A Valiant Attempt To Explain The Inexplicable: The Structure Of The NHS In England

(Last Updated On: October 30, 2017)


During a commercial break in a recent radio interview, I was asked: “During the next segment (about four minutes) could you try to explain the structure of the UK’s National Health Service?” Sadly, the shot answer was: “Sorry, but I don’t think there’s anyone in the NHS itself who could do that”. Not to mention that my audience was, predominantly, American, and specifically those who tend to believe that state-run health care is the political equivalent of ‘original sin’.

Since then, I found this video, released by The King’s Fund, in June, 2013. It’s worth noting, that the video only covers the basics, and only for the NHS in England. Arrangements are devolved, and are different, in each of Scotland, Wales and Northern Ireland. I should say, at this point:

The King’s Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.

The King’s Fund

The NHS will be 67 years old on 5 July, 2015. In that time, our health system has undergone profound change, following the Health and Social Care Act, 2012, introducing the most wide-ranging reforms since the NHS was founded in 1948.

In thanking The King’s Fund for their video, I should also point out that it runs for six minutes and thirty seconds, and, intentionally, only covers England. Now I don’t feel so bad for avoiding the temptation to describe the UK-wide structure, since it is really a multitude of interlocking, and competing structures, in less than four minutes.

As we approach a general election, in May 2015, I have no idea what will happen to the NHS, except that whichever party, or parties, end up in government, The NHS will be changed, and reorganised… again…

The good news is that The NHS has, so far, survived seventeen UK general elections, not because of governments, but in-spite of them.

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