NHS Structure & Function

Question 1

The NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then minister of health, Aneurin Bevan, on 5 July 1948, it was based on three core principles:

Answer 1

1. It meets the needs of everyone
2. It is free at the point of delivery
3. It is based on clinical need, not ability to pay

Question 2

How many people does the NHS in England employ?

Answer 2

1.7 million

It is the country’s biggest employer and one of the largest employers globally. The NHS in Scotland, Wales and Northern Ireland employs 161,153 & 111,526 & 65,809 people respectively.

Question 3

The introduction of the Health and Care Act 2022 saw the formalisation of the Integrated care systems (ICSs), with Clinical Commissioning Groups being dissolved and the transfer of commissioning and funding to ICSs.

What makes up ICSs?

Answer 3

Integrated Care Partnerships (ICPs)
Integrated Care Boards (ICBs)

Question 4

What are the three levels of the whole structure & what makes up each?

Answer 4

System: ICB & ICPs

Place: locally agreed place-based partnerships

Neighbourhood: PCNs

Question 5

5 roles of The Department of Health and Social Care (DHSC):

Answer 5

1. Supporting & advising ministers to deliver policies of government objectives
2. Setting direction for the future
3. Ensure departments and bodies remain accountable and deliver what they’re meant to
4. Ensure the rules, policies, and frameworks are fit for purpose and work together
5. Troubleshoot & resolve complex issues

Question 6

Two purposes of ICSs:

Answer 6

1. Join providers, voluntary sectors, and councils together for collective care
2. Improve health & care services by focussing on prevention and reducing inequalities

Question 7

How many ICSs are there in England?

Answer 7

42

They are formed by NHS organisations and upper-tier local councils in that area and also include the voluntary sector, social care providers and other partners with a role in improving local health and wellbeing

Question 8

What are three organisations within an ICS?

Answer 8

ICP
ICB
Upper tier local authorities

Question 9

What does an ICP do?

Answer 9

An alliance of partners who all have a role in improving local healthcare including social care providers, voluntary, community

Each ICP sets a long-term strategy in that area

Question 10

What does an ICB do?

Answer 10

Plan health services for their local population and manage NHS budget

Question 11

What do upper tier local authorities do?

Answer 11

Responsible for social care and public health services in their ICS area as well as for housing, education, leisure, and transport

Question 12

Three benefits of an ICS:

Answer 12

1. Use of collective resources
2. Support long-term conditions
3. Improve health of children and young people

Question 13

What does tertiary care involve?

Answer 13

Highly specialised treatments such as neurosurgery, chemotherapy, transplants etc

Question 14

How many providers are there?

Answer 14

205

Consisting of acute, ambulance services, integrated, community, mental health etc

Question 15

What is the role of the UK Health Security Agency (UKHSA)?

Answer 15

Prevents, prepares, and responds to infectious diseases and environmental hazards

Question 16

Where do Health & Wellbeing Boards (HWBs) sit and who is within them?

Answer 16

Act as a statutory committee of the local authority made up of political, clinical, and community leads across their population

Question 17

What are their two core roles?

Answer 17

1. Assess health of local population and publish a joint strategic needs assessment (JSNA) as a result
2. Set out priorities to improve health of local population and publish joint local health and wellbeing strategy (JLHWS)

Question 18

The CQC is the independent regulator of health and social care in England that speaks with
an independent voice, publishing views on major quality issues in health and social care.

The CQC is responsible for making sure health and social care services provide people with
safe, effective, compassionate, high-quality care, and encouraging care services to improve.

Question 19

Two specific responsibilities of the CQC:

Answer 19

1. Register care providers
2. Monitor, inspect, and rate healthcare services

Question 20

Purpose of Healthwatch England:

Answer 20

Receive feedback by patients and public on GPs, hospitals, dentists, and care homes

Ensure NHS leaders listen to feedback and improve standards of care

Question 21

NICE evaluates new health technologies for NHS use, considering clinical effectiveness and
value for money.

NICE covers both drugs and health guidance for all practicioners and care-givers