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The history of the NHS in England

The NHS in the 2010s

The NHS is undergoing major changes in its core structure, including who makes decisions about NHS services, service commissioning, and the way money is spent. Find out more in the NHS in 2013.

So far, the 2010s have seen great medical breakthroughs and health innovations, and the NHS was celebrated at the London 2012 Olympic Games and marked its 65th anniversary on July 5 2013.


The NHS in 2010

Stroke ACT F.A.S.T. campaign wins award

Stroke campaign posterIn May 2010, the campaign won an IPA Effectiveness Gold Award. The judges remarked: "F.A.S.T was a fantastic mnemonic that brought it home what to do if somebody's having a stroke and will without doubt save lives."

The Mid Staffordshire NHS Foundation Trust public inquiry

The Mid Staffordshire inquiry is based on a previous report carried out by the Healthcare Commission (now the Care Quality Commission) in March 2009. The investigation was into the apparently high mortality rates of patients admitted as emergencies to Mid Staffordshire NHS Foundation Trust since April 2005, and the care provided to these patients.

On June 9 2010 the then Secretary of State for Health, Andrew Lansley MP, announced a full public inquiry into the role of the commissioning, supervisory and regulatory bodies in the monitoring of Mid Staffordshire Foundation NHS Trust.

Commonwealth Fund reports NHS second most impressive healthcare systems in international comparison

In comparison with the healthcare systems of 6 other countries (Australia, Canada, Germany, Netherlands, New Zealand and the US), the NHS was found to be the second most impressive overall by the Commonwealth Fund in 2010.

Read the full report, Mirror, Mirror on the Wall, published on June 23 2010.

Also read the 2014 update to the Mirror, Mirror on the Wall report, which states that the NHS was rated as the best system in terms of efficiency, effective care, safe care, co-ordinated care, patient-centred care and cost-related problems. It was also ranked second for equity.

Equity and excellence: liberating the NHS white paper

The white paper was launched on July 12 2010. It sets out proposals for the future of the NHS – including plans to make it more efficient. This includes:

  • putting patients at the heart of everything the NHS does
  • focusing on continually improving those things that really matter to patients – the outcome of their healthcare
  • empowering and liberating clinicians to innovate, with the freedom to focus on improving healthcare services

Download Equity and excellence: liberating the NHS.

UK's first cochlear implant operation to give sound in both ears

cochlear implant Cochlear implants are small hearing devices that are fitted behind your ear during surgery. On August 27 2010, the UK's first operation to fit a single cochlear implant capable of giving sound in both ears took place at Southampton General Hospital. 

Relaunch of the antibiotics awareness campaign

November 18 2010 sees the relaunch of the antibiotics awareness campaign.
Antibiotics are important medicines – they help fight infections caused by bacteria. Antibiotic resistance (when an antibiotic is no longer effective) is a major problem. It's one of the most significant threats to patients safety in Europe, and is driven by overuse of antibiotics and prescribing them inappropriately.

Launch of NHS 111 pilots

NHS 111 is the new non-emergency number that has been piloted in some parts of England. The service was introduced to make it easier for people to access local NHS healthcare services in England. You should call 111 when you need medical help fast but it's not a 999 emergency.

NHS 111 will be available across England from summer 2013.

Reducing violence and aggression in A&E (2010 to November 2011) 

According to the National Audit Office, violence and aggression towards frontline hospital staff is estimated to cost the NHS at least £69 million a year in staff absence, loss of productivity and additional security. The Design Council has developed toolkits for NHS managers, clinicians, and design and healthcare planners who want to develop and deliver a better service in effective and inspiring environments.

The NHS in 2011

The Health and Social Care Bill

The Health and Social Care Bill was published in draft form on January 19 2011. The Bill takes forward the Equity and Excellence: Liberating the NHS white paper (July 2010) and is a crucial part of the government’s vision to modernise the NHS so that it is built around patients, led by health professionals, and focused on delivering world-class healthcare outcomes.

Find out more about the Health and Social Care Bill from a series of fact sheets. 

Listening exercise

The Health and Social Care Bill was temporarily paused in spring 2011 to allow a 'listening exercise', led by a panel of experts in the NHS Future Forum headed by Professor Steve Field, to review the proposals and make recommendations.

In June 2011 the Future Forum published 16 recommendations for government on the modernisation of health and social care.

Read the reports about NHS Future Forum: recommendations to government on NHS modernisation on the GOV.UK website

Successful trial of an artificial pancreas

In April 2011, researchers from Cambridge University, funded by Diabetes UK, successfully demonstrated, for the first time, the potential of an artificial pancreas in preventing night-time hypoglycaemia in adults with type 1 diabetes.

Read all about the research on Cambridge University's website.

Phase 1 of NHS dental contract pilot programme

A small group of practices providing NHS dental services in England started to trial a different approach to looking after people’s teeth as part of the new NHS dental pilot scheme. The scheme started in April 2011 and aims to improve dental access and dental health for NHS patients.

The pilots test various ways of making sure the public understands how to look after their mouths and teeth better, and also ensures dentists are fairly paid for helping people do this.

UK’s first Selective Dorsal Rhizotomy (SDR) operation performed

In May 2011, the Frenchay Hospital in Bristol performed a pioneering neurosurgical procedure called Selective Dorsal Rhizotomy (SDR) that could enable children with cerebral palsy to walk. It is the first hospital in the UK to perform an SDR.

Beau Britton, seven, from Cornwall is the first child to be funded by a local NHS trust for the neurological procedure. SDR is a major operation used to treat lower limb spasticity, which involves cutting some of the sensory nerves in the lower spinal column. This can reduce muscle stiffness in the legs, as well as cramps and spasms.

First man in the UK to receive an artificial plastic heart

Matthew Green with wife and sonMatthew Green becomes the first UK patient to receive a portable total artificial heart implant at Papworth Hospital in Cambridgeshire. Before receiving the implant, the 40-year-old father had been critically ill from end-stage heart failure and it was thought he might not survive until a suitable donor heart could be found.

Living well with dementia (2011 – April 2012)

The Department of Health has teamed up with the Design Council to develop five innovative new design solutions to improve the quality of life for people living with dementia.

The NHS in 2012

Act FAST campaign relaunched to save more lives

Results show an exceptionally high awareness of the campaign and a significant improvement in the public’s ability to spots signs of stroke. It is hoped that the Act F.A.S.T campaign, relaunched on February 27 2012, will continue to help increase awareness about the signs of stroke so people can help family, friends and others should a stroke occur.

The Department of Health’s Act F.A.S.T. website has been updated and now includes a simple online exercise enabling people to test their knowledge of F.A.S.T.

Any Qualified Provider

The Any Qualified Provider (AQP) was launched in April 2012. The scheme means that, for some conditions, patients will be able to choose from a range of approved providers, such as hospitals or high street service providers.

Patients and GPs can choose a service based on what's important to them – perhaps one that is closer to home, has a shorter waiting list or better outcomes.

These services will remain free for patients to use, and access to them will be based on clinical need, in line with the NHS Constitution.

The Health and Social Care Act 2012

The Health and Social Care Act 2012 was first published on June 15 2012 and took effect on April 1 2013. The Act brought in the most wide-ranging reforms of the NHS since it was founded in 1948.

It puts clinicians at the centre of commissioning, frees up providers to innovate, empowers patients, and gives a new focus to public health. The Act covers the following five themes:

  • strengthening the commissioning of NHS services
  • increasing democratic accountability and public voice
  • liberating provision of NHS services
  • strengthening public health services
  • reforming health and care arm’s-length bodies. 

You can read the Health and Social Care Act 2012: fact sheets on the GOV.UK website.

London 2012 Olympic Games opening ceremony pays tribute to the NHS

Nurses at the 2012 Olympic opening ceremonyThe opening ceremony of the 2012 Olympic Games took place on the evening of July 27 2012  in the Olympic Stadium in London. Danny Boyle paid tribute to the NHS during the
opening ceremony because universal healthcare, free and for everyone, is one of the core values of British society. The health service was featured as one of Britain's proudest achievements. More than 600 real-life nurses and other healthcare workers joined Boyle's army of volunteers during the extravaganza.

See the highlights of both the opening and closing ceremonies on the London 2012 website.

Increasing patient choice of GP practices

The Department of Health is expanding patient choice of GP practices in two ways. One is the Patient Choice Scheme pilot and the other is the introduction of outer practice boundaries. Both will allow patients to have a greater choice of GP practices available to them. Both schemes were launched in July 2012.

The first UK heart failure patient received new nerve-stimulating implant

Dr. André Ng, who performed the procedureOn August 23 2012, the University of Leicester announced the device would be fitted for the first time in a UK patient with chronic heart failure by their researchers at Glenfield Hospital. The new implant stimulates part of the nerve supply to the heart (the vagus nerve), slowing the heart rate and reducing blood pressure. Researchers hope this will help to reduce stress on the heart and alleviate heart failure symptoms.

NHS Mandate published

The Mandate to NHS England was published by the Department of Health on November 13 2012. It was drawn up following consultation with the public, health professionals and key organisations across the health system between July and September 2012.

The Mandate sets out the objectives for the NHS and highlights the areas of health and care where the government expects to see improvements. The Mandate between the government and NHS England sets out the ambitions for the health service for the next two years. The NHS Mandate is structured around five key areas:

  • preventing people dying prematurely
  • enhancing quality of life for people with long-term conditions
  • helping people to recover from episodes of ill health or following injury
  • ensuring that people have a positive experience of care
  • treating and caring for people in a safe environment and protecting them from avoidable harm

Through the Mandate, the NHS will be measured, for the first time, by how well it achieves the things that really matter to people.

National roll out of Personal health budgets

Minister of State for Care Services, Norman Lamb MP, announced the national roll out of personal health budgets on November 30 2012. This followed a three year pilot programme, which ended in October 2012, and the publication of an independent evaluation report, led by the University of Kent. People who are already receiving NHS continuing care will have a right to ask for a personal health budgets from April 2014. Clinical commissioning groups will also be able to offer personal health budgets to others they feel may benefit from the additional flexibility and control.

Compassion in Practice - new three year vision and strategy for nursing, midwifery and care staff

Compassion in Practice is the new three year vision and strategy for nursing, midwifery and care staff drawn up by Jane Cummings, the Chief Nursing Officer for England (CNO) at the NHS Commissioning Board (now NHS England), and Viv Bennett, Director of Nursing at the Department of Health.

It was launched at the CNO annual conference in Manchester on December 4 2012 following an 8-week consultation with over 9,000 nurses, midwives, care staff and patients.

Announcement of DNA mapping for cancer patients

On December 10 2012, the prime minister David Cameron, announced plans to transform cancer treatment in England with new proposals to introduce high-tech DNA mapping for cancer patients and those with rare diseases, within the NHS. The project has had £100 million set aside for it for its three to five year duration.

The aim is to give doctors an advanced understanding of a patient’s genetic make-up, condition, and treatment needs, and to develop life-saving new drugs, treatments and scientific breakthroughs.

First person in the UK to have a hand transplant

Mark Hill, hand transplant patientOn 27 December 2012, a surgical team at Leeds General Infirmary carried out the UK’s first hand transplant operation. The operation involved amputating Mark Hill’s hand and then transplanting a donor hand during the same operation.

Read the full story on the Leeds General Infirmary website.

Innovation in primary care

In partnership with NHS London, the Design Council has supported London’s GPs to generate and implement new ideas for improving the services they offer patients. Speakers from general practice, NHS commissioning, research, academic institutions, industry and design discussed the ever changing primary care landscape and specific GP centric challenges both practices and patients now face. Prevalent topics included access to GP services (use of technology and infrastructure), empowerment of patients, empowerment of GPs (networks, capitation, diffusion of innovation) and GPs role in wider public health initiatives. The project ended in June 2013.

The Knee High Project (2012-14)

The Knee High Project is an ongoing initiative which started in 2012. The project was developed in partnership with Guy's and St Thomas' Charity, the London boroughs of Southwark and Lambeth, and the Design Council. The aim is to find ways to improve the health and wellbeing of children under 5.

The NHS in 2013

Final report into the Mid Staffordshire NHS Foundation Trust public inquiry published

Following an extensive inquiry into failings at Mid Staffordshire NHS Foundation Trust, Robert Francis QC published his final report on February 6 2013. It highlights a whole system failure, and not just one NHS trust. The system should have had checks and balances in place, and have been working to ensure patients were treated with dignity and suffered no harm, but it fell well short. The 1,782 page report has 290 recommendations which have major implications for all levels of the health service across England. This includes a more patient-centred approach, better medical training and nursing, as well as better complaints handling and service governance and regulation.

The Keogh Mortality Review

Sir Bruce KeoghOn February 6 2013, the Prime Minister announced that he had asked Professor Sir Bruce Keogh, NHS Medical Director for England, to review the quality of care and treatment provided by those NHS trusts and NHS foundation trusts that are persistent outliers on mortality indicators. A total of 14 hospital trusts were investigated as part of this review.

The review was guided by the NHS values set out in the NHS Constitution and underpinned by the following key principles:

  • patient and public participation
  • listening to the views of staff
  • openness and transparency
  • co-operation between organisations

Find out more about the Keogh Mortality Review and the 14 NHS hospital trusts investigated.

First NHS Change Day

NHS Change Day started with a single tweet in March 2013. The NHS Change Day is a frontline-led movement that aims to inspire and mobilise people everywhere - staff, patients and the public – to make pledges that will help to improve patient care.

The first NHS Change Day saw 189,000 people pledge actions that could improve the NHS. Find out more about the latest achievements for NHS Change Day.

The new NHS

The NHS is undergoing major changes in its core structure. The new health and care system became fully operational on April 1 2013. It delivers the ambitions set out in the Health and Social Care Act. Public Health England, the NHS Trust Development Authority and Health Education England took on their full range of responsibilities at the same time.

NHS England is an independent body, seperated from the government. Its main aim is to improve health outcomes for people in England. It will do this by creating the culture and conditions for health and care services and staff to deliver the highest standard of care and ensure valuable public resources are used effectively to get the best outcomes for individuals, communities, and society now and for future generations.

Locally, clinical commissioning groups, made up of doctors, nurses and other health professionals, buy services for patients, while local councils formally took on their new roles in promoting public health. Health and wellbeing boards bring together local organisations to work in partnership and Healthwatch England provides a powerful voice for patients and local communities. 

Find out more about the new NHS, its structure, new organisations and all changes involved in the process.

Putting Patients First: The NHS England Business Plan for 2013/14 – 2015/16

Putting Patients First explains how NHS England’s commitment to transparency and increasing patients’ voices are fundamental to improving patient care. The plan, published in April 2013, describes an 11 point scorecard which NHS England will introduce for measuring performance of key priorities, focused on receiving direct feedback from patients, their families and NHS staff.

This supports the cultural change needed to put people at the centre of the NHS, a key theme in the report by Robert Francis QC, by making sure patients’ voices are heard and used to deliver better services.

You can download the business plan from NHS England's website.

Updated version of the NHS Constitution published

The NHS CconstitutionAn updated NHS Constitution was published on April 1 2013, following a consultation that sought views on a number of proposed changes. Important areas that were improved include:

  • patient involvement
  • feedback
  • duty of candour
  • end of life care
  • integrated care
  • complaints
  • patient information
  • staff rights, responsibilities and commitments
  • dignity, respect and compassion

There were also some technical amendments to ensure that the NHS Constitution is in line with the new  health and care system introduced in April 2013.

Find out more about the NHS Constitution and learn about your rights as an NHS patient. For more detailed information about the updates to the NHS Constitution or the consultation process visit the GOV.UK website.

Phase 2 of NHS dental contract pilot programme

On October 5 2012, the government announced the publication of its proposals for a second stage of dental contract piloting.

Following a review of the selection process, a further 20 to 25 additional pilots will be recruited into the programme. For the first time, salaried primary dental care services will also be taking part.

Training and induction for successful applicants ran early in 2013, and the second pilot stage went live on April 1 2013.

The NHS friends and family test

Starting from April 2013, patients will be asked whether they would recommend hospital wards and A&E departments to their friends and family if they needed similar care or treatment. This means every patient in these wards and departments will be able to give feedback on the quality of the care they receive.

From October 2013, the test will also be available to women who use maternity services, and as soon as possible after that to everyone using NHS services. Learn more about the NHS friends and family test. Alternativerly, you can download guidance for maternity services and case studies from NHS England's website.

E-cigarettes to be regulated as medicines

E-cigaretteElectronic cigarettes are to be licensed and regulated as an
aid to quit smoking from 2016, it has been announced.

Until this happens, e-cigarettes are only covered by general product safety legislation, meaning they can legally be promoted and sold to children. However, it is currently
uncertain what ingredients are used or how much nicotine they contain. The MHRA will not ban the products entirely during this interim period, but will encourage e-cigarette manufacturers to apply for a medicine licence.

Read the full story E-cigarettes to be regulated as medicines.  

World's first liver kept alive outside the human body and then transplanted successfully

Researchers from Oxford University and King's College Hospital have successfully taken a human liver and kept it alive and functioning on machine outside the patient’s body and then transplanted into a recipient patient. Ian Christie, 62, is the first person to receive a transplanted liver kept alive on the new device.

The National Health Service 65th anniversary

The NHS turned 65 on July 5 2013. The NHS is looking back at the achievements since its launch in 1948 to highlight champions and heroes who make the health service what it is today. Visit the NHS anniversary section

The NHS in 2014

Commonwealth Fund publishes update to the 2010 Mirror, Mirror, on the Wall report

In 2014, the Commonwealth Fund declared that in comparison with the healthcare systems of 10 other countries (Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the US) the NHS was the most impressive overall. The NHS was rated as the best system in terms of efficiency, effective care, safe care, co-ordinated care, patient-centred care and cost-related problems. It was also ranked second for equity.

Page last reviewed: 06/07/2015

Next review due: 06/07/2018

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