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The NHS in England

About the National Health Service (NHS)

Since its launch in 1948, the NHS has grown to become the world’s largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive.

The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth, a principle that remains at its core. With the exception of some charges, such as prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK. That is currently more than 63.2m people. It covers everything from antenatal screening and routine treatments for long-term conditions, to transplants, emergency treatment, and end-of-life care.

Responsibility for healthcare in Northern Ireland, Scotland and Wales is devolved to the Northern Ireland Assembly, the Scottish Government and the Welsh Assembly Government respectively.

Scale

The NHS employs more than 1.7m people. Of those, just under half are clinically qualified, including, 39,780 general practitioners (GPs), 370,327 nurses, 18,687 ambulance staff and 105,711 hospital and community health service (HCHS) medical and dental staff.

Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people.

The NHS in England is the biggest part of the system by far, catering to a population of 53m and employing more than 1.35m people. The NHS in Scotland, Wales and Northern Ireland employs 153,427; 84,817 and 78,000 people respectively.

The NHS deals with over 1 million patients every 36 hours.

Funding

Funding for the NHS comes directly from taxation and is granted to the Department of Health by Parliament. When the NHS was launched in 1948 it had a budget of £437 million (roughly £9 billion at today’s value). For 2012/13 it is around £108.9 billion. 

Structure

The NHS in England is undergoing some big changes, most of which will take effect on April 1 2013. This will include the abolition of primary care trusts (PCTs) and strategic health authorities (SHAs) and the introduction of clinical commissioning groups (CCGs) and Healthwatch England.

However, none of this will have an effect on how you access front-line services and your healthcare will remain free at the point of use. For detailed information about all the changes, see the section about the NHS structure.

Performance 

In the UK, life expectancy has been rising and infant mortality has been falling since the NHS was established. Both figures compare favourably with other nations. Surveys also show that patients are generally satisfied with the care they receive from the NHS. Importantly, people who have had recent direct experience of the NHS tend to report being more satisfied than people who have not.

In 2010, the Commonwealth Fund declared that in comparison with the healthcare systems of six other countries (Australia, Canada, Germany, Netherlands, New Zealand and USA) the NHS was the second most impressive overall. The NHS was rated as the best system in terms of efficiency, effective care and cost-related problems. It was also ranked second for patient equality and safety.

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Page last reviewed: 28/01/2013

Next review due: 28/01/2015

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