NHS Structure & Management

Question 1

Outline a brief history of the NHS

Answer 1

Created in 1948 as part of welfare state
- Universal (covering everyone)
- Comprehensive (covering all health needs)
- Free at point of delivery
Secretary of State for Health has a duty to provide health services
NHS initially run centrally by Department of Health
Increasing role for manager through time

Question 2

What is the Health and Social Care Act 2012?

Answer 2

Devolves power (especially commissioning) to GPs and others in primary care
Shakes up NHS structure significantly

Question 3

Describe the current structure (sections) of the NHS

Answer 3

Secretary of State for Health
Department of health
National commissioning board
Clinical commissioning groups
Primary, secondary & community services
Patients

Question 4

What is the role of the secretary of state for health?

Answer 4

Overall accountability for the NHS

Question 5

What is the role of the department of health?

Answer 5

Sets national standards
Shapes direction of NHS & social care services
Sets ‘national tariff’ (fee for services charged by service providers e.g. hospital trusts, to commissioners e.g. CCGs)

Question 6

What is the role of the national commissioning board?

Answer 6

Authorises CCGs

Supports, develops & performance-manages commissioning

Question 7

What is the role of clinical commissioning groups (CCGs)?

Answer 7

Crucial bodies in the current organisation of the NHS
Bring together GPs, nurses, specialists, public health, patients, the public & others to commission secondary & community healthcare services
Must account for national guidance (commissioning board, NICE etc) in these decisions

Question 8

What is the role of a medical director in the NHS?

Answer 8

1 doctor in trust has overall responsibility for medical quality
Sits on trust’s board of directors - key link between senior management & medical staff
Communicates between board & medical staff
Leadership of medical staff
Works in partnership with human resource/personnel functions
Approves job descriptions, interview panels, equal opportunities
Leads on organisations’ clinical policy & clinical standards

Question 9

What is the role of a clinical director in the NHS?

Answer 9

Overall responsibility for directorate
Provide continuing medical education & other training
Design & implement directories policies on junior doctors’ hours of work, supervision, tasks & responsibilities
Implement clinical audit
Induction of new doctors

Question 10

What is the role of a consultant in the NHS?

Answer 10

Responsibility for team

Question 11

What can be the role of a General Practitioner (GP) in the NHS?

Answer 11

Practice principal or partner