Session 7

Question 1

Describe the current (new) structure and function of the NHS in England

Answer 1

Secretary of State for health –> national board –> four regional hubs –> 50 local offices of the board –> 240 CCGs –> hospitals, mental health units, community services –> patients
Secretary of State for health –> national board –> 240 CCGs –> hospitals, mental health units, community services –> patients
Secretary of State for health –> national board –> GPs, dentists, specialist services –> patients

Question 2

Define the role of the Secretary of State, the department of health, NHS England and CCGs

Answer 2

Secretary of State - overall accountability for NHS
Department of Heath - sets national standards, shapes direction of NHS and social care services, sets ‘national tariff’
NHS England - authorises CCGs, commissions specialist services, primary care etc.
CCGs - responsible for the flow of much of the NHS budget (65%), commissioners can place contracts with private sector providers

Question 3

Give examples of management activities and functions undertaken by doctors in the NHS

Answer 3

Medical director -overall responsibility for medical quality, communicates between board and medical staff, disciplinary processes, approves job description
Clinical director - overall responsibility for directorate, based on specialties, is a doctor, provide education and training, implement clinical audit, inductions
Consultant - responsibility for team
GP - practice principal or partner
Skills include strategic, financial, operational, human resources

Question 4

Define the term ‘clinical governance’

Answer 4

A system through which NHS organisations are accountable for continually improving the quality of their services and safeguarding standards of care by creating an environment in which excellence in clinical care will flourish
The process by which the trust can ensure that present and future clinical and managerial practices are of the highest recognised standards

Question 5

Define the term ‘never event’

Answer 5

A serious, largely preventable patient safety incident that should not occur if the available preventative measures have been implemented

Question 6

Describe the process of clinical audit

Answer 6

1. Identify problem/issue
2. Set standards of care
3. Observe current practice/collect data
4. Compare practice with standard
5. Implement recommendations
6. Re-audit

Question 7

Outline a brief history of the NHS

Answer 7

Creation in 1948

Three aims - universal, comprehensive, free at point of delivery