7. The NHS is accountable to the public, communities and patients that it serves
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6
Q

Reform legislation- Key changes

A
  • April 2013, the health and social care act 2012 came into force
  • NHS England and clinical commissioning groups (CCGs) became responsible for commissioning the vast majority of NHS services, with local authorities taking on new public health commissioning responsibilities
  • Monitor assumed the role of system regulator for all NHS-funded service an all remaining NHS trusts are expected to become NHS foundation trusts within the next few years
  • CQC (Care Quality Commission) is the independent regultor for quality
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7
Q

The projected increase in the UK population 2008-33 is concentrated in older groups

A
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8
Q

Age of the population

A
  • Age structure of the population alive today ‘Baby Boom’ 1960’s
  • Increasing longevity
  • Health life expectancy has not increased as fast, resulting in proportionally greater demands on public services such as the NHS
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9
Q

What did the health and social care act change

A
  • Structure
  • Accountabilities
  • Funding arrangements
  • Working relationship
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10
Q

Simplified diagram of structure of NHS

A
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11
Q

DoH

A
  • The DH is responsible for strategic leadership and funding for both health and social care in England
  • The DoH is a ministerial department, supported by 23 agencies and public bodies
  • For detailed information, visit the DoH website
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12
Q

NHS England

A
  • An independent body, at arm’s length to the government
  • It sets the priorities and direction of the NHS and to improve health and care outcomes for people in England
  • NHS England’s Five Year Forward View sets out the future vision for the NHS
  • NHS England is the commissioner for primary care services such as GP’s, pharmacists and dentists, including military health services and some specialised services
  • Primary care co-commissioning increased the role of CCGs in the commissioning of GP services. Read more about co-commissioning
  • NHS England managers around £100 billion of the overall NHS budget and ensures that organisations are spending the allocated funds effectively. Resources are allocated to CCGs
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13
Q

NHS England

A
  • NHS England is the new negotiating partner for the Pharmaceutical services Negotiating Committee (PSNC) on the terms of the community pharmacy contract, and will continue to use the NHS BSA for pharmaceutical payments
  • It is tasked with progressing the quality, innovation, productivity and prevention (QIPP) agenda and commissioning certain public health services at a national level such as immunisation and screening programmes
  • Selected patient safety functions formerly fulfilled by the National Patient Safety Agency (NPSA) now reside within NHS England. IT services, including the electronic prescription service and NHSmail, also fall under the commissioning board’s remit, although it is expected to farm these duties out to local bodies
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14
Q

NHS England Local Area Teams (LATs)

A
  • 27 local area teams that will handle, among other tasks, the day-to-day development commissioning of pharmaceutical services within their regions
  • They are responsible for developing and engaging with local professional networks (LPNs), which are a key means for pharmacists to engage with and inform the commissioning process
  • LATs are also in charge of emergency planning, assuring the quality of clinical commissioning groups and managing the national performers lists for GPs, dentists and ophthalmic practitioners
  • There’s no such list for pharmacists, therefore LATs will work closely with the GPhC to manage pharmacists’ performance
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15
Q

Clinical commissioning groups

A
  • CCGs are clinically led staturotry NHS bodies responsible for the planning and commissioning of healthcare services for the local areas
  • CCGs include GPs and other clinicians, such as nurses and consultants. Responsible for 60% of NHS budget, commission most secondary care services, and play a part in the commissioning of GP services, and play a part in the commissioning of GP services
    • Planned hospital care, Rehab care, Urgent and emergency care, Most community health service, Mental health services
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16
Q

CCGs

A
  • CCGs can commission any service provider that meets NHS standards and costs e.g. NHS hospitals, social enterprises, charities or private sector providers
  • CCGs must ensure the quality of services they commission, taking into account both NICE guidelines and the CQC data about service providers
  • Both NHS England and CCGs have a duty to involve their patients, carers and the public in decisions about the services they commission
  • Commissioning- what’s the big deal
17
Q

Vanguards

A
  • Vanguards were introduced in 2015 as part of the NHS 5 year forward view
  • 50 chosen vangaurds are tasked to develop new care models and potentially redesign the health and care system
  • It is envisaged that this could lead to better patient care, service access and more simplified system
  • Information about Vangaurds can be found on the NHS England website
18
Q

Regulation

A
  • Responsibility for regulating particular aspects of care is now shared across a number of different bodies such as
  • CQC- a quality inspector
  • NHS improvement- an umbrella organisation that brings together monitor, NHS trust development authority, patient safety, the national reporting and learning system, advanced changing team and the Intensive support teams
  • Individual professional regulatory bodies: GMC, Nursing and midwifery council, GDC, GPhC, Health care professional council
  • Other regulatory, audit and inspection bodies- some of which are related to healthcare and some specific to the NHS
  • For more information about individual regulators: Health watchdogs and authorities
19
Q

Commissioning diagram

A
20
Q

Local Professional Networks

A
  • Local pharmaceutical, dental and optical networks are a means for professionals in each of these healthcare disciplines to influence commissioning
  • They are not intended to be stand-alone organisations, but to be integral to NHS England’s area teams and how those teams operate
  • Each LPN will use a tiered structure to gain access to clinicians offering NHS services in it’s area, both in primary and secondary care
    • The networks should be 2-way street: as well as providing clinical leadership, they are a means for care providers to pass their ideas to commissioners
    • If harnessed correctly, the networks can be used to promote pharmacy’s role in improving medicines use and supporting wellness- through, for example the health living pharmacy model
21
Q

Public health England (PHE

A
  • PHE provides national leadership and expert services to support public health, and also works with local government and the NHS to respond to emergencies
  • Co-ordianatesa national public health service and delivers some elements of this
  • Builds an evidence base to support local public health services
  • Supports the public to make healthier choices
  • Provides leadership to the public health delivery system
  • Supports the development of the public health worksforce
22
Q

Health and Wellbeing Boards (HWB)

A
  • HWB’s were established by local authorities (LAs) to act as a forum for local commissioniers across the NHS, social care, public health and other services
  • They increase democratic input into strategic decisions abouit health and wellbeing services
  • Strengthen working relationships between health and social care
  • Encourages integrated commissioning of health and social care services
23
Q

Healthwatch

A
  • Healthwatch is the new independent consumer champion created to gather represent the views of the public
  • Healthwatch will play a role at both national and local level (local Healthwatch replaces LINKs) and will make sure that the views of the public and people who use services are taken into account
  • Healthwatch England will work with local HealthWatch and will also
    • Advise on NHS England, LA, Monitor and the secretary of state
  • Is a statutory committee of the CQC
  • Has the power to recommend that action is taken by the CQC when there are concerns about health and social care services
24
Q

Providers: regulation and accountability

A
25
Q

How providers are regulated

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26
Q

CQC

A
  • Quality inspectorate for health and care providers
  • Sets standards of quality and safety for health and adult social care
  • Registers care services that meet the standard
  • Monitors inspect and regulate care services to make sure that they continue to meet the standards
  • Protects the rights of vulnerable people, including those whose rights are restricted under the mental health act
  • Challenges all providers, with the worst performers getting the most attention
  • Takes appropriate action if care services are failing to meet the standards
  • Carries out in-depth investigations to look at care across the system
  • Reports on the quality of care services, publishing clear and comprehensive information, including performance ratings to help people choose care

PH3611- Clinical module (28 decks)

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