The NHS Structure

Click here to view an interactive diagram of the new health care system (opens in a new window)

The Secretary of State for Health

The Secretary of State for Health has ultimate responsibility the health service in England, ensuring the whole system works togather to meet patients' needs.

The Department of Health

The Department of Health (DH) is responsible for strategic leadership of both the health and social care systems, but will no longer be the headquarters of the NHS, nor will it directly manage any NHS organisations. For detailed information about the department's new priorities and roles visit the DH website.

NHS England

Formerly established as the NHS Commissioning Board in October 2012, NHS England is an independent body, at arm’s length to the government. It's main role is to improve health outcomes for people in England. It will:

  •     provide national leadership for improving outcomes and driving up the quality of care
  •     oversee the operation of clinical commissioning groups
  •     allocate resources to clinical commissioning groups
  •     commission primary care and specialist services

For more information, visit NHS England.

Clinical commissioning groups (CCGs)

Primary care trusts (PCTs) used to commission (or buy) most NHS services and controled 80% of the NHS budget. On April 1 2013, PCTs were abolished and replaced with clinical commissioning groups (CCGs).
CCGs have taken on many of the functions of PCTs and in addition some functions previously undertaken by the Department of Health.

All GP practices belong now to a CCG and the groups also include other health professionals, such as nurses. CCGs commission most services, including:

  •     planned hospital care
  •     rehabilitative care
  •     urgent and emergency care (including out-of-hours)
  •     most community health services
  •     mental health and learning disability services

CCGs can commission any service provider that meets NHS standards and costs. These can be NHS hospitals, social enterprises, charities, or private sector providers.

However, they must be assured of the quality of services they commission, taking into account both National Institute for Health and Care Excellence (NICE) guidelines and the Care Quality Commission's (CQC) data about service providers.

Both NHS England and CCGs have a duty to involve their patients, carers and the public in decisions about the services they commission.

Health and wellbeing boards

Every 'upper tier' local authority is establishing a health and wellbeing board to act as a forum for local commissioners across the NHS, social care, public health and other services. The boards are intended to:

  •     increase democratic input into strategic decisions about health and wellbeing services
  •     strengthen working relationships between health and social care
  •     encourage integrated commissioning of health and social care services

Public Health England

A new organisation is also being created; Public Health England (PHE) will provide national leadership and expert services to support public health and will also work with local government and the NHS to respond to emergencies. PHE will:

  •     coordinate a national public health service and deliver some elements of this
  •     build an evidence base to support local public health services
  •     support the public to make healthier choices
  •     provide leadership to the public health delivery system
  •     support the development of the public health workforce

More information is available on the NHS Choices website. Click here to view.