INTERESTING INFORMATION ABOUT THE NHS?

Department of Health

This is the department that supports the government to improve the health and well being of the population.

The Department of Health has recently started a programme of change, designed to make sure they provide leadership to the NHS and social care. The Department is responsible for:

  • Setting overall direction and leading transformation of the NHS and social care
  • Setting national standards to improve quality of services
  • Securing resources and making investment decisions to ensure that the NHS and social care are able to deliver services
  • Working with key partners to ensure quality of services, such as:
    • Strategic Health Authorities, the local headquarters of the NHS
    • The Commission for Healthcare Audit and Improvement (CHAI) and the Commission for Social Care Inspection (CSCI), new independent bodies
    • The NHS Modernisation Agency and the Social Care Institute for Excellence to identify and spread best practice locally

WHY NOT? Visit the Department of Health website .

Shifting the Balance of Power
Shifting the Balance of Power is the name for the programme of changes that are reforming the way the NHS works. The aim is to design a service centred around patients, which puts them first. It will be faster, more convenient and offer them more choice.

The main feature of the change has been to give locally-based Primary Care Trusts (PCTs) the role of running the NHS and improving health in their areas. This has also meant creating new Strategic Health Authorities which cover larger areas and have a more strategic role.

Modernisation Agency
The Modernisation Agency supports NHS clinicians and managers in their efforts to deliver improvements to their services. The best performing organisations will be rewarded with more power to make decisions at a local level. The Agency will also support NHS organisations where services are poor or failing - identifying problems and helping to get these organisations back on track.

Special Health Authorities
These are health authorities which provide a health service to the whole of England, not just to a local community - for example, the National Blood Authority. Find out more information about all the current Special Health Authorities .

Strategic Health Authorities
In April 2002, 28 new, larger Strategic Health Authorities (SHAs) were set up to develop strategies for the NHS, and to make sure their local NHS organisations were performing well.

The new health authorities are responsible for:

  • Developing plans for improving health services in their local area
  • Making sure local health services are of a high quality and are performing well
  • Increasing the capacity of local health services - so they can provide more services
  • Making sure national priorities - for example, programmes for improving cancer services - are integrated into local health service plans

They manage the NHS locally and are a key link between the Department of Health and the NHS.

Primary Care
This is the care provided by people you normally see when you first have a health problem. It might be a visit to a doctor or dentist, an optician for an eye test, or just a trip to a pharmacist to buy cough mixture. NHS Walk-in Centres, and the phone line NHS Direct , are also part of primary care. All the people offering primary care are now managed by new local health organisations called Primary Care Trusts (PCTs).

Primary Care Trusts
Primary Care Trusts (PCTs) are local health organisations responsible for managing health services in your local area. They work with local authorities and other agencies that provide health and social care locally to make sure the community's needs are being met.

PCTs are now at the centre of the NHS and will get 75% of the NHS budget. As they are local organisations, they are in the best position to understand the needs of their community, so they can make sure that the organisations providing health and social care services are working effectively.

For example, PCTs must make sure there are enough services for people in their area and that they are accessible to patients. They must also make sure that all other health services are provided, including hospitals, dentists, opticians, mental health services, NHS Walk-In Centres, NHS Direct, patient transport (including accident and emergency), population screening, pharmacies and opticians. They are also responsible for getting health and social care systems working together to the benefit of patients.

Doctors / GPs
Doctors look after the health of people in their local community and deal with a whole range of health problems. They also give health education and advice on things like smoking and diet, run clinics, give vaccinations and carry out simple surgical operations.

Doctors usually work with a team including nurses, health visitors and midwives, as well as a range of other health professionals such as physiotherapists and occupational therapists. If a Doctor cannot deal with your problem themselves, they'll usually refer you to a hospital for tests, treatment or to see a consultant with specialised knowledge.

Every UK citizen has a right to be registered with a local Doctor and visits to the surgery are free.

Dentists
Dentists treat your teeth and gums. They provide check-ups and carry out treatment such as fillings, extractions, fitting bridges and dentures, and scaling and polishing. Part of their work involves teaching people to look after their teeth and gums in order to prevent problems.

Dental practices can take private and NHS patients, and most practices take a mixture of both.

Some dentists work with the Community Dental Service which cares for children in school and people in the community with special needs.

Dentists can refer you to see a hospital dentist – they do very specialised work, which can include surgery, orthodontics (straightening teeth) and more complicated bridge and root canal work.

Opticians
Three kinds of opticians provide eye services to the general public:

  • Ophthalmic medical practitioners are qualified doctors who specialise in diseases and abnormalities of the eyes. They will test your sight, examine the health of your eyes, and give a prescription for spectacles, although they do not dispense them
  • Optometrists (also known as ophthalmic opticians) are the opticians you are most likely to visit for sight tests and spectacles. They are also trained to recognise abnormalities and diseases that are revealed in the eye, such as diabetes and glaucoma
  • Dispensing opticians are qualified to fit and supply spectacles to a prescription provided by an optometrist or ophthalmic medical practitioner

Pharmacists
Pharmacists (sometimes called Chemists) are experts in medicines and how they work. They play a key role in providing quality healthcare to patients. Working in the community, primary care and hospitals, pharmacists use their clinical expertise together with their practical knowledge to ensure the safe supply and use of medicines by patients and members of the public.

The services that may be available from your Pharmacy are:

  • Emergency Contraception
  • Truss Fittings
  • Incontinence Supplies
  • Stoma
  • Needle Exchange
  • Pregnancy Testing
  • Oxygen

They dispense your prescriptions, provide a range of services related to specific health related issues and can advise on minor ailments.

Minor ailments include:

  • Bugs and viruses
  • Minor injuries
  • Tummy troubles
  • Women's health
  • Skin conditions
  • Allergies
  • Aches and pains
  • Children's problems

NHS Walk-in Centres
NHS Walk-in Centre's give you fast access to health advice and treatment. There are now 43 throughout England. Open seven days a week, from early in the morning until late in the evening, they offer:

  • Treatment for minor illnesses and injuries
  • Assessment by an experienced NHS nurse
  • Advice on how to stay healthy
  • Information on out-of-hours GP and dental services
  • Information on local pharmacy services
  • Information on other local health services.

NHS Direct
NHS Direct is a 24-hour phone line, staffed by nurses, which offers quick access to health care advice. NHS Direct nurses will give you advice and support on self treatment or if you need further help, they'll put you in touch with the right service. If it's a serious condition or an emergency, the nurse will give you speedy advice on what you need to do, and will call an ambulance if needed.

You can find information and advice about the most common illnesses, and a range of treatments for them, on NHS Direct online or by phoning NHS Direct on 0845 4647.

*NHS Direct was made a Special Health Authority in April 2004.

Care Trusts
Care Trusts are organisations that work in both health and social care. They may carry out a range of services, including social care, mental health services or primary care services. Care Trusts are set up when the NHS and Local Authorities agree to work closely together, usually where it is felt that a closer relationship between health and social care is needed or would benefit local care services. At the moment there are only a small number of Care Trusts, though more will be set up in the future.

Secondary Care
If a health problem cannot be sorted out through primary care, or there is an emergency, the next stop is hospital. If you need hospital treatment, a GP will normally arrange it for you. NHS hospitals provide acute and specialist services, treating conditions which normally cannot be dealt with by primary care specialists.

Primary Care Trusts are responsible for planning secondary care. They look at the health needs of the local community and develop plans to improve health and set priorities locally. They then decide which secondary care services to commission to meet people's needs. Therefore they work closely with the providers of the secondary care services that they commission to agree about delivering those services.

Mental Health Trusts
Mental Health services can be provided through your GP, other primary care services, or through more specialist care. This might include counselling and other psychological therapies, community and family support, or general health screening. For example, people suffering bereavement, depression, stress or anxiety can get help from primary care or informal community support. If they need more involved support they can be referred for specialist care.

More specialist care is normally provided by Mental Health Trusts or local council social services departments. Services range from psychological therapy, through to very specialist medical and training services for people with severe mental health problems. About two in every thousand people need specialist care for conditions such as severe anxiety problems or psychotic illness.

NHS Trusts
Hospitals are managed by NHS Trusts (also known as Acute Trusts ), which make sure that hospitals provide high quality health care, and that they spend their money efficiently. They also decide on a strategy for how the hospital will develop, so that services improve.

Trusts employ most of the NHS workforce, including nurses, doctors, dentists, pharmacists, midwives and health visitors as well as people doing jobs related to medicine - physiotherapists, radiographers, podiatrists, speech and language therapists, counsellors, occupational therapists and psychologists. There are many other non-medical staff including receptionists, porters, cleaners, IT specialists, managers, engineers, caterers and domestic and security staff.

Some Trusts are regional or national centres for more specialised care. Others are attached to universities and help to train health professionals. Trusts can also provide services in the community, for example through health centres, clinics or in people's homes.

Except in the case of emergencies, hospital treatment is arranged through your GP. This is called a referral. Appointments and treatment at NHS hospitals are free.

Foundation Trusts
Foundation Trusts are a new type of NHS hospital run by local managers, staff and members of the public which are tailored to the needs of the local population. Foundation Trusts have been given much more financial and operational freedom than other NHS Trusts and have come to represent the Governments commitment to de-centralising the control of public services. These Trusts remain within the NHS and its performance inspection system.

The first 20 NHS Foundation Trusts have been authorised by the Independent Regulator and were established on 1 April and 1 July 2004.

Ambulance Trusts
There are 33 ambulance services covering England, which provide emergency access to health care.

If you call for an emergency ambulance the calls are prioritised into three categories:

  • Category A emergencies - which are immediately life threatening
  • Category B or C emergencies - which are not life threatening

The control room decide what kind of response is needed and whether an ambulance is required. For all three types of emergency, they may send a rapid response vehicle, crewed by a paramedic, equipped to provide treatment at the scene of an accident. Over the last five years the number of ambulance 999 calls has gone up by a third.

The NHS is also responsible for providing transport to get patients to hospital for treatment. In many areas it is the Ambulance Trust which provides this service.

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