How the NHS works

Department of Health

This is the Government department responsible for delivering fast, fair, convenient and high quality health and social care services to the people of England. It has offices in Leeds and London and is responsible for:

• management of the overall health and social care system
• developing policy and managing major change in the NHS
• regulation and inspection of the NHS (increasingly at arms length through organisations such as the Commission for Health Improvement)
• intervention, should problems occur in the running of the NHS at any level.

Strategic Health Authorities

Strategic Health Authorities are responsible for developing strategies for the local health services and ensuring high-quality performance. They oversee the development of the NHS locally and are a key link between the Department of Health and the NHS.They also ensure that national priorities (such as programmes for improving cancer services) are integrated into local plans.

NHS Trusts

Hospital trusts (such as Gloucestershire Hospitals NHS Trust) provide a range of services to local patients such as operations, Accident & Emergency, and outpatient appointments. Except in the case of emergencies, hospital treatment is arranged through your family doctor. This is called a referral. Appointments and treatment are free. Gloucestershire Partnership NHS Trust provides health and social care to people with mental health problems, people with learning disabilities and people who have developed problems with substance misuse. It does this by working in partnership with service users and carers, health and social care organisations such as Social Services, Housing and voluntary agencies.

Ambulance Trusts

Ambulance Trusts (such as Gloucestershire Ambulance Service NHS Trust) provide emergency treatment and transport for people who have had a serious accident or are seriously ill. In addition to this, they also provide a non-emergency transport service for patients receiving treatment at hospitals and treatment centres within and outside the county for specialist services. They work closely with local family doctors in transporting urgent cases to hospital and assist in transferring patients between medical sites.

Primary Care Trusts

PCTs are the cornerstone of the NHS, responsible for the planning and securing of health services and improving the health of the local population.

For example, PCTs must make sure there are enough family doctors to provide for their population and that they are accessible to patients. PCTs must also ensure the provision of other health services including
hospitals, dentists, mental health care, NHS Direct, patient transport (including accident and emergency) , population screening, pharmacies and opticians. In addition, they are responsible for developing closer working with social care so the two systems work together for patients.

The 303 PCTs in England have been given the funding to plan and commission health services for their local communities - a role previously carried out by health authorities. It means that decisions about local services are made at a local level by those best placed to make them.

Primary care

The first port of call for many people when they develop a health problem is their local doctor, also known as a general practitioner (GP) or family doctor. These doctors usually form a small practice or surgery to serve a particular neighbourhood. GPs are on the frontline of the NHS -the part officially called ‘primary care’. Many other health professionals work as part of this frontline team -nurses, health visitors, dentists, opticians, pharmacists and a range of specialist therapists. Every UK citizen has a right to be registered with a local GP and visits to the surgery are free.

NHS Direct -0845 4647

NHS Direct offers fast and free 24-hour advice about personal health care. NHS Direct nurses aim to provide callers with the advice and reassurance they need to care for themselves at home -or, if they need further help, to direct them quickly to the right service at the right time. Information and advice about the most common illnesses and a range of treatments is now also available on NHS Direct online:
www.nhsdirect.nhs.uk/

Dentists
Dentists are specialist health professionals who are specifically trained to look after teeth and mouths. The government has now created the NHS Personal Dental Service (PDS) , which is provided by salaried dentists. PDS provides an emergency and pain relief service with a waiting list for booked appointments. For information about NHS dentists in your area and the Personal Dental Service in the county, contact the Gloucestershire Dental
Helpline on 01452 318858 or NHS Direct.

Optometrists/Opticians
These are specialist health professionals who test eyes and prescribe lenses to correct sight problems. They are more commonly known as opticians. A dispensing optician fits and sells glasses but does not test eyes. An ophthalmic optician specialises in making glasses and in testing eyes and prescribing lenses.

Pharmacists
These are specialist health professionals who make and sell medicines. They usually have a shop in the high street, and are often called ‘chemists’. They are experts on medicines and the way they work and will make up prescriptions issued by your doctor. They can give advice on treatments that can be bought over-the-counter.