NHS Founding Principles (founded in 1948)
- The NHS should meet the needs of everyone.
- The NHS should be free at the point of delivery.
- The NHS should be based on clinical need, not the ability to pay.
NHS Principles (underpinned by founding principles)
- The NHS provides a comprehensive service available to all. - Access
to NHS services is based on clinical need, not ability to pay. - The NHS
aspires to the highest standards of excellence and professionalism.
- The patient will be at the heart of everything the NHS does. -
The NHS works across organisational boundaries.
- The NHS is committed to providing the best value for taxpayers money. -
The NHS is accountable to the public, communities and patients that it
serves.
NHS Services
Primary care - this is the first point of contact for people who need healthcare,
and acts as a ‘gatekeeper’ to further services.
Examples include GP’s, sexual health clinics and drop-in centres.
Secondary care - services which patients are referred to (following primary
care).
Examples include hospital wards and specialist services.
Emergency care (e.g A&E) also fits into secondary care.
Tertiary care - these are any highly specialised services. Accessed through
referral from secondary care.
Examples include neurosurgery, neonatal intensive care, rehabilitation centres
etc.
, General Practices (GP’s)
- GPs are run as small individual businesses that are contracted to the
NHS.
- Most are run by a GP partnership (usually 2+ GPs working as business
partners). All partners are responsible for fulfilling the NHS contract for
their practice and in return share any profits.
How is the NHS funded?
- The majority of public NHS funding comes from general taxation and
National Insurance Contributions.
↳tax is a compulsory financial charge paid to the government calculated
based off of incomes (other forms such as inheritance tax), national
insurance contributions are similar and a form of tax however are
specifically for social security purposes such as the NHS.
- A small proportion comes from patient charges for services such as
prescriptions and dental treatment.
NHS structure
- HM Treasury controls all public spending and so determines how much is
put into the NHS. Barnett formula used to calculate how much goes to
Wales/Scotland/Northern Ireland.
- This goes to the department of health, which spends some on
governmental health causes e.g public health campaigns and centrally
managed projects.
- The rest of this then goes to NHS England who spend some on nationally
commissioned services and allocate the rest to clinical commissioning
groups (see below) who spend it on local needs (commission the trusts).