London Health Libraries Induction 12 th May The NHS in London

Transcription

1 Induction 12 th May 2011 The NHS in London Alan Fricker Knowledge & Library Service Manager Newham University Hospital NHS Trust

2 Outline NHS structure Trust functions Regulators Clinical governance Policy AHSCs and HIECs

3 NHS Largest employer in Europe 1,431,557: Total number of NHS employees in England: 41,962 managers and senior managers 721,717 professionally qualified clinical staff, including: 39,409 GPs 37,752 consultants 410,615 qualified nurses

4 NHS finance 99.5bn for (according to 2011 Budget) 95% from general taxation and NI protected in CSR Primary Care Trusts > 75% of budget Acute care > 60% expenditure

5 NHS structure (as is / was)

6 NHS Structure The Department of Health enacts the will of Parliament through policy development Strategic Health Authorities (SHAs) manage the NHS locally (except NHS Foundation Trusts). Commissioners (primary care trusts) ensure adequate services are available for their local population by assessing needs and purchasing services. NHS providers, independent contractors and other provider organisations are responsible for providing these services.

7 NHS structure (new!) Diagram from Burningourmoney.blogspot.com

8 Pause Photograph: Dan Kitwood/Getty Images

9 NHS London Strategic Health Authority (SHA) for London (one of 10 SHAs in England) million population with 200 communities and 300 languages spoken 250,000 health and care staff 32 London Boroughs & City of London Mayor + London Assembly = Greater London Authority

10 NHS in London 6 Primary Care Clusters (31 Primary Care Trusts (PCTs)) 21 NHS Trusts (Acute hospitals) 3 Mental Health Trusts London Ambulance Service 15 Foundation Trusts (including 7 mental health)

11 Primary Care Clusters 6 for London: North West London (Brent, Harrow, Ealing, Hounslow, Hammersmith and Fulham, Westminster, Kensington and Chelsea, Hillingdon) Outer North East London (Waltham Forest, Redbridge, Barking and Dagenham, Havering) East London and the City (Newham, Tower Hamlets, City and Hackney) South East London (Lambeth, Southwark, Lewisham, Greenwich, Bexley, Bromley) North Central London (Enfield, Barnet, Haringey, Camden, Islington) South West London (Richmond and Twickenham, Wandsworth, Sutton and Merton, Croydon, Kingston)

12 Primary Care Trusts (PCTs) Key organisations responsible for ensuring there is a comprehensive range of health services for the local population. Public health care assess need and work in partnership Commissioning and contracting services PCTs control the vast majority of the NHS budget and are responsible for commissioning healthcare services for their area. Direct provision of services PCTs have now largely stopped directly providing services to patients (March 2011 was deadline). Governance PCTs hold service providers to account via contracts. PCTs are held to account by the relevant SHA.

13 Service providers Services are delivered to the population via: Acute Trusts Mental Health Trusts Ambulance Trusts GP practices Dental practices Community pharmacies Optical practices Community hospitals NHS, private sector, Third sector, social enterprise

14 How do Foundation Trusts differ? Must meet financial requirements to become one Independent from SHA/DH control Regulated by Monitor Increased financial obligations to maintain surplus Freedoms include: Keep receipts from capital sales Decide how to meet national targets Borrow money under strict conditions Set terms and conditions for staff locally All Trusts must become Foundation Trusts

15 Regulators Care Quality Commission (CQC) - health and adult social care providers in public and independent sectors. Monitor - finances and governance of NHS Foundation Trusts Audit Commission audits NHS Trusts, PCTs and SHAs to review quality of financial systems NHS Litigation Authority handles negligence claims made against member NHS bodies in England via: Clinical Negligence Scheme for Trusts (CNST)

16 Clinical governance System through which NHS organisations are accountable for continuously monitoring and improving the quality of their care and services. Clinical audit Clinical effectiveness Risk management Research and development Education and training

17 NHS Policy Equity & Excellence: Liberating the NHS No decision about me, without me Information revolution Choice Outcomes not targets Payment for performance End of SHAs & PCTs bonfire of the quangos

18 Pause Photograph: Dan Kitwood/Getty Images

19 NHS Policy Liberating the NHS: an information revolution Consultation complete Information = data Lots about us but not named Results of consultation expected soon Strategy to follow

20 Academic Health Sciences Centres (AHSCs) Collaborations between NHS Trusts and academic institutions to improve partnership working and links between teaching, research and clinical practice Imperial, UCL and King s College London

21 Health Innovation and Education Clusters (HIECs) Focus on quality Impact on innovation Cross-sectors, settings, professions Strengthen accountability Support commissioner-provider split Link with AHSCs 17 in all three in London

22 Health Innovation and Education Clusters (HIECs) North East London, North Central London and Essex HIEC, lead by Queen Mary University of London - focus on the prevention of ill health, acute care and chronic conditions North West London HIEC, lead by Chelsea and Westminster Hospital NHS Foundation Trust - focus on cancer and cardiovascular services South London HIEC, lead by Kings College London - focus on diabetes, mental heath services, stroke care and infectious diseases. 11 million between all 17

23 Any questions?