CBP-7206 (2).pdf - BRIEFING PAPER Number CBP 07206 7 July...

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BRIEFING PAPER
Number CBP 07206, 7 July 2017
The structure of the NHS
in England
By Thomas Powell
Inside:
1. Background
2. Commissioning
3. Access to treatment
4. Regulation and accountability
5. Education and training
6. Competition and non-NHS
providers
7. Public health services
8. Health and Wellbeing boards
and Healthwatch
9. Safety of care
10. Integration of health and
social care services
11. Mental health policy
12. Health services in Scotland,
Wales and Northern Ireland
13. Further information

Number CBP 07206, 7 July 2017 2
Contents
Summary 3
1. Background 6
1.1 Structural changes 6
1.2 Funding and performance 6
1.3 The Five Year Forward View 8
2. Commissioning 11
2.1 Clinical Commissioning Groups 11
2.2 NHS England 12
2.3 Duties of CCGs and NHS England 13
3. Access to treatment 15
3.1 NICE 15
NICE technology appraisals 15
Highly Specialised Technologies programme 15
3.2 Individual Funding requests 16
3.3 The Cancer Drugs Fund 17
4. Regulation and accountability 19
4.1 NHS Improvement 19
4.1 The Care Quality Commission 19
4.2 The Secretary of State for Health 21
4.3 The Health Select Committee 21
5. Education and training 22
6. Competition and non-NHS providers 23
7. Public health services 24
7.1 Public health and local government 24
7.2 Public Health England and directly commissioned services 25
8. Health and Wellbeing boards and Healthwatch 27
8.1 Health and Wellbeing Boards 27
8.2 Healthwatch England and local Healthwatch 27
9. Safety of care 29
Learning from clinical incidents in the NHS 29
10. Integration of health and social care services 32
11. Mental health policy 33
12. Health services in Scotland, Wales and Northern Ireland 34
Scotland 34
Wales 34
Northern Ireland 35
13. Further information 36
Cover image copyright: Record shot by Ron Adams . Licensed under CC BY 2.0 / image
cropped.

3 The structure of the NHS in England
Summary
This Library briefing provides an overview of the funding and accountability relationships
in the English NHS, and an introduction to the roles of key organisations, including:
• NHS England and Clinical Commissioning Groups (CCGs), which commission NHS
services;
• NHS Improvement, which since April 2016 has brought together Monitor and the
NHS Trust Development Authority;
• The Care Quality Commission (CQC), which regulates the safety of services; and
• Health Education England (HEE), which leads workforce planning, education and
training.
It also covers:
• Public Health England (PHE) and local authorities’ public health duties;
• Health and Wellbeing Boards and the co-ordination of health and social care
services; and
• The National Institute for Health and Care Excellence (NICE) and access to treatment
This briefing highlights some of the key health policy issues for the current Parliament,
including patient safety, funding, and the redesign of services. In 2015, NHS organisations
were asked to come together to create local blueprints for delivering the NHS Five Year
Forward View (5YFV), known as Sustainability and Transformation Plans (STPs).