The National Health Service in the UK - Essay Example

?The National Health Service Tamana Sayed The National Health Service (NHS) is a comprehensive health care system in the United Kingdom. NHS covers anumber of healthcare services, which are segregated through a hierarchy of departments in accordance with funding and accountability. Currently, NHS can be divided into two broad sections that are one that deals with the strategy and managerial issues, and the other that deals with the clinical aspects such as provision of health care services to the patients. There are a number of institutions and sectors that collectively form the NHS. This paper explains each of such institutions and sectors briefly along with their source of funding and the authority to which they are accountable. STRUCTURE OF NHS The following diagram shows the structure of the NHS: Diagram 1: Structure of NHS It can be observed from the diagram that the highest authority in the NHS is held by the Parliament and a number of sectors are accountable directly to the parliament. Following is the brief explanations of each of the constituent of the NHS. Parliament Like every other department run by the government, the NHS is also accountable to Parliament. The Government allocates funds to the NHS from the revenue received from taxation. Parliament determines the extent of funds to be allocated to the NHS. The funds are then forwarded to the Department of Health, which is ultimately accountable to the Parliament for the utilization of the funds and the overall performance of the NHS. Parliament oversees the Department of Health and it ensures that the Department of Health is performing efficiently. The Parliament can initiate any inquiry procedures against the Department of Health in order to assess its effectiveness. In case of any inquiries regarding the NHS, Parliament summons the personnel who are accountable from the Department of Health. Thus, the highest place in the hierarchy of the NHS is given to the Parliament. Department of Health The Department of Health is responsible for running the NHS and improving its overall performance. The organisation provides the NHS with; the resources that are necessary to run the service, the strategic direction, and the standards that need to be followed uniformly throughout the subsidiary departments in the NHS. Thus, the Department of Health regulates the NHS as a whole and performs a central role in the effectiveness of the NHS. Each subsidiary institution in the NHS is accountable to the Department of Health and this department does the allocation of funds of each of the subsidiary institution. The Department of Health constitutes of the Secretary of State for Health along with five Health Ministers and a number of boards that are assigned with different tasks regarding the oversight and betterment of the subsidiary institutions of the NHS. The decisions regarding the formation of strategy, allocation of funds and investments, setting of quality standards and business development are done y the Ministerial core of the department and the boards are responsible to carry out their respective tasks such as; exercising oversight over professions within the healthcare systems such as; dentists, pharmacists etc. Monitor Monitor is an independent institute funded by the Department of Health and accountable directly to the Parliament. The objective of this institute is to assess the NHS trusts and determining whether the trusts are eligible to be classified as foundation trusts and to regulate the foundations trusts. The factor that makes this institute a powerful body is that it is independent of the central government. The results of its assessments and other reporting procedures are given directly to the Parliament. The institute assesses the NHS trusts in accordance with three criteria that are; whether they are well governed, whether they are financially viable, and whether they are constituted legally. As a regulatory, Monitor ensures that all the trusts are governed properly and they meet the national quality standards as set by the standard setting bodies. Each foundation trusts reports to the Monitor and the institute assesses whether the trust is deviating from the unified strategy or quality standards. Thus, the Monitor steps in to resolve any such problems. NHS Foundation Trusts The Foundation Trusts are non-profit making entities that are regulated by Monitor. They are not run by the Department of Health but these organisations are required to comply with all the policies and standards that are set by the department. Foundations trusts are funded by the Primary Care Trusts (PCTs) and they are accountable to a number of authorities but primarily to the Monitor. Each foundation trust has a board of elected Governors who work in collaboration with the Management Board of the foundation trust. The Governors ensure that the organisation is complying with its license and it is implementing on its strategy to meet its objectives. The board of Governors is also responsible for determining a strategic direction for the Trust. Thus, a foundation trust is accountable to its board of elected Governors as well along with the Monitor and other regulatory authorities. Care Quality Commission The Care Quality Commission (CQC) is an institute that exercises oversight over all the health and adult social care services including those provided by NHS, local authorities, private companies, or voluntary organisations. The CQC is funded by the Department of Health and it is accountable to the Department of Health as well. However, the CQC has significant authority to conduct its regulatory operations autonomously. The CQC ensures that all the potential quality standards are followed in any institute that provides health care services ranging from hospitals to private care homes. The department has a wide range of enforcement powers to take action on behalf of the people who use services if the services are not in accordance with the quality standards. In order to improve the quality of health care in the UK, the CQC conducts periodic reviews of the providers of the health care services. The priority of the CQC is to improve the experience of the public regarding health and social care. Strategic Health Authorities (SHAs) Strategic Health Authorities (SHAs) are the institutes that are responsible for managing the NHS at a regional level. There are a number of SHAs operating throughout the UK and their role is to support the efforts of the local health service by improving the performance of local health service and ensuring that national quality standards are applied in the provision of healthcare services. Another function of the SHAs is to resolve conflicts between NHS organizations. SHAs also monitor the performance of the NHS organizations at local level, specifically that of the Primary Care Trusts (PCTs). SHAs are funded by the Department of Health and they are accountable to the Department of Health as well. One of the main roles of SHAs is training of the staff to be allocated to different institutions associated with NHS. Since the main objective of SHAs is to improve the performance of local health service by ensuring the quality of services provided, it is also one of the objectives of SHAs to ensure that staff providing the services is also competent. A significant proportion of the overall budget allocated to SHAs is spent on staff training. SHAs enter into agreements with different universities that train the staff on behalf of the SHAs. NHS Trusts NHS Trusts are the trusts that provide hospital care services at the local level. These trusts employ the majority of the health service workforce. These trusts are funded by Primary Care Trusts (PCTs) in accordance with their performance. These trusts enter into agreements with their local PCT to be paid in accordance with the results. Thus, a trust that performs exceptionally well receives more funding however the trust that fails to deliver the promised quantity has the agreement withdrawn. NHS trusts are bound to provide healthcare services in accordance with the national quality standards and they are primarily accountable to Strategic Health Authorities and secondarily to Care Quality Commission. These trusts are accountable to the SHAs. NHS trusts include; acute trusts that provide medical and surgical care to the local population, care trusts that provide an integration of health and social services, mental health trusts, ambulance trusts, children’s trusts and foundation trusts. Primary Care Trusts Primary Care Trusts (PCTs) are responsible for planning, securing, and improving health services in the local area. Since PCTs are given the authority to fund and oversee the NHS trusts, PCTs are directly funded by the Department of Health and the most significant proportion of the overall fund is allocated to the PCTs. The operations of a PCT are overseen by the PCT Board that is responsible for the governance, utilisation of funds and the overall quality of care in the jurisdiction of that particular PCT. Since the main role of PCTs is to oversee NHS trusts and ensure the efficiency of the fund allocation, it can be said that PCTs performs non-hospital services for the NHS. A significant proportion of planning regarding the allocation of funds to NHS trusts is done by PCTs therefore PCTs are the main channel for funds to hospital service providers. REFERENCES Monitor-NHSFT. (2012) About Monitor: What We Do. [Internet]. Available from < http://www.monitor-nhsft.gov.uk/home/about-monitor/what-we-do> [March 4, 2012] Monitor-NHSFT. (2012) About NHS Foundation Trusts. [Internet]. Available from < http://www.monitor-nhsft.gov.uk/about-nhs-foundation-trusts> [March 4, 2012] NHS. (2012) The NHS Structure. [Internet]. Available from http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspx [March 3, 2012] NHS. (2012) NHS Authorities and Trusts. [Internet]. Available from [March 3, 2012] NHS. (2012) Care Quality Commission (CQC). [Internet]. Available from < http://www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/carequalitycommission.aspx> [March 3, 2012] Read More