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• England
• Northern Ireland
• Wales
• Scotland

England

In July 2000, the Government’s NHS Plan promised investment, reform and a shift in power towards principal healthcare professionals and patients. Old health authorities were disbanded and replaced by 28 Strategic Health Authorities.

Primary Care Trusts

A fundamental part of this reform was the setting up of Primary Care Trusts. Primary Care Trusts are local organisations responsible for managing health services in the community. They are comprised of:

• GPs
• Community nurses
• Local community hospitals (not acute hospitals – see NHS Trusts below)
• Mental health services
• NHS Direct
• NHS Walk-in Centres
• Patient transport (including ambulances)
• Screening and health promotion programmes
• Dentists
• Pharmacists
• Opticians

They are also responsible for the integration of health and social care, ensuring that local health organisations work together with local authorities.

It is intended that Primary Care Trusts receive 75% of the NHS budget to provide effective health and social care. They are responsible for ensuring that the services available can meet the demand from people in the local community and that they are accessible to them.

NHS Trusts

NHS Trusts manage the acute hospitals which are responsible for providing medical and surgical treatment and care whether it is planned or an emergency. They are also responsible for the development and improvement of services. The Trusts employ NHS staff including medical personnel, such as doctors and nurses, and non-medical personnel, such as porters and receptionists.

Both Primary Care Trusts and Acute Hospital NHS Trusts are accountable to the Strategic Health Authorities. They are both responsible for developing working relationships by means of service level agreements.

Northern Ireland

In Northern Ireland, Health and Personal Social Services are provided as one integrated service. The four health and social services boards are agents of the Department of Health, Social Services and Public Safety (DHSSPS) in planning, commissioning, monitoring and purchasing services for the residents in their areas. The nineteen Health and Social Services (HSS) Trusts are the providers of health and social services. They manage staff and services and control their own budgets.

Wales

In Wales, there are 22 local health boards which cover exactly the same areas as the 22 local authorities in Wales. This facilitates closer working relationships between the NHS and local councils. Within the 22 local areas there are Primary Care providers, principally GPs, community nurses, physiotherapists and other health care professionals, which broadly fulfil the role of the English Primary Care Trusts. There are also fourteen NHS Trusts in Wales, covering broadly the same responsibilities as their equivalents in England.

Scotland

In Scotland, the NHS is divided into NHS Boards. The role of these Health Boards is the protection and improvement of the health of their respective residents through implementation of The Health Improvement Programme. This is intended to improve co-operation not only between Trusts but also with the Local Authorities. Primary Care Trusts and Acute Hospital Trusts, responsible for acute hospital services, operate within the geographical boundaries of individual Health Boards.

 
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