The NHS is a constantly evolving system made up of multiple organisations. Decision-making is held across national, regional, and local contexts. As a result, understanding the NHS landscape is critical so you can engage with the right organisations at the most appropriate level. Questions this page aims to answer:
- How is the NHS structured?
- What roles do national organisations such as DHSC, NHS England, CQC, NICE, and Health Innovation Networks play?
- What are Integrated Care Boards?
- How do Integrated Care Boards and Integrated Care Partnerships differ?
- What role do local organisations such as Primary Care Networks and local authorities play in planning and commissioning services?
- How is frontline care delivered across primary, secondary, and tertiary services?
- What are the current strategic priorities of the NHS?
- Where can I find reliable updates on changes to NHS structures?
What is the overarching NHS landscape?
The NHS landscape can be categorised into 4 different levels:
National
These organisations set national priorities and allocate funding to other NHS organisations. They are led by the Department of Health and Social Care.
Responsible for the NHS overall, the Department of Health and Social Care (DHSC) allocates resources, develops policies, and sets the strategic direction of health and social care in the UK.
The Care Quality Commission (CQC) is an independent regulator that ensures NHS services are providing safe, quality care for all patients. The CQC publishes ratings to allow patients to make informed choices about their care.
The National Institute for Health and Social Care Excellence (NICE) determines whether new innovations should be made available in the NHS, provides clinical guidelines on patient care, and develops standards to measure performance and quality of services.
The innovation arm of the NHS, made up of 15 Health Innovation Networks across England. They connect organisations such as the NHS, local authorities, charities, and industry together with the aim of improving patient outcomes.
Regional
The plans set out by national organisations are adapted to regional needs across England. Regional organisations support local organisations. Regional NHS partnerships across England bring together NHS organisations, local councils, and voluntary and community sector partners to coordinate services and improve population health. These arrangements include Integrated Care Boards (ICBs), which are responsible for NHS planning and funding, and Integrated Care Partnerships (ICPs), which focus on broader health and social care priorities across local communities.
Local
Local organisations plan services based on the needs of the local population in effort to improve health outcomes for the community. This consists of:
Primary Care Networks (PCNs):
GP practices, community, mental health, social care, and voluntary services collaborating to provide care. There are 1,250 PCNs across England.
Local authorities:
Councils who commission services such as sexual health, drug treatment, and social care. There are 317 local authorities across England.
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Service
These organisations are the frontline of the NHS. They deliver direct care to patients. They can be categorised into primary care (treat and prevent illness and management of chronic conditions), secondary care (treatment for more complex conditions), and tertiary care (specialist services for life-threatening conditions):
What are the priorities of the NHS?
All organisations in the NHS work together in effort to fulfil priorities set out to improve the NHS. The current Fit for the Future: 10 Year Health Plan for England identified the below main priorities:
Shifting from a hospital to a community setting through the Neighbourhood Health Service
Integrating digital technologies to replace analogue methods
Moving from treating ill health to preventing ill health
Shift the NHS from a centrally driven system to a locally driven system
Increase transparency and accountability of care quality
Strengthen the staff workforce through increasing skills, motivation, and sustainability
Drive transformation through new innovations, such as AI technologies
Adapt NHS funding to improve productivity and financial sustainability
Where should I go for the latest news about changes to the NHS landscape?
The following sites are known as trustworthy sources for the latest updates on the structure of the NHS:
A clear understanding of the NHS landscape helps innovators to engage with the right organisations, at the right level, and at the right time. Knowing who sets priorities, allocates funding, and delivers services is essential for effective procurement and partnership working.