| intranet.parliament.uk/commons-library | [email protected] | @commonslibrary 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).
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