|Headquarters||39 Victoria Street |
|Annual budget||£138.9 billion; 2020–21 ($185 billion)|
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|Politics of the United Kingdom|
The Department of Health and Social Care (DHSC) is the UK government department responsible for government policy on health and adult social care matters in England, along with a few elements of the same matters which are not otherwise devolved to the Scottish Government, Welsh Government or Northern Ireland Executive. It oversees the English National Health Service (NHS). The department is led by the Secretary of State for Health and Social Care with three Ministers of State and three Parliamentary Under-Secretaries of State.
The department develops policies and guidelines to improve the quality of care and to meet patient expectations. It carries out some of its work through arms-length bodies (ALBs),including executive non-departmental public bodies such as NHS England and the NHS Digital, and executive agencies such as Public Health England, the UK Health Security Agency and the Medicines and Healthcare products Regulatory Agency (MHRA).
The Department of Health was formally created in 1988 through The Transfer of Functions (Health and Social Security) Order. Like many others, the department with responsibility for the nation's health has had different names and included other functions over time.
In the 19th century, several bodies were formed for specific consultative duties and dissolved when they were no longer required. There were two incarnations of the Board of Health (in 1805 and 1831) and a General Board of Health (1854 to 1858) that reported directly into the Privy Council. Responsibility for health issues was also at times, and in part, vested in local health boards and, with the emergence of modern local government, with the Local Government Act Office, part of the Home Office. In the early part of the 20th century, medical assistance was provided through National Health Insurance Commissions.
The first body, which could be called a department of government was the Ministry of Health, created through the Ministry of Health Act 1919, consolidating under a single authority the medical and public health functions of central government. The co-ordination of local medical services was expanded in connection with emergency and wartime services, from 1935 to 1945, and these developments culminated in the establishment of the NHS in 1948.
In 1968, the Ministry of Health was dissolved and its functions transferred (along with those of the similarly dissolved Ministry of Social Security) to the newly created Department of Health and Social Security (DHSS). Twenty years later, these functions were split back into two government departments, forming the Department of Social Security (DSS) and the Department of Health.
After the 2018 British cabinet reshuffle, the department was renamed the Department of Health and Social Care.
The department's headquarters and ministerial offices are at 39 Victoria Street, London. The department moved from its previous location in Richmond House, Whitehall in November 2017. Its other principal offices are Skipton House (Elephant and Castle), Wellington House near Waterloo station and Quarry House in Leeds. Wellington House is now mainly occupied by staff from the department's arms-length bodies. New King's Beam House near Blackfriars Bridge was formerly a Department of Health office prior to the expiry of its lease in October 2011. Alexander Fleming House, Hannibal House and Eileen House(all in Elephant and Castle) were previously used by the department. The archives are at Nelson, Lancashire.
As of March 2021 [update] there are 7 ministerial posts at the DHSC including: the Secretary of State, three Ministers of State, and three Parliamentary Under-Secretaries of State. The term Health and Social Care minister refers to any minister junior to the Secretary of State for Health and Social Care.
The ministers are as follows:
|The Rt Hon. Matt Hancock MP||Secretary of State||Overall responsibility|
|Edward Argar MP||Minister of State for Health||operational performance; Long Term Plan Bill; finance, efficiency and commercial; NHS capital, land and estates; transformation; NHS England mandate; devolved administrations – non-EU Exit; secondary legislation; departmental management; EU Exit, global development and trade |
Sponsorship of: NHSE, NHSI, NHSBSA.
|Nadine Dorries MP||Minister of State for Mental Health, Suicide Prevention and Patient Safety||mental health; suicide prevention and crisis prevention; offender health; vulnerable groups; patient safety; women's health strategy; maternity care; inquiries; patient experience; cosmetic regulation; data and technology; medicines and devices regulation |
Sponsorship of: NHS Resolution, CQC, MHRA, NHSX, NHSD.
|Helen Whately MP||Minister of State for Social Care||adult social care; health/care integration; workforce; dementia, disabilities and long-term conditions; abortion; NHS Continuing Healthcare; NHS security management including cyber security; research and life sciences; blood and transplants, organ donation |
Sponsorship of: HRA, NHSBT, HTA, HFE, HEE.
|Jo Churchill MP||Parliamentary Under-Secretary of State for Prevention, Public Health and Primary Care||public health system; health improvement; health inequalities; public health delivery; primary care; gender identity services; major diseases; community health; lead minister for crisis response |
Sponsorship of PHE and FSA.
|The Rt Hon. The Lord Bethell||Parliamentary Under-Secretary of State for Innovation||life sciences; medicines; research; anti-microbial resistance; global health security; international diplomacy and relations; data and technology; rare diseases; NHS security management, including cyber security; blood and transplants and organ donation |
Sponsorship of: NHS Blood and Transplant; The Human Tissue Authority; The Human Fertilisation and Embryology; Authority; The Medicines and Healthcare products Regulatory Agency; The National Institute for Health and Care Excellence; NHS Digital; Health Research Authority; NHSX; NHS Business Services Authority
|Nadhim Zahawi MP||Parliamentary Under-Secretary of State for COVID-19 Vaccine Deployment||COVID-19 vaccine deployment.|
The permanent secretary at the Department of Health and Social Care is Sir Christopher Wormald KCB, who was appointed in 2016.
Previous permanent secretaries:
Following the resignation of Sir Nigel Crisp in March 2006, a separate post of Chief Executive of the National Health Service in England was created, held by Sir David Nicholson. Following the Health and Social Care Act 2012 and the creation of the independent NHS Commissioning Board, known as NHS England, this post has evolved into Chief Executive of the new organisation. As of 1 April 2014, the incumbent is Simon Stevens.
The department has six chief professional officers who provide it with expert knowledge and also advise the Ministers, other government departments and the Prime Minister. The Chief Medical Officer and Chief Nursing Officer are also directors of the department's board.
The department acts as a 'steward' for the health and adult social care system in England and oversees fifteen arms-length bodies (ALBs):
The department has two executive agencies:
The department has thirteen executive non-departmental public bodies:
The publication of Professor Lord Darzi's review of the NHSprompted criticism of the government and the Department of Health, claiming that it paved the way for user charging, and so contradicting the NHS Plan 2000 which stated that "user charges are unfair and inequitable in they increase the proportion of funding from the unhealthy, old and poor compared with the healthy, young and wealthy". The report also introduces the concept of personal budgets.
Darzi's reportsplits previously integrated services into 'core', 'additional' and 'enhanced' services, which critics say will lead to abandoning the open-ended duty of care on which the NHS was founded.
This section needs to be updated.December 2020)(
Fatal outbreaks of antibiotic-resistant bacteria ("superbugs"), such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile , in NHS hospitalshas led to criticism in 2008 of the department's decision to outsource cleaning via private finance initiative contracts as "cutting corners on cleaning".
A "Deep Clean" initiative announced by the Department of Health was criticised by infection control experts and by the Lancet as a gimmick which failed to address the causes of in-hospital infections,by the firms doing the work as an attempt to avoid paying for regular better cleaning, and by NHS managers as ineffective.
It also attracted criticism because only a quarter of the £60m funding for the scheme went to hospitals,[ clarification needed ] and because a number of hospitals missed the completion target, and as of June 2008 one in four NHS trusts was not meeting the government's standards on hygiene.
Its advice to primary care on prescribing drugs such as proton pump inhibitors has been criticised as wasteful.
The DH has attracted criticism for its handling of the outcome of Modernising Medical Careers, in particular in the changes it made to the specialist training of doctors and the Medical Training Application Service (MTAS). These changes left "29,193 junior doctors from the UK and overseas... chasing 15,600 posts..." [ clarification needed ] following accusations that she had lied to the House of Commons over the system. Even after the abolition of MTAS, anger among the medical profession continued, with the British Medical Association commenting of the DH response that "Not only is this response too late, it does not go far enough".and resulted in accusations that the DH had broken the law by refusing to reveal scores to candidates. Ultimately there was a judicial review and a boycott of the system by senior doctors across the country. MTAS was eventually scrapped and Patricia Hewitt, the then Secretary of State for Health, resigned
The official government inquiry into MMC recommended that the responsibility for medical training be removed from the DH.
Successive DH ministerial teams have been criticised for repeated reorganisations of the NHS in England, where primary care commissioning responsibility, in particular, has been allocated to four different sets of organisations in the last ten years: PCGs,[ clarification needed ] small area Primary Care Trusts (PCTs) (e.g. covering a rural local authority district or part of a city), larger-area PCTs (e.g. covering a whole county), PCT clusters (e.g. quarter of London or South of Tyne and Wear) and the currently unspecified Clinical Commissioning Groups. The tendency to introduce each reorganisation before its predecessor has had time to settle down and generate improved performance has attracted censure amongst healthcare professions in the UK and beyond, including reference to the ironic concept of 'redisorganization'.
Andrew Lansley's promise before the 2010 general election not to impose top-down reorganisation, followed by the instigation from ministerial level of one of the most fundamental NHS reorganisations yet envisaged, has generated especially widespread opprobrium, although some commentators have also suggested that this is to some extent completing the job started under the Blair administration.
The NHS as of 1 April 2013 is no longer situated within the DH, as NHS England also went 'live' at the same time. Therefore, the DH has a further scrutiny role of NHS services and commissioning. (See Arms Length Bodies section).
In recent years the Department of Healthand the NHS have come under considerable scrutiny for its use of IT. Since being elected to power in 1997 the Labour government had sought to modernise the NHS through the introduction of IT. Although the policy is correct in aim, many claim its execution is lacking.
In September 2008 a new leadership team was established, CIO for Health, Christine Connelly, and director of programme and system delivery Martin Bellamy. Previous CIO Richard Granger was believed to have been the most highly paid civil servant in the UK and was a controversial figure.Connelly left the DH for a position in the Cabinet Office in June 2009 and was replaced by Tim Donohoe and Carol Clarke.
Connelly's role was to "deliver the Department's overall information strategy and integrating leadership across the NHS", according to the DH's website. That strategy, known as the National Programme for IT, [ needs update ]is intended to do nothing less than revolutionise NHS information workflow and is costed at about £12.7bn. The success or otherwise of Connelly's reign will be based on her promise to end delays of electronic medical records. She has said that if there is not clear progress by November 2009, a new plan could be hatched.
On the eve of the departure of Fujitsu as an outsourcing partner, Connelly said in April 2009 that she would open up sourcing to competition at "acute" sites in the south of England and offer toolkits by March 2010 to allow more local configuration of systems.
In January 2009, MPs criticised DH for its confidentiality agreement with key supplier CSC and in March the department was admonished by the Information Commissioner for its records management. In May 2011, Prime Minister David Cameron announced that he was considering scrapping the project.
In response to Government spending reduction targets following the 2008-9 international financial crisis and subsequent recession, DH in common with several other Government Departments resorted to large-scale[ vague ] staffing reductions.[ citation needed ] In order to minimise redundancy costs,[ citation needed ] the predominant impact was upon DH staff not employed through a traditional civil service 'headcount' contract, with a resultant emphasised effect upon more recent or innovative work-streams dependent upon seconded or externally hosted staff. This has attracted criticism from several of the professional and patient communities of interest concerned, for instance as regards the impact upon Improving Access to Psychological Therapies (IAPT) and the withdrawal of the practical assistance available to the NHS and local authorities via the national support teams.
Most health policy in Scotland, Wales and Northern Ireland is devolved to the department's counterparts:
A number of health issues are, however, wholly or partly reserved to Westminster:
In Northern Ireland, abortion law is a criminal justice matter and is devolved.
Under the Welsh devolution settlement, specific policy areas are transferred to the Welsh Government rather than reserved to Westminster. As the distinction between government and actual health services is seen as less pronounced than in England, the main source of information about current developments is the NHS Wales article.
The Secretary of State for Health and Social Care, also referred to as the Health Secretary, is a senior secretary of state position within the Government of the United Kingdom, and leads the Department of Health and Social Care (DHSC). The officeholder has responsibility for all health and social care matters in England, including the National Health Service (NHS). Alongside the Chief Medical Officer for England, the officeholder serves as the principal adviser to the Prime Minister of the United Kingdom on all health matters. The office forms part of the Cabinet of the United Kingdom.
A foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care. As of March 2019 there were 151 foundation trusts.
Strategic health authorities (SHA) were part of the structure of the National Health Service in England between 2002 and 2013. Each SHA was responsible for managing performance, enacting directives and implementing health policy as required by the Department of Health at a regional level.
Professor Sir Bruce Edward Keogh, KBE, FMedSci, FRCS, FRCP is a Zimbabwean-born British surgeon who specialises in cardiac surgery. He was Medical Director of the National Health Service in England from 2007 and National Medical Director of the NHS Commissioning Board from 2013 until his retirement early in 2018. He is Chair of Birmingham Women's and Children's NHS Foundation Trust.
Polyclinics in England were intended to offer a greater range of services than were offered by current general practitioner (GP) practices and local health centres. In addition to traditional GP services they would offer extended urgent care, healthy living services, community mental health services and social care, whilst being more accessible and less medicalised than hospitals. A variety of models were proposed, ranging from networks of existing clinics to larger premises with several colocated general practitioner (GP) practices, more extensive facilities and additional services provided by allied healthcare professionals.
NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland, and one of the four systems which make up the National Health Service in the United Kingdom. It operates fourteen territorial NHS boards across Scotland, seven special non-geographic health boards and NHS Health Scotland.
Health and Social Care (HSC) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.
Sir David Nicholson is a public policy analyst, forthcoming Chair of Sandwell and West Birmingham NHS Trust, current Chair of Worcestershire acute hospitals NHS trust and NHS manager who was Chief Executive of the National Health Service in England. He was appointed in October 2011 following the NHS reforms, having been seventh Chief executive of the NHS within the Department of Health since September 2006. He issued what has become known as the "Nicholson challenge" regarding the finances of the NHS. He retired from the role on 1 April 2014.
Ara Warkes Darzi, Baron Darzi of Denham, is an Iraqi-British surgeon, academic, and politician.
The Health and Social Care Select Committee is a Departmental Select Committee of the British House of Commons, the lower house of the United Kingdom Parliament. It oversees the operations of the Department of Health and Social Care (DHSC) and its associated 29 agencies and public bodies.
Health care in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences now exist between these systems.
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use. Some services, such as emergency treatment and treatment of infectious diseases, are free for most people, including visitors.
Healthcare in the UK is mainly provided by the National Health Service, a public body that provides healthcare to all permanent residents of the United Kingdom that is free at the point of use. Since health is a devolved matter, there are differences with the provisions for healthcare elsewhere in the United Kingdom. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing to pay.
NHS London was a strategic health authority of the National Health Service in England. It operated in the London region, which is coterminous with the local government office region. The authority closed as part of the Health and Social Care Act 2012 on 31 March 2013.
Tim Kelsey is CEO of Pacific Knowledge Systems (PKS), an international pioneer in health data analytics based in Sydney, Australia. PKS is an Australian Healthcare company (ASX:PKS) that works around the world to better capture, manage and leverage human expertise to improve performance and health outcomes. He started in the role in December 2020.
The Health and Social Care Act 2012 is an act of the Parliament of the United Kingdom. It provides for the most extensive reorganisation of the structure of the National Health Service in England to date. It removed responsibility for the health of citizens from the Secretary of State for Health, which the post had carried since the inception of the NHS in 1948. It abolished primary care trusts (PCTs) and strategic health authorities (SHAs) and transferred between £60 billion and £80 billion of "commissioning", or healthcare funds, from the abolished PCTs to several hundred clinical commissioning groups, partly run by the general practitioners (GPs) in England but also a major point of access for private service providers. A new executive agency of the Department of Health, Public Health England, was established under the act on 1 April 2013.
Genomics England is a company set up and owned by the Department of Health and Social Care to run the 100,000 Genomes Project, which aims to sequence 100,000 genomes from NHS patients with a rare disease and their families, and patients with cancer. An infectious disease strand is being led by Public Health England.
Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England.
NHS Improvement (NHSI) is a non-departmental body in England, responsible for overseeing the National Health Service's foundation trusts and NHS trusts, as well as independent providers that provide NHS-funded care.
Exercise Cygnus was a three-day simulation exercise carried out by NHS England in October 2016 to estimate the impact of a hypothetical H2N2 influenza pandemic on the United Kingdom. It aimed to identify strengths and weaknesses within the United Kingdom health system and emergency response chain by putting it under significant strain, providing insight on the country's resilience and any future ameliorations required. It was conducted by Public Health England representing the Department of Health and Social Care, as part of a project led by the "Emergency Preparedness, Resilience and Response Partnership Group". Twelve government departments across Scotland, Wales and Northern Ireland, as well as local resilience forums (LRFs) participated. More than 950 workers from those organisations, prisons and local or central government were involved during the three-day simulation, and their ability to cope under situations of high medical stress was tested.
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