The Secretary of State for Health
The Secretary of State for Health has ultimate responsibility for the provision of a comprehensive health service in England, and ensuring the whole system works together to respond to the priorities of communities and meet the needs of patients.
The Department of Health
The Department of Health (DH) is now responsible for strategic leadership of both the health and social care systems, but is no longer the headquarters of the NHS, nor will it directly manage any NHS organisations. For detailed information about the department's new priorities and roles, visit the DH website.
Formerly established as the NHS Commissioning Board in October 2012, NHS England is an independent body, at arm’s length to the government. It's main role is to improve health outcomes for people in England. It:
- provides national leadership for improving outcomes and driving up the quality of care
- oversees the operation of clinical commissioning groups
- allocates resources to clinical commissioning groups
- commissions primary care and specialist services
For more information, visit NHS England.
Clinical commissioning groups (CCGs)
Primary care trusts (PCTs) used to commission most NHS services and controlled 80% of the NHS budget. On April 1 2013, PCTs were abolished and replaced with clinical commissioning groups (CCGs). CCGs have taken on many of the functions of PCTs and in addition some functions previously undertaken by the DH.
All GP practices belong now to a CCG and the groups also include other health professionals, such as nurses. CCGs commission most services, including:
- planned hospital care
- rehabilitative care
- urgent and emergency care (including out-of-hours)
- most community health services
- mental health and learning disability services
CCGs can commission any service provider that meets NHS standards and costs. These can be NHS hospitals, social enterprises, charities, or private sector providers.
However, they must be assured of the quality of services they commission, taking into account both National Institute for Health and Care Excellence (NICE) guidelines and the Care Quality Commission's (CQC) data about service providers.
Both NHS England and CCGs have a duty to involve their patients, carers and the public in decisions about the services they commission.
Find your local CCG.
Health and wellbeing boards
Every "upper tier" local authority is establishing a health and wellbeing board to act as a forum for local commissioners across the NHS, social care, public health and other services. The boards are intended to:
- increase democratic input into strategic decisions about health and wellbeing services
- strengthen working relationships between health and social care
- encourage integrated commissioning of health and social care services
For more information, read the DH’s guide on the Health and wellbeing boards.
Public Health England
A new organisation has been created: Public Health England (PHE), which provides national leadership and expert services to support public health, and also works with local government and the NHS to respond to emergencies. PHE:
- coordinates a national public health service and deliver some elements of this
- builds an evidence base to support local public health services
- supports the public to make healthier choices
- provides leadership to the public health delivery system
- supports the development of the public health workforce