How the NHS works

What is the NHS?

The NHS is the National Health Service. It is the health service that is available to everyone living in the UK. And it offers care that is funded by the Government.

Services like visiting a GP or hospital, getting surgery, getting specialist treatment, and being taken to hospital by an ambulance are seen as ‘free’. They are actually paid for by money that comes from people paying tax and is put into national health care.

There are also parts of service that aren’t fully funded by the Government. For example, some people covered by NHS England have to pay for all or part of their prescribed medicines.

The NHS is a complex system. And, it’s getting more complex as it gets bigger. In fact, The Health and Social Care Act 2012 led to one of the greatest re-organisations of the NHS since its creation in the 1940s. And, the Health and Care Act of 2022 furthered this re-organisation.

An example is the creation of Integrated Care Systems to deliver NHS services in local areas. These are designed to give GPs and other clinicians the power to influence which services are brought in (commissioned) in their area, in line with what their patients need.

Finding your way through the maze of organisations that now exist within, or are linked to, the NHS can be confusing at the best of times. This can be even more the case if you are undergoing the shock and possible cognitive effects of being diagnosed with, and treated for, a brain tumour.

How does the NHS work?

Since 1999, the NHS hasn’t been run by the UK Government. Instead, healthcare is the responsibility of the individual governments within the UK.

Healthcare is looked after by NHS England, NHS Scotland, NHS Wales, and the Health and Social Care Services (HSC) in Northern Ireland. So there is a difference in structures and management approaches. And there’ also a difference in the way social care relates to health in the four countries.

In addition to these differences, the NHS was designed to treat individual conditions. So, even though many people have multiple conditions that need more of a holistic approach, the national healthcare structure is still very broken up.

This could be very confusing for people trying to understand the different parts of the NHS that sometimes work without consulting each other.

This situation led to what we have seen in recent years, which is an attempt to create more unity amongst the organisations of the NHS. But, there were laws that meant parts of the NHS couldn’t join up further.

The 2022 Health and Care Act

In 2022, the Government brought in the Health and Care Act. This was designed to make it easier for health care providers to work together.

Clinical commissioning groups (CCGs), which were the partnerships formed under the Health and Social Care Act in 2012, were given legal status and became Integrated Care Systems.

These are made up of Integrated Care Boards and Integrated Care Partnerships.

Integrated Care Boards create the NHS budget and make sure healthcare is offering the best possible value for money.

Integrated Care Partnerships work with local authorities to help improve healthcare in their areas.

There is also the Care Quality Commission, which works independently to monitor the level of healthcare being given across the NHS.

And, the Department of Health and Social Care decides what the NHS should deliver based on the taxpayer money that is gets from the Government.  

Future of the NHS

Because of the ongoing changes to the NHS system, we should see parts of the NHS being able to work closer together. This should give us improvements in care times and support, as well as home treatment.

There are, of course, some challenges. The NHS is dealing with the effects of the Covid-19 pandemic, and has long waiting lists and staff shortages.

But, the NHS is always looking to evolve and improve. So, the impact of any changes will be watched closely and changed for the better as time goes on.