The Local NHS

Including Shropshire Community Health NHS Trust

An overview of health and care organisations in Shropshire, Telford & Wrekin and mid Wales

The way the NHS is England is planned, commissioned and monitored changed from 1 April 2013. This briefing summarises the main health and care organisations for Shropshire, Telford & Wrekin and midWales—locally, regionally and nationally.

Providing Health Services

The NHS is made up of a wide range of organisations specialising in different types of services for patients. Together, these services deal with over 1 million patients every 36 hours.

Primary Care providers such as GPs, dentists, pharmacists and opticians are the first point of contact for physical and mental health and wellbeing concerns, in non-urgent cases. www.nhs.uk

The Shrewsbury and Telford Hospital NHS Trust (SATH) is the main provider of acute hospital services for half a million people in Shropshire, Telford & Wrekin and mid Wales. www.sath.nhs.uk

Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust (RJAH) is a specialist provider of orthopaedic services based on Oswestry. www.rjah.nhs.uk

Shropshire Community Health NHS Trust (SCHT) is the main provider of community health services in Shropshire and Telford & Wrekin, including the community hospitals. www.shropscommunityhealth.nhs.uk

South Staffordshire and Shropshire Healthcare NHS Foundation Trust (SSSFT) is the main provider of specialist mental health and learning disability services for Shropshire and Telford & Wrekin, as well as providing these and other services to a wider population across South Staffordshire, regionally and nationally. www.southstaffsandshropshealthcareft.nhs.uk

West Midlands Ambulance Service NHS Foundation Trust (WMAS) is the provider of NHS ambulance services for the West Midlands www.wmas.nhs.uk

Commissioning Health Services

The NHS is funded by taxation with a fixed budget available to spend on services for the whole population. The challenge faced by the NHS is how to spend that budget in a way that results in the best possible outcomes for individual patients and delivers value for money for the public. This planning and purchasing of NHS services is undertaken by organisations (or individuals) known as commissioners. They are responsible for assessing the reasonable needs of their populations and using their buying power as purchasers to secure services that are affordable and of the highest quality.

The majority of commissioning is undertaken by GPs and other clinicians working together in Clinical Commissioning Groups (CCG). There is one CCG for Shropshire and CCG for Telford & Wrekin. Specialised services and primary care are commissioned by NHS England, mainly through Area Teams. Public health and social care services are commissioned by local authorities (see overleaf).

Shropshire Clinical Commissioning Group (CCG) is the main commissioner of health services on behalf of patients and communities in Shropshire. www.shropshireccg.nhs.uk

Telford & Wrekin Clinical Commissioning Group (CCG) is the main commissioner of health services on behalf of patients and communities in Telford & Wrekin. www.telfordccg.nhs.uk

NHS England—Shropshire and Staffordshire Area Team (AT) is the main commissioner of specialist services and primary care for patients and communities across Shropshire and Staffordshire. www.england.nhs.uk

Technical and business support to commissioners is provided by Commissioning Support Units (CSU). Staffordshire and Lancashire Commissioning Support Unit is the designated CSU for Shropshire and Telford & Wrekin. www.staffordshirelancashirecsu.nhs.uk

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Local Authorities, Social Care, Public Health and Health & Wellbeing Boards

Local authorities (or councils) have a wide range of duties and responsibilities regarding the health of their populations, which extend beyond the NHS into both public health and social care.

Shropshire Council is the main commissioner of social care and public health services on behalf of communities in Shropshire. www.shropshire.gov.uk

Telford & Wrekin Council is the main commissioner of social care and public health services on behalf of communities in Telford & Wrekin. www.telford.gov.uk

Every upper tier or unitary local authority in England must have a Health and Wellbeing Board (HWB). The health and wellbeing board encourages work to improve local health and wellbeing outcomes, including (where appropriate) more joined up working across the NHS, public health, social care, and other services:

Shropshire Health and Wellbeing Board www.shropshiretogether.org.uk

Telford & Wrekin Health and Wellbeing Board www.telford.gov.uk/hwb

Local authorities also have responsibility for improving public health. This includes the planning and provision of public health services, such as smoking cessation, and considering the public health effects through the planning of other services, such as education, housing and transport.

For information about public health in Shropshire visit the Healthy Shropshire website. www.healthyshropshire.co.uk

For information about public health in Telford & Wrekin visit the Telford & Wrekin Council website www.telford.gov.uk

Public Health England (PHE), an operationally independent executive agency of the Department of Health, supports local authorities in their duty to improve public health and has national responsibility for protecting the public against major health risks. www.gov.uk/phe

Protecting, safeguarding and developing

Organisations providing NHS services are ‘regulated’ to ensure they meet essential standards. The boards of organisations providing NHS care have the primary responsibility to ensure the care they provide is safe and of high quality. Regulators exist to ensure providers are fulfilling their obligations to patients and the public.

The Care Quality Commission (CQC) is responsible for assessing and making judgments as to the level of safety and quality of care provided by providers of health and social care. www.cqc.org.uk

Monitor protects and promotes the interests of people who use health care services by promoting the provision of health care services which is effective, efficient and economic, and maintains or improves the quality of services. It now has responsibilities that apply to all providers of NHS-funded services and not just to NHS Foundation Trusts. www.monitor-nhsft.gov.uk

The NHS Trust Development Authority is responsible and supporting the development of an all-Foundation Trust provider sector. This includes support and performance management for non-FTs. www.ntda.nhs.uk

Other regulators and safeguarding bodies include:

Human Tissue Authority www.hta.gov.uk

Human Fertilisation and Embryology Authority www.hfea.gov.uk

Health Research Authority www.hra.nhs.uk

Medicines and Healthcare Products Regulatory Authority www.mhra.gov.uk

NHS Blood and Transplant www.nhsbt.nhs.uk

Professional regulators are responsible for ensuring that health and social care professionals are providing safe care. They are focused on the individuals who give care, rather than organisations that provide care. In England, there are regulators for different healthcare professions: doctors (the General Medical Council), nurses and midwives (Nursing and Midwifery Council), dental teams (General Dental Council), optical professionals (General Optical Council), pharmacists (General Pharmaceutical Council), chiropractors (General Chiropractic Council), osteopaths (General Osteopathic Council), health, psychological and social work professionals (Health and Care Professions Council).

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Empowering patients and communities

NHS organisations have a legal duty to make arrangements for the involvement of patients in decisions about the running of services. Every upper tier and unitary local authority area in England has arrangements with a Local Healthwatch organisation to support patient and public involvement activities in its area.

Healthwatch Shropshire is responsible for supporting patient and public involvement in Shropshire. www.healthwatchshropshire.co.uk

Healthwatch Telford & Wrekin is responsible for supporting patient and public involvement in Telford & Wrekin. www.healthwatchtelfordandwrekin.co.uk

Healthwatch England is a committee of the Care Quality Commission (CQC) that acts with operational independence in the interests of patients, social care service users and the public. Healthwatch England provides national leadership, support and advice to local Healthwatch organisations. www.healthwatch.co.uk

NHS providers have a Patient Advice and Liaison Service (PALS) that seeks to resolve patient concerns and help patients and carers in making a complaint. See individual provider websites for details.

Local Authorities arrange advocacy services to support people who wish to complain about the NHS. The provider for Shropshire and Telford and Wrekin is POhWER. www.pohwer.net

If a patient is unhappy with the way their complaint has been handled, they may contact the Parliamentary and Health Service Ombudsman. The Ombudsman conducts independent investigations into complaints that the NHS in England has not acted on properly or fairly, or has provided a poor service. www.ombudsman.org.uk

Every upper tier and unitary local authority also has a Health Overview and Scrutiny Committee which has statutory powers to review health services in its area and can refer contested decisions on substantial variation to local health services to the Secretary of State. Locally there is a Health Overview and Scrutiny Committee for Shropshire and for Telford & Wrekin. Further information is available from the local authority websites (see previous page).

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NHS Employers has provided the infographic below to summarise the new NHS. You can find the full infographic at www.nhsemployers.org

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Key National Bodies in England

Health Education England is responsible for promoting high quality training and education, undertaking national planning and leadership, allocating financial resources, monitoring outcomes and securing the required supply of qualified staff . www.hee.nhs.uk

At a local level, education and training is co-ordinated by local education and training boards (LETBs). The LETBs are statutory committees of HEE and act as the bodies for all providers and professionals to work collectively to improve the quality of education and training outcomes within their local area – in order to meet the needs of patients, the public and service providers. Our LETB is Health Education West Midlands. www.wm.hee.nhs.uk

NHS Employers works on behalf of employers across the NHS to lead on key workforce issues such as pay and negotiations. www.nhsemployers.org

The NHS Leadership Academy supports and encourages leadership development across the NHS. www.leadershipacademy.nhs.uk

The Health and Social Care Information Centre (HSCIC) collects, analyses and publishes national data and statistical information and works to deliver national IT systems and services to support health and care providers. HSCIC is responsible for assessing the quality of information it collects and making it readily available to those who need it in safe, de�identified formats, with safeguards in place to protect confidential information. www.hscic.gov.uk

The National Institute for Health Research (NIHR) is responsible for maintaining a health research system in which the NHS supports outstanding individuals, working in world class facilities, conducting leading edge research focused on the needs of patients and the public.www.nihr.ac.uk

The National Institute for Health and Care Excellence (NICE) is the main source of evidence-based guidance and advice for health and social care practitioners, patients, service users and the public on the most effective way to prevent, diagnose and treat disease and ill health. www.nice.org.uk

NHS Improving Quality (NHS IQ) is the driving force for improvement across the NHS in England. It brings together the wealth of knowledge, expertise and experience from across the NHS, establishing a new vision and re-shaping the healthcare improvement landscape. www.england.nhs.uk/nhsiq

The NHS Litigation Authority manages negligence and other claims against member NHS organisations in England. www.nhsla.com

NHS England is responsible for translating national policy from the Department of Health into an effective health system that improves health outcomes for the population. It operates at national level (NHS England), regional level (e.g. Midlands and East region) and local level (e.g. Shropshire and Staffordshire Area Team). www.england.nhs.uk

The Secretary of State for Health has responsibility to Parliament for the provision of the health service. The Secretary of State works through the Department of Health to provide strategic direction for the NHS and wider health and care system and holds all of the national bodies to account for their operational and financial performance, thereby ensuring that the different parts of the system work properly together. www.gov.uk/dh

The main organisations in Wales Powys Teaching Health Board (tHB) is responsible for planning and providing services for the population of Powys. They commission hospital services from us for people in northern Powys. They also provide local community services. www.powysthb.wales.nhs.uk Welsh Ambulance Services NHS Trust is the provider of ambulance services for Wales www.ambulance.wales.nhs.uk Montgomeryshire Community Health Council (CHC) is an independent body that represents the interests of the public in the NHS. For example, we consult with the CHC on proposals for significant changes to health services. www.wales.nhs.uk/sitesplus/906/ Welsh Health Specialised Services Committee is a committee of the Local Health Boards in Wales that is responsible for commissioning specialised services www.wales.nhs.uk Welsh Government Health and Social Care Department sets national policy and guidance for the NHS in Wales. www.wales.nhs.uk Public Health Wales is responsible for improving health and wellbeing and reducing health qualities in Wales. www.publichealthwales.wales.nhs.uk

Produced by the Communications Team at SaTH. Reproduced with kind permission. June 2013.

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