It is both important and useful to understand the basic structure funding and services provided by the NHS, whether you are a prospective medical student, a qualified doctor, or just curious.

Important Statistics:

 The NHS interacts with over 1 million patients every 36 hours ⌛

 The workforce consists of over 1.5 million people (approximately 200,000 of which are

Doctors) 

 1st April 2013: Health and Social Care Act (2012) came into force which changed the structure of the NHS 📅

The Structure of the NHS:

The Department for Health:

  Government department in charge of UK healthcare policies and funding 📁

Sustainability and Transformation Partnerships (STPs):

 Unite local authorities, NHS providers, commissioners etc.

 To plan services based on long term needs of local populations (1 to 3 million people) 👫

Clinical Commissioning Groups (CCGs):

 As of 2020, there were 135 CCGs

 A group of hospitals/services that cover a geographical UK locations 🏨

 Decide the services/treatments available in their hospitals and secondary care provision 🏨

NHS England:

 Independent body that oversees healthcare and ensures an effective system of CCGs 🔎

 Also supports commissioning

NHS Foundation Trusts:

 Primary care services, hospitals, ambulance services, mental health services and social care services 🏨

 Provide the care commissioned by CCGs

Primary Care:

 Delivered by General Practitioners 

 Almost all GP Practices in England are part of 1300 Primary Care Networks (cover 30,000 to 50,000 people) 👫

Secondary Care:

 Specialists and healthcare professionals 

 Provide secondary care to patients referred by a GP

 E.g. A & E, outpatient clinics, mental health and maternity health etc. 🏨

Tertiary Care:

  Specialised doctors/ nurses in specialised hospitals 🏨

 Provide tertiary care to patients referred from secondary care

 E.g. plastic surgery

National Institute for Health and Care Excellence (NICE):

 Evaluates evidence for current and prospective treatments 📉

 CCGs have to provide funding for treatments recommended by NICE 💷

The Care Quality Commission:

 Independent monitoring agency that inspects safety/quality of hospitals/ GPs/ other healthcare organisations 🔎

 Oversees the lifelong training and education of the NHS workforce 

Quick Summary

1. The NHS funding and policies are determined by the Department for Health
2. STPs are in charge of long term healthcare planning
3. CCGs are in charge of distributing local healthcare funding
4. CCGs must provide funding for treatments recommended by NICE
5. The Care Quality Commission assesses the safety and quality of healthcare services

NHS Funding:

 The NHS funding comes directly from UK taxation 💷

 98.8% of funding comes from tax and national insurance

 1.2% of funding comes from patient charges

 The current budget is £129.9 bn for 2020/21 💷

 CCGs in the UK are in control of distributing the available funding to hospitals and community care 🏨

Quick Summary

1. The NHS is 98.8% funded by UK taxation
2. The remaining 1.2% of funding is obtained from patient charges

NHS Services:

The NHS provides numerous healthcare services. It is important to understand the structure and pathways through which patients in the UK access NHS healthcare services.

Emergency Healthcare

999 Emergency:

 The UK telephone number for seriously ill patients who require immediate medical attention 📞

 For life-threatening illness/injury 💀

Emergency Department:

 A service where doctors and nurses treat life threatening illness/injury primarily 💀

 Patients arrive via ambulance or voluntarily 🚑

 Patients are registered, then triaged and given a priority rating by a doctor/nurse to establish which patients need to be seen to most urgently ❗

 Current target wait time is 4 hours ⌛

111 NHS Service:

 The UK telephone number for patients who are not seriously ill but wish to seek medical advice or guidance about which healthcare service they should attend 📞

 For non-life-threatening illness/injury 🤢

NHS Walk-in Centre:

 A service where doctors and nurses treat non-life threatening illness/injury primarily 🤢

 Genitourinary Medicine services and chronic disease and infection management are also located within the walk-in centre 🏥

Primary care Services

General Practice:

 GPs are often the first point of contact for people with a physical or mental health problem, either in a GP surgery or in a patient’s home 🏥

 Everyday in the UK, there are over 1.3 million GP consultations 

 GPs treat a broad range of common medical conditions

 They also offer counselling, advice and education for patients

 GPs can conduct tests themselves, order imaging investigations, or refer patients who cannot be treated in the community to hospital services where they receive specialist treatment 🏥

 GPs work in a multidisciplinary team, alongside nurses, healthcare assistants, receptionists, midwives etc. 👫

NHS Dental Services:

 Most dental practice in the UK is private, hwoever, some patients are entitled to free dental care on the NHS 💷

 Patients can attend the Emergency Department for dental emergencies and pay a standard rate (£23.80 as of January 2021) which can then be claimed back by those entitled to free dental care 💷

NHS Pharmacy Service:

 Pharmacists are experts in medicine and drug therapeutics 💊

 They dispense medications to patients in the community and in hospitals 🏥

 The current cost of a prescription (January 2021) is £9.15 💷

 Pharmacists can also advise patients on how to manage common health issues such as colds and pains etc.

General Ophthalmic Services:

 General Ophthalmic Services provide free corrective or preventative eye care for patients who qualify for it on the NHS

 Patients eligible for ophthalmic care on the NHS can receive free sight tests, optical vouchers and NHS vouchers fro repairs or replacements

Secondary care Services

Hospital Services:

 To receive secondary care within a hospital, a patient must be referred from a community service such as a GP 🏥

 Hospital services can be separated into: medicine, paediatrics, pathology, psychiatry, radiology and surgery 💊

Mental Health Services:

 A patient must be referred to mental health services by their GP 

 Mental health services are for people with mental health conditions such as: eating disorders, psychological disorders, depression, anxiety and drug and alcohol problems 🧠

 Patients can undergo behavioural therapy rather than taking medication 🧠

 There is a separate mental health service available for children 👧

Quick Summary

1. The NHS provides both life-threatening and non-life threatening emergency healthcare services
2. There are a range of Primary care services provided by the NHS, including: GPs, Dental services, Pharmacy services and Opthalmic services
3. There are Secondary care services which a patient must be directly referred to from a primary care service, such as: hospitals and mental health services

Summary

1. The Health and Social Care Act came into force on the 1st April 2013, changing the structure of the NHS and subsequently, its funding
2. The Department for Health is the government department in charge of healthcare funding and policies
3. Clinical Commissioning Groups were created which unite hospitals and services in a geographic location, enabling them to make decisions about how the available healthcare funding is spent locally
4. 98.8% of of NHS funding comes from UK taxation
5. The NHS provides a range of emergency, primary and secondary care services which work together to cover the healthcare needs of the UK