Structure and Organisation of the NHS Flashcards
True or false: NHS 111 is a type of primary care
True
True or false: Ambulances are a type of secondary care
True
You are referred via the EOC
True or false: A and E departments are primary care providers
False
A and E counts as secondary care
In 2007, Lord Darzi led a review of the NHS. What was this review called and what did it lead to?
The NHS Next Stage Review ‘Our NHS, Our Future’
Led to ‘High Quality Care for All’ report
What was laid out in the ‘High Quality Care for All’ Report?
10 year plan to provide highest quality of care and services for patients in England
The NHS Constitution came about because of which report?
‘High Quality Care for All’ (2008)
Which report describes a system for workforce planning, education and training?
‘High Quality Care for All’ (2008)
True or false: The aim of the Health and Social Care Act (2008) was to modernise and integrate health and social care
True
What were the four main policy areas of the Health and Social Care Act (2008)?
- CQC
- Professional regulation
- Public Health Protection Measures
- Health in Pregnancy grant
From January 2010, all providers and commissioners of NHS care have a legal obligation to regard which document in their decisions?
NHS Constitution
True or false: The government has a legal duty to review the NHS constitution every 7 years
False
The government has legal duty to review the Constitution every 10 years
What does the NHS constitution set out?
- Rights of patients, public and staff
- Pledges which the NHS is committed to achieve
- Responsibilities of patients, public and staff
What are the 7 guiding principles of the NHS (as set out in the NHS Constitution)?
- Comprehensive service, available to all
- Access based on clinical need, not ability to pay
- Highest standards of excellence and professionalism
- Patient at the heart of everything
- Working across organisational boundaries in the interests of patients, communities and wider population
- Value for taxpayers money
- Accountability to public and service users
What are the NHS Values?
- Working together
- Respect and dignity
- Quality of care
- Compassion
- Improving lives
- Everyone counts
What are the 6 C’s?
Care Compassion Competence Communication Courage Commitment
60% of the NHS budget is spent on what?
Staff wages
NHS England manages approximately much of the total budget?
£100Bn
Total budget is £124.7Bn
What were the challenges identified in 2010?
Rising demand and treatment costs
Need for improved standards
State of public finances
What promises were made by the coalition government in 2010?
Equity and excellence: liberating the NHS
- Putting patients first
- Improving healthcare outcomes
- Autonomy, accountability and democratic legitimacy
- Cutting bureaucracy and improving efficiency
What does the 2010 promise “putting patients and public first” mean?
(Equity and excellence: Liberating the NHS)
Shared decision-making - “no decision about me, without me”
Access to necessary info
Choice of care provider, practice and treatment
Rate hospitals
Support for carers
“Health Watch England” (part of CQC)
Equality
Health Watch England is a part of which organisation? When was it founded?
Care Quality Commission
Born 2010
What does the 2010 promise “improving healthcare outcomes” mean?
(Equity and excellence: Liberating the NHS)
↓ mortality
↓ morbidity
↑ safety and patient experience
Evidence-based outcome measures, not process targets
Transparency
Follow NICE quality standards
Money to follow patient
Providers paid on performance
What does the 2010 promise “autonomy, accountability and democratic legitimacy” mean?
(Equity and excellence: Liberating the NHS)
Empower professionals and providers
Devolution of powers - CCGs
Independent commissioning board - NHS England. Allocates resources, lead on improvement and outcomes
Foundation trusts - ↑ power
All trusts to become FT
Monitor (NHS Improvements) becomes economic regulator for healthcare
↑ role of CQC
What does the 2010 promise “cutting bureaucracy and improving efficiency” mean?
(Equity and excellence: Liberating the NHS)
↑ efficiency gains - release £20bn by 2015 to reinvest in care
Cut management costs by 45% to ↑ resources in front-line care
↓ NHS bodies and role of DoH in NHS
What changes occurred in NHS structure post-2010?
↓ role of DoH
Primary Care Trusts gone, CCG’s arrived
Strategic Health Authorities gone, NHS Trust Development Authority arrived
All NHS Trusts to become FTs, or part of one
CCG’s replace PCT’s - every GP practise required to join one
New DoH executive agency: Public Health England
Health and Social Care Act 2012
Which commissioning groups make up the ‘Health and Wellbeing Board’?
CCG’s
Healthwatch Local
Local Authorities
Which commissioning organisation oversees primary care, specialist services, offender healthcare and armed forces healthcare?
NHS England
Which commissioning organisation immediately oversees secondary care, community services, mental health services and rehab services?
CCG’s
Which commissioning organisation oversees immunisations and screening in young children?
Public Health England
Which organisations are responsible for data and evidence?
NICE
Health and Social Care Information Centre
Which organisations are responsible for monitoring and regulation?
Trust Development Authority
Healthwatch England
Monitor
CQC
who has overall responsibility for the work of the DoH?
Secretary of state for Health and Social Care
Which organisation oversees the operation of CCGs?
NHS England
Which organisation allocates resources to CCG’s?
NHS England
Which organisation commissions primary care and specialist services?
NHS England
Which organisation provides national leadership for improving health outcomes and driving up quality of care?
NHS England
True or false: Private providers can become commissioned providers for the NHS
True
CCGs can commission any service provider that meets NHS standards and costs.
Providers are usually NHS Trusts/FTs but can include private providers
What is the role of the Chief Medical Officer?
Governments principal medical and scientific adviser
Professional lead for doctors in England, as well as all directors of public health in local government
What is the role of the National Medical Director?
Clinical policy and strategy
Promote focus on clinical outcomes
Enhancing clinical leadership
Promoting innovation
What is the role of the Chief Nursing Officer?
Professional lead for nurses and midwives in England
Oversees quality improvements in patient safety and experience
What are the concerns about the post-2010 changes?
Speed of reforms
GP’s involved in CCGs have less time for patients so may need more GPs. GPs also require more training
Loss of trust in GPs as they control funds
Reforms only save £1bn, needs £20bn
What policy changes were made after the 2015 change of government?
Policies remained basically the same
What are today’s 4 key challenges for the NHS?
- 7 day working
- Junior doctor contracts
- The NHS Mandate
- 5 Year Forward View
NHS England is legally bound to seek to achieve the objective and comply with the requirements of the __?__
NHS Mandate
How regularly is the NHS Mandate produced?
Annually
What are the 7 objectives set out in the 2017-18 NHS Mandate?
- Better commissioning to ↑ health outcomes, ↓ inequalities
- Create the safest, highest quality service (including 7-day service, culture of learning, focus on cancer outcomes)
- Balance the budget
- Preventing ill health and encouraging healthy living (obesity and diabetes, dementia)
- Improve/maintain performance
- Improve out-of-hospital care (GP, mental health, social care)
- Support research, innovation and growth
__?__ were introduced in 2015 as part of the NHS Five Year Forward View. 50 were chosen and tasked to develop new care models and potentially redesign the health and care system
Vanguards
What are STPs?
Sustainability and Transformation Plans
- Result of NHS Five Year Forward View
- Ensure health and social services are built around needs of local population
