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The NHS System


NHS England

NHS England replaced NHS Commissioning Boards as from 1st April 2013. It plays a key role in the Government's vision to modernise the health service with the key aim of securing the best possible health outcomes for patients by prioritising them in every decision it makes.

NHS England is an independent body that supports NHS services nationally and ensures that money spent on NHS services provides the best possible care for patients. It funds local clinical commissioning groups to commission services for their communities and ensures that they do this effectively.

Some specialist services continue to be commissioned by NHS England centrally where this is most efficient. Working with leading health specialists, NHS England brings together expertise to ensure national standards are consistently in place across the country. Throughout its work it promotes the NHS Constitution and the Constitution's values and commitments.
For more information go to www.england.nhs.uk/


Clinical Commissioning Groups

Healthcare professionals joined together to form Clinical Commissioning Groups (CCGs). CCGs are able to commission services for their local community from any service provider which meets NHS standards and costs.  These could be NHS hospitals, social enterprises, voluntary organisations or private sector providers.

Health and Wellbeing Boards
Health and Wellbeing Boards are set up in every area.  They make sure that all the services commissioned work together and respond to communities’ needs and priorities.
They do this by bringing together local commissioners from the NHS, public health and social care, elected representatives and representatives of Healthwatch. The Clinical Commissioning Groups are responsible for the NHS Budget, subject to Parliamentary approval.



Healthwatch logoHealthwatch is the new consumer champion for both health and social care. It runs in two distinct forms – Local Healthwatch, at local level, and Healthwatch England, at national level.


Healthwatch England
Healthwatch England is a national body to represent the views of the public at the highest level, making sure that the voices of the people who use health and social care services are heard by the Secretary of State, the Care Quality Commission, the NHS Commissioning Board, Monitor and every local authority in England.
They use evidence based on real experiences to highlight national issues and trends and raise these at the highest levels.

They actively seek views from all sections of the community – not just from those who shout the loudest, but especially from those who sometimes struggle to be heard.

For more information go to: http://www.healthwatch.co.uk/


Local Healthwatch

Local Healthwatch have additional functions and powers such as establishing relationships with local authorities, CCGs, patient representative groups, the local voluntary and community sector and service providers to ensure it is inclusive and truly representative of your local community.

A Local Healthwatch is an independent organisation, which can employ its own staff and involve volunteers, so that the public have a stronger voice to influence and challenge how health and social care services are provided in their area. Local Healthwatch enables people’s views and concerns about their local health and social care services to be shared and understand that their contribution will help build a picture of where services are doing well and where they can be improved.

Local Healthwatch is funded by local authorities and held to account by them for their ability to operate effectively and be value for money.

The Health and Social Care Act 2012 states that local authorities will have to provide an advocacy service to people who wish to make a complaint about their experience of the local NHS. Local authorities have the responsibility to commission the service from any provider including Local Healthwatch.

Local Healthwatch has a seat on the health and wellbeing boards, ensuring that the views and experiences of patients, carers and other service users are taken into account when local needs assessments and strategies are prepared, such as the Joint Strategic Needs Assessment (JSNA) and the authorisation of Clinical Commissioning Groups. Healthwatch has a role in promoting public health, health improvements and in tackling health inequalities.

Local Healthwatch has the power to enter and view services being provided and be able to alert Healthwatch England and the Care Quality Commission to any concerns about specific care providers.

Local Healthwatch provides or signposts people to, information about local health and care services and how to access them.  They also provide people with information about their choices and what to do when things go wrong; this includes either signposting people to the relevant provider, or itself providing (if commissioned by the local authority), support to individuals who want to complain about NHS services.

Local Healthwatch will provide authoritative, evidence-based feedback to organisations responsible for commissioning or delivering local health and social care services.

To find your Local Healthwatch go to: http://www.healthwatch.co.uk/find-local-healthwatch


Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategies (JHWSs)

A Joint Strategic Needs Assessment (JSNA) is an assessment of health and social care needs of local populations that could be met by local authorities, CCGs and local partners. A Joint Health and Wellbeing Strategy (JHWS) is a strategy (plan) for meeting the needs identified in JSNAs.

Both JSNAs and JHWSs, are prepared by local authorities and CCGs and are unique to each local area. The Health and Wellbeing Boards, however, have overal responsibility for these.

JSNA’s provide analyses of data to show the health and wellbeing status of local communities, define where inequalities exist, provide information on local community views and evidence of effectiveness of existing interventions which will help to shape future plans for services, make specific recommendations based on the information and evidence collected.

Health and Wellbeing Boards can request relevant information from members and other organisations when preparing JSNAs or JHWSs and they have a duty to supply the information.

The JHWSs should explain what health and wellbeing priorities the Health and Wellbeing Board has set. They should be available for download from your local authority.

For more information on JSNAs go to: http://www.ic.nhs.uk/jsna


Public Health England

Public Health England has been established to protect and improve the nation’s health and wellbeing, and to reduce inequalities. It provides national leadership and expert services, to support public health and work with local government and the NHS to respond to emergencies.

You can download the Structure of Public Health England Factsheet here:


Health Education England

Health Education England logoHealth Education England ensures that the healthcare workforce has the right skills and training to improve the care patients receive. It supports a network of Local Education and Training Boards (LETBs) that will plan the education and training of the workforce to meet local and national needs.

For more information go to: http://healtheducationengland.dh.gov.uk/


The National Institute for Health and Care Excellence (NICE)

NICE website logoThe National Institute for Health and Care Excellent (NICE) provides guidance to healthcare professionals and others to make sure that the care they provide is of the best possible quality and offers the best value for money.  They help health and social care professionals deliver the best possible care based on independent, authoritative and evidence-based guidance.
Their guidance is for the NHS, local authorities, charities, and anyone with a responsibility for commissioning or providing healthcare, public health or social care services.

For more information go to: http://www.nice.org.uk/


The National Institute for Health Research (NIHR)

National Institute for Health Research logo The mission of the National Institute for Health Research (NIHR) is to maintain a health research system in which the NHS supports outstanding individuals, working in world class facilities, conducting leading edge research focused on the needs of patients and the public.

The NIHR is funded through the Department of Health to improve the health and wealth of the nation through research.

For more information go to: http://www.nihr.ac.uk/about/Pages/default.aspx


The Care Quality Commission

Care Quality Commission logoThe Care Quality Commission (CQC) is the independent regulator of all health and social care services in England. Their job is to make sure that care provided by hospitals, dentists, ambulances, care homes and services in people’s own homes and elsewhere meets national standards of quality and safety. They assess the quality and safety of services against government standards through its registration, regulation and monitoring of services, ensuring that people are treated with dignity and respect. Healthwatch England will work as part of the CQC.
For more information go to: http://www.cqc.org.uk/



Monitor logoMonitor is the independent regulator of NHS foundation trusts.  They were established in January 2004 to authorise and regulate NHS foundation trusts. They are independent of central government and directly accountable to Parliament.

For more information go to: http://www.monitor-nhsft.gov.uk/


The Health Research Authority (HRA)

The Health Research Authority logoThe Health Research Authority (HRA) works to protect and promote the interests of patients and the public in health research.

For more information go to: http://www.hra.nhs.uk/


NHS Improvement

NHS Improvement logoNHS Improvement supports foundation trusts and NHS trusts to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable



The Medicines and Healthcare Products Regulatory Agency  (MHRA)

MHRA logoThe Medicines and Healthcare products Regulatory Agency (MHRA) is the government agency which is responsible for ensuring that medicines and medical devices work, and are acceptably safe. The MHRA is an executive agency of the Department of Health.

Part of their role is to:

  • assess the safety, quality and efficacy of medicines and authorise their sale or supply in the UK for human use
  • investigate and monitor adverse reactions to medicines and adverse incidents involving medical devices and take any necessary action to safeguard public health, for example through safety warnings, removing or restricting the availability of products or improving designs
  • regulate clinical trials of medicines and medical devices
  • provide the public and professions with authoritative information to enable informed dialogue on treatment choices

For more information go to:


To download The Health and Social Care Act 2012 go to:



Last updated 11/4/2016