Welcome to the NHS
For the NHS a typical day includes:
- Over 835,000 people visiting their GP practice or practice nurse
- Almost 50,000 people visiting accident and emergency departments
- 49,000 outpatient consultations
- 94,000 people admitted to hospital as an emergency admission
- 36,000 people in hospital for planned treatment
- 28,000 sight tests being carried out
- 18,000 calls to NHS Direct
The structure of the NHS
Hospitals in the NHS are managed by NHS trusts (sometimes called acute or foundation trusts) and are run by a trust board. These trusts make sure that hospitals provide high quality health care and that they spend their money efficiently. Mental health trusts and ambulance trusts have a similar structure but tend to cover wider areas. There are almost 250 hospital, mental health and ambulance trusts in England, 51 primary care trust clusters (PCTs) and a growing number of clinical commissioning groups. Clinical commissioning groups are groups of GP practices working together to manage local budgets and buy services for patients direct with other NHS colleagues and other health providers.
Primary care is provided in your local community via your local GP, NHS walk-in centre, dentist, pharmacist and optician. NHS Direct is also responsible for providing healthcare advice and information 24 hours a day via the internet and over the telephone.
Currently, all hospital and mental health trusts are dependent on PCTs commissioning services such as elective surgery, outpatient visits and other treatments from them, but PCTs also run community-based hospitals and provide services such as district nursing and health promotion. However, there are new government proposals to give GP practices much more responsibility for spending the NHS budget in England and commission services direct from hospitals and other health providers for their patients.
PCTs still tend to commission many services from their local hospital. However, under the patient choice initiative, anyone needing elective hospital treatment should be offered a choice of where it is carried out, including independent sector treatment centres (ISTCs) run by private companies.
Strategic health authorities (SHAs) cover large areas - typically neighbouring counties or large city areas - and are responsible for overseeing other NHS organisations in their area and leading on issues such as workforce development and capacity.
