Family practitioner committees were established by the National Health Service Re-organisation Act 1973. They replaced local executive councils which had been established in 1948 to manage primary care.
Executive councils were direct descendants of the insurance committees established by section 59 of the National Insurance Act 1911 but with additional responsibility for NHS dentistry and NHS optician services. Their role was essentially neutral and routine. They played little part in developing the services they administered. There were 138 executive councils in England and Wales and 25 in Scotland. [1] The role of the Council was to maintain GPs’ lists of patients and to receive practitioners’ claims for payment. It was headed by an administrator with managerial control only over the staff, not the practitioners. [2]
Each family practitioner committee had thirty members, eleven of which were appointed by the area health authority with which it was coterminous. Eight were appointed by the local medical committee, three by the local dental committee, two by the local pharmaceutical committee, two by the local optical committee and four by the local authority.
One of the tasks of the committee was to maintain lists of registered patients and registered practitioners. [3]
The National Health Service and Community Care Act 1990 abolished the committees and they were replaced by family health services authorities. Nearly half of all family practitioner committee administrators were sacked, and the new appointees came from outside the NHS, nearly all from industry or the armed forces. [4] The functions of the FHSAs were later subsumed into primary care trusts. The Family Health Services Appeal Authority was established to hear appeals and applications resulting from decisions made about the inclusion of patients and practitioners in lists. It was abolished in 2005. [5]
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.
An NHS trust is an organisational unit within the National Health Service in England and Wales, generally serving either a geographical area or a specialised function. In any particular location there may be several trusts involved in the different aspects of providing healthcare to the local population. As of April 2020 there are altogether 217 trusts, and they employ around 800,000 of the NHS's 1.2 million staff.
General medical services (GMS) is the range of healthcare that is provided by general practitioners as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. Today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. In 2013 60% of practices had a GMS contract as their principle contract. The contract has sub-sections and not all are compulsory. The other forms of contract are the Personal Medical Services or Alternative Provider Medical Services contracts. They are designed to encourage practices to offer services over and above the standard contract. Alternative Provider Medical Services contracts, unlike the other contracts, can be awarded to anyone, not just GPs, don't specify standard essential services, and are time limited. A new contract is issued each year.
Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May 2011 they also provided community health services directly. Collectively PCTs were responsible for spending around 80 per cent of the total NHS budget. Primary care trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012, with their work taken over by clinical commissioning groups.
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.
Emergency medical services in the United Kingdom provide emergency care to people with acute illness or injury and are predominantly provided free at the point of use by the four National Health Services (NHS) of England, Scotland, Wales, and Northern Ireland. Emergency care including ambulance and emergency department treatment is only free to UK residents and a charge may be made to those not entitled to free NHS care. The NHS commissions most emergency medical services through the 14 NHS organisations with ambulance responsibility across the UK.
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 and Community Care Act 1990 introduced an internal market into the supply of healthcare in the United Kingdom, making the state an 'enabler' rather than a supplier of health and social care provision.
The National Health Service Act 1946 came into effect on 5 July 1948 and created the National Health Service in England and Wales thus being the first implementation of the Beveridge model. Though the title 'National Health Service' implies a single health service for the United Kingdom, in reality one NHS was created for England and Wales accountable to the Secretary of State for Health, with a separate NHS created for Scotland accountable to the Secretary of State for Scotland by the passage of the National Health Service (Scotland) Act 1947. Similar health services in Northern Ireland were created by the Northern Ireland Parliament through the Health Services Act 1948.
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.
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.
Health Education England (HEE) is an executive non-departmental public body of the Department of Health and Social Care. Its function is to provide national leadership and coordination for the education and training within the health and public health workforce within England. It has been operational since June 2012.
NHS England, officially the NHS Commissioning Board, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the National Health Service in England as set out in the Health and Social Care Act 2012. It directly commissions NHS general practitioners, dentists, optometrists and some specialist services. The Secretary of State publishes annually a document known as the NHS mandate which specifies the objectives which the Board should seek to achieve. National Health Service Regulations are published each year to give legal force to the mandate.
Dentistry provided by the National Health Service in the United Kingdom is supposed to ensure that dental treatment is available to the whole population. Most dentistry is provided by private practitioners, most of whom also provide, on a commercial basis, services which the NHS does not provide, largely cosmetic. Most adult patients have to pay some NHS charges, although these are often significantly cheaper than the cost of private dentistry. The majority of people choose NHS dental care rather than private care: as of 2005, the national average proportion of people opting for private care was 23%. NHS dentistry is not always available and is not managed in the way that other NHS services are managed.
Healthwatch England is a body established under the Health and Social Care Act 2012, which took effect in April 2013. Its role is to gather and champion the views of users of health and social care services, in order to identify improvements and influence providers' plans. The Healthwatch network is made of up of local Healthwatch groups in each of England's local authority areas, and Healthwatch England, the national body.
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.
Healthcare in Dorset is primarily the responsibility of Dorset Clinical Commissioning Group. Dorset County Council is leading in the development of an electronic health record, to be called the Dorset Care Record, provided by Orion Health. It is intended to enable all health and social care providers to share records.
The private provision of NHS services has been controversial since at least 1990. Keep Our NHS Public, NHS Support Federation and other groups have campaigned against the threat of privatisation, largely in England.