NHS England

NHS England is an executive non-departmental public body of the Department of Health and Social Care. It oversees the commissioning of health services within England, operating within the framework of the National Health Service. Established by the Health and Social Care Act 2012, it holds responsibility for the budget, planning, and operational delivery of the commissioning system. The body works to improve health outcomes and reduce health inequalities across the country, setting the strategic direction for the wider NHS.

History

The creation of NHS England followed the passage of the Health and Social Care Act 2012 under the Coalition Government led by David Cameron. This legislation enacted a major reorganisation, largely abolishing the previous Primary Care Trusts and Strategic Health Authorities. The first chief executive was Sir David Nicholson, who had previously led the NHS Midlands and East. A significant early focus was implementing the NHS Five Year Forward View, published in 2014 under the leadership of Simon Stevens. Subsequent developments have included responding to the COVID-19 pandemic in England and publishing the NHS Long Term Plan in 2019, which set out ambitions for service transformation and integration.

Structure and organisation

NHS England is led by a chief executive, currently Amanda Pritchard, and a board chaired by Lord Prior of Brampton. It operates through a national headquarters and four regional teams: North, Midlands, East, and London. The organisation commissions specialised services, primary care (through local teams), and some aspects of armed forces healthcare. It holds Clinical Commissioning Groups (CCGs) to account, though these are being replaced by Integrated Care Systems following the Health and Care Act 2022. Key partners include NHS Improvement, NHS Digital, and Public Health England.

Funding

NHS England manages over £150 billion of the Department of Health and Social Care's annual budget, which is primarily funded through general taxation. The funding settlement is typically outlined in government spending reviews, such as those delivered by HM Treasury. A landmark commitment was the government's pledge of an additional £33.9 billion in annual funding by 2023-24, following the launch of the NHS Long Term Plan. Funding is allocated to Integrated Care Systems and used to pay providers, including NHS Trusts and Foundation Trusts, through mechanisms like the National Tariff Payment System. Additional funding has been provided for specific initiatives, such as the response to the COVID-19 pandemic.

Services

NHS England commissions a wide range of services, including specialised treatments for rare conditions, HIV services, and secure mental health care. It sets the rules and contracts for general practitioner services, dentistry, pharmacy, and optometry. The organisation also oversees national screening programmes, such as for breast cancer and bowel cancer, and vaccination programmes like those for HPV and influenza. It directs major service transformation programmes, including the expansion of NHS 111 and the development of Integrated Care Systems to better coordinate care between hospitals, mental health services, and social care.

Performance and challenges

Performance is monitored against key targets, such as those for Accident and Emergency waiting times, cancer treatment, and elective care backlogs, often reported on by organisations like The King's Fund. Major ongoing challenges include managing increasing demand from an ageing population, workforce shortages, and the legacy of the COVID-19 pandemic. NHS England is also focused on addressing health inequalities, a theme central to the NHS Long Term Plan, and improving integration with social care services. The performance of the commissioning system is scrutinised by bodies including the House of Commons Health and Social Care Committee and the National Audit Office.

Category:Healthcare in England Category:National Health Service Category:Department of Health and Social Care