NHS Structure

Question 1

Who oversees the NHS and what do they do?

Answer 1

The Secretary of State of Health and Social care mandates and allocates finances for the NHS

Question 2

What does the DHSC do?

Answer 2

Develops health policies and allocates funds to NHS organisations

Question 3

NHS England status

Answer 3

Abolished:
- back to DHSC control

Question 4

Positives of DHSC control of NHS

Answer 4

Could increase consistency

Question 5

Negatives of DHSC control of NHS (3):

Answer 5

1. Increases inequalities between regions
2. Many staff are redundant -> risks morals and livelihoods as the government is in pursuit of £400m in savings
3. Autonomy may be lost by letting politics influence healthcare -> aims to reduce bureaucracy and improve efficiency

Question 6

ICBs

Answer 6

• Responsible for planning and commissioning healthcare needs regionally
• Allocate funding in healthcare providers

Question 7

NICE

Answer 7

Provides evidence-based guidance and evaluates treatments to ensure high-quality, cost-effective healthcare services across the NHS - tests drugs and the QALYs from a treatment

Question 8

NHS foundation trusts

Answer 8

• Focuses on the operational management of hospitals and community health services
• Deliver direct patient care and manage health services

Question 9

What is the flow of funding?

Answer 9

NIC (general tax) -> Secretary of State for Social and Health -> DHSC -> NHS England -> NHS Providers -> 7 Regional teams of England -> ICBs -> NHS Providers

Question 10

How many ICS are there in the UK?

Answer 10

42

Question 11

What do ICS consist of?

Answer 11

ICB and ICP

Question 12

What do ICPs do?

Answer 12

Collaborate with local populations, authorities and other organisations to ensure ICBs meet their target

Question 13

What is CQC?

Answer 13

Overall regulating body of the NHS that carries out inspections and monitors a wide range of services

Question 14

BMA role

Answer 14

It is the professional body for doctors and medical students in the UK -> it represents, supports and advocates for the medical profession. Negotiating working conditions, pay and contracts for doctors, providing legal and employment advice -> supporting members with issues in training or the workplace.

Beyond that, BMA contributes to national healthcare policy, ethical guidance and improving patient care by protecting doctors’ wellbeing and professional standards

PROTECTS DOCTORS

Question 15

What is the GMC?

Answer 15

The independent regulator of doctors and medical students in the UK. Its role is to protect patients by ensuring that doctors meet high standards of practice, behaviour and training. Sets the professional standards, oversees medical education, maintains the register of licensed doctors, investigating concerns about doctors’ fitness to practise.

PROTECTS THE PUBLIC

Question 16

What is the goal and role of palliative care?

Answer 16

Palliative care is a specialised approach to caring for people with serious, life-limiting or terminal illnesses. The focus isn’t on purely treating the disease but improving the overall quality of life for the patient in a holistic way

One of the key goals is to manage symptoms - whether it’s pain, breathlessness, nausea or anxiety or anything else affecting comfort -> aims to help patients live as well as possible for as long as possible

It provides emotional, psychological and spiritual support to the patient and their families so they address fears, uncertainty and distress

Support patients with decision-making -> involves honest, compassionate conversations about their goals, values and preferences helping them make choices that align with what matters most to them.

Overall it focuses on the person than the diseases ensuring that the end of life or any stage of a illness is approached with compassion, clarity and respect.

Question 17

Changes to the NHS if I had the power - link to problems of the NHS.

Answer 17

Firstly I would improve workforce retention, many doctors leave due to burnout, limited progression and work-life imbalance. Improving flexible rotas, providing protected teaching time and reducing unnecessary administrative burden could help keep experienced clinicians in the system -> keeping staff is more efficient than constantly training new staff

Secondly, improve primary and preventative care, huge amount of hospital pressure comes from preventable chronic conditions, increasing access to GPs, community nurses, mental health services and early screening would reduce long-term costs and improve population health.

Finally improve the digital infrastructure as many hospitals use outdated systems, leading to duplicated work and inefficiency, interoperable IT systems, shared records and AI tools for admin could save enormous time for clinicians and speed up patient flow.

Overall I would improve the workforce, boost prevention, modernise systems which are all realistic to long-term care for patients.

Question 18

What is it like to be a doctor?

Answer 18

It’s incredibly rewarding but also demanding - it’s centred around helping people at their most vulnerable moments which can be fulfilling and challenging -> no days are the same you’re constantly problem solving, communicating with patients and working with a wider healthcare team.

Deals with uncertainty, doctors have to make decisions with incomplete information, manage risk and take responsibility for outcomes. It can be stressful especially dealing with complex cases or under time pressure.

Job involves long unpredictable hours which can be emotionally draining to see patients who are frightened, ill or not improving but being there to reassure them and make a real difference makes the work meaningful.

A career of lifelong learning, guidances evolve, treatments change and every patient brings new perspectives and challenges so you need to adapt and change and reflect.

It’s a challenging job but it has variance, resilience and your work directly impacts peoples lives -> people who value learning, teamwork, compassion and problem-solving, it’s a really fulfilling and rewarding profession/

Question 19

How to deal with overpopulation?

Answer 19

A complex issue which need long term solutions. Most effective approaches are education, reducing child mortality, empowerment.

Firstly improving access to education - especially for girls - consistently reduces birth rates in a sustainable way leading to more freedom of autonomy, career opportunities and informed choices about family size.

Secondly, increase access to reproductive healthcare and contraception allowing people to plan their families safely and responsibly. Reduces unintended pregnancies and supports maternal and child health.

Another factor is reducing child mortality -> when families feel confident their children will survive, they naturally choose to have fewer children through vaccination programmes especially.

It is important to consider cultural and human values as this can be only addressed ethically through empowerment and not enforcement.

Question 20

Longterm consequences of COVID on the NHS has it changed the way it works?

Answer 20

COVID has had a lasting impact on the NHS - one of the biggest long-term effects is the backlog of care - routine surgeries, cancer screenings and outpatient appts were delayed -> trying to catch up on and has increased waiting times

Rise in long-term conditions which has increased demand for respiratory care, rehabilitation and primary care services. COVID puts a huge pressure on the workforce, leading to burnout, staff shortages and challenges with recruitment and retention

It has however positively affected the the NHS digitally as remote GP consultations, virtual wards and online triage have now become part of normal practice. Hospitals have redesigned care pathways, placing more emphasis on community care and preventing unnecessary admissions

It has also highlighted health inequalities which has strengthened the focus on public health, prevention and targeted support for vulnerable groups

Overall there’s more flexibility and innovation but there’s a huge backlog and workforce challenge for the NHS