Ultimate NHS & Doctor's Training Guide 2024

The Funding of NHS

The National Health Service (NHS) is primarily funded by the UK government. In 2021, the Department of Health and Social Care was allocated a substantial budget of approximately £190bn, with the lion's share of over £130bn directly supporting the operations of the NHS.

How the NHS Spends Its Budget

While some NHS funding is earmarked for national initiatives, such as specialised treatments for rare cancers, the majority is dispersed to local Clinical Commissioning Groups (CCGs). These key organisations are responsible for understanding and addressing the unique healthcare needs of their local communities.

Understanding CCGs: The Gatekeepers of Local Health Services

CCGs play a pivotal role in the structure of the NHS. Their funding allocation is influenced by various factors, such as local population size, average age, and levels of deprivation. These insights allow them to direct resources strategically to services including hospitals and GP practices, ensuring the needs of their communities are met.

The Role of CCGs in Broader NHS Structure

Beyond their individual remits, CCGs are part of a wider network of health and social care commissioners, including non-NHS local authorities. Together, these groups form Sustainability and Transformation Partnerships (STPs) to ensure strategic and coordinated healthcare provision.

From STPs to Integrated Care Partnerships (ICPs)

ICPs are the operational units within this system. They bring together NHS trusts that provide acute, community, and mental health care, along with other providers of NHS-funded care, such as GPs, voluntary sector organisations, social enterprises, and even private sector partners. This collaborative approach enables a holistic delivery of care that meets the diverse needs of each locality.

Navigating the Future with Integrated Care System (ICS) Boards

To further streamline the process, NHS is transitioning to Integrated Care Systems (ICSs). Under ICSs, CCGs and STPs will work together more closely under a unified ICS board. This move is designed to foster improved cooperation and ensure that healthcare provision is as effective, efficient, and equitable as possible.

In this way, the complex system of NHS funding, and the interconnected roles of CCGs, STPs, and ICSs, allow for flexible, community-focused healthcare throughout the UK.

The Structure of NHS Trusts

The NHS is comprised of numerous trusts, each responsible for different aspects of care. They include:

1. Acute Trusts: These trusts are responsible for short-term care, typically in a hospital setting, such as emergency medicine, surgery, and general medical care.

2. Mental Health Trusts: These specialise in mental health services, including counselling, psychotherapy, and psychiatric care.

3. Community Trusts: These provide care in a community setting, such as district nursing, health visiting, or care in a patient’s home.

4. Ambulance Trusts: These trusts are responsible for providing responsive care in emergency situations and patient transport.

Understanding how these trusts interact and collaborate can help you navigate the system more efficiently and advocate for your patients better.

Primary Care Networks (PCNs)

Primary Care Networks are groups of local GP practices working closely with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas. They are an essential part of the NHS structure and are designed to offer integrated, patient-centred care.

Healthcare Professions Regulators

As a prospective doctor, you should also be aware of the General Medical Council (GMC). The GMC maintains the official register of medical practitioners within the United Kingdom, sets the standards for medical schools, and manages the licensing process.