Post on 27-Dec-2015
The NHS is no longer a single organisation
• Northern Ireland
– Pooled Budgets across Health and Social Care
– No Provider competition
• England– Quasi market– Complex funding systems– Market entry and exit– Patient choice and competition– Means tested social care
• Wales• No quasi market in
health care• No Prescription
charges
• Scotland• No quasi market in health
care• No Prescription charges• State funded personal
care
What does the Act really do?Establishes an independent NHS Board to allocate
resources and provide commissioning guidanceIncreases GPs’ powers to commission services on
behalf of their patientsTransfers Public Health to Local Authorities and
Public Health EnglandAll Hospitals to become Foundation TrustsInstalls robust regulation (Monitor and CQC)Frees Market entry and market exit – AQP and
Failure Regime
The architecture...
1 NCBA4 Regions27 Local Area Teams19 Commissioning Support Services10 Specialised Commissioning LATs211 Clinical Commissioning Groups12 Clinical Senates4 Strategic Clinical Networks130+ Health & Wellbeing Boards
Policy Makers
Commissioners
Providers
Regulators
• DH• NHS England• NICE
• Clinical Commissioning Groups• Local Area Teams• Local Authorities
• GPs• Hospitals• Optometrists• Dentists• Community pharmacists
• Care Quality Commission• Monitor
NHSE Mandate
Treasury110bn
DH
Public Sector
AgreementSpecialist
commissioning
Primary CareContracting
LAPH
HWB5-6%
Hospitals
Prescribing
CCG55%
Follow the money Trail – Now...