The changing health service

The entire infrastructure of the NHS in England is being revamped on 1 April.

Primary care trusts and strategic health authorities are being scrapped and replaced by the NHS Commissioning Board and 211 clinical commissioning groups (CCGs).

Along with councils, which are getting responsibility for public health, they will determine what services are provided.

Constructed around these organisations is a complex infrastructure designed to ensure the NHS is properly accountable, coordinated and regulated.

There are two main regulators - the Care Quality Commission (CQC) and Monitor. The CQC will be in charge of ensuring services meet the required quality standards, while Monitor will be more focused on finance and competition.

And each local authority area will have its own Healthwatch body representing patients.

Meanwhile, councils have had to set up health and wellbeing boards that include representatives from CCGs, hospitals and patient groups as well as councillors.

They have the job of ensuring services are integrated and co-ordinated across the NHS, social care and public health sectors.

There are also strict rules regarding CCGs. They will need to have a written constitution and a governing body, composed of a nurse, lay people and a hospital specialist.

And the NHS Commissioning Board has a series of regional offices (to provide oversight on the ground) and strategic networks (to provide expert advice to CCGs in areas such as dementia, heart disease and cancer).

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