NHS bodies and their roles
18.2The Secretary of State for Health has overall responsibility for the NHS and plays a key strategic role, particularly by setting the annual NHS Mandate for England.
18.3NHS England is the operational name of the National Health Service Commissioning Board, which was created by section 9 of the Health and Social Care Act 2012. It licenses and to some extent manages Clinical Commissioning Groups. It also commissions a range of specialist NHS services, pursuant to NHSA 2006 ss1H and 3A including:
i)primary care (from GPs, which are almost entirely private sector businesses);
ii)dental services (which are almost entirely private sector businesses);
iii)prison health services;
iv)medical services for the armed forces;
v)services for patients with rare conditions; and
vi)a range of specialised, tertiary acute services (eg high security psychiatric services).
18.4Clinical Commissioning Groups are corporate bodies created by section 10 of the Health and Social Care Act 2012, comprised of local GPs who hold NHS commissioning contracts with NHS England, whose function is to commission a range of acute and community NHS services for patients within its area of responsibility, other than the primary care, dental and specialist services commissioned by NHS England. Provision is largely made by NHS Trusts and NHS Foundation Trusts (which are intended shortly wholly to replace NHS Trusts).
18.5Local authorities (unitary authorities or county councils) became responsible for public health commissioning, by virtue of sections 29-31 of the Health and Social Care Act 2012.
18.6There are also numerous regulatory bodies:
•the Care Quality Commission
1www.cqc.org.uk/.oversees the provision of safe, effective, compassionate and high quality care in hospitals, care homes, dental and GP surgeries and all other care services in England;
•NHS Improvement
2https://improvement.nhs.uk/.brings together Monitor, the NHS Trust Development Agency and the Patient Safety elements operated by NHS England and aims to protect and promote the interests of patients by ensuring that the whole health sector works for their benefit – in effect it regulates competition within the NHS and manages performance generally;
•Healthwatch England and Local Healthwatch organisations
4www.healthwatch.co.uk/.are founded by Chapter 1 of Part 5 of the Health and Social Care Act 2012 and are designed to feed the voice of the patient into the NHS and to champion their interests (there are now 152 Local Healthwatch groups);
•Health Overview and Scrutiny Committees, set up by Chapter 3 of Part 12 of the NHSA 2006, are comprised of members of the local social services authority. They may review and scrutinise any matter relating to the planning, provision and operation of the health services in their area and are entitled to be consulted about any substantial development of the health service in their area and to refer any objection on their part to the Secretary of State for Health (see Part 4 of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013);