NHS Structure and Pharmacy Role Notes

Understanding the NHS Structure and its Influence on Pharmacy

  • NHS Overview

    • The National Health Service (NHS) is the publicly funded healthcare system in the UK.
    • Provides free services at the point of use.
    • Contains multiple organizations across four regions: NHS England, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland.

  • Establishment

    • Founded on July 5th, 1948, by Health Minister Aneurin Bevan.

  • NHS Constitution

    • Major principles include:
    1. Healthcare for everyone.
    2. Access based on clinical need, not ability to pay.
    3. Commitment to high standards of care.
    4. Focus on patient-centered care.
    5. Responsible spending of taxpayer money.
    6. Collaboration with other organizations.
    7. Accountability to the public.

  • Devolution of Healthcare

    • Health is a devolved matter in the UK; spending is decided by devolved governments, despite central funding from the UK Parliament.

Current NHS Structure

  • Historical Structure:

    • Involves various components, including:
    • Hospital services
    • Primary Care
    • Community Services
    • Boards and committees manage local services and governance.

  • Integrated Care Systems (ICSs)

    • Established in July 2022, these are joint efforts to deliver coordinated, efficient healthcare, integrating various services.
    • Representatives from local authorities and health organizations form integrated care partnerships (ICPs) for strategic planning.
    • Key functions of ICSs:
    • Improving health outcomes
    • Reducing inequalities
    • Enhancing productivity
    • Supporting broader community development.

  • Funding

    • Source: Central government collects funds through taxes and national insurance to allocate to the Department of Health & Social Care.
    • Expenditure (2018/19): £130.3 billion, approx. £2,300 per person in England.
    • Divided into:
    • £5.9 billion for capital spending (infrastructure).
    • £124.4 billion for revenue (salaries, medicines).
    • Local Clinical Commissioning Groups (CCGs) assess local health needs and allocate funds accordingly.

Pharmacy’s Role in the NHS

  • Integration within NHS

    • Pharmacies are vital in both community and hospital settings:
    • Directly funded by NHS for hospital services.
    • Contracted to provide NHS services in community settings.
    • Involved in urgent care and prevention (e.g., health screenings and lifestyle support).

  • Community Pharmacy Contractual Framework (CPCF)(2019-2024)

    • Key agreements include:
    • Launch of pharmacy contraception service.
    • Extension of existing services e.g. Blood pressure checks.
    • Five-year strategy aligning community pharmacy with NHS Long Term Plan priorities.

  • Community Pharmacy Services

    • Divided into:
    1. Mandatory: Dispensing, advising on self-care, etc.
    2. Essential: Flu vaccinations, New Medicine Service, consultations for minor ailments.
    3. Advanced Services: E.g., anticoagulation services, tailored health-checks.

  • Funding Mechanisms

    • Community pharmacies are funded through various channels:
    • Per-activity fees for core services.
    • Payments for advanced/enhanced services.
    • Retained margin from prescription medicine sales based on price discrepancies with the Drug Tariff.

  • Private Healthcare in Community Pharmacy

    • Community pharmacies may offer private services (e.g., vaccinations, consultations).

Conclusion and Learning Objectives Revisiting

  • Factors influencing NHS care provision.
  • Outline of the current NHS structure.
  • Understanding of pharmacy's essential functions within the NHS framework.