Chapter 3: Institutional settings
3.1 NHS and NHS Foundation Trusts
National Health Service (NHS) is a publicly funded health caring system composed by four distinct organizations, namely NHS England, Health and Social Care in North Ireland (HSCNI), NHS Scotland and NHS Wales, with each part operating in its own way. NHS mainly derives money from the country’s tax income, which is paid by all the permanent residences of United Kingdom earning certain amount of income. NHS expenditure takes up the largest proportion of UK’s social benefit expenditure. In this way, about 60 million people in UK are able to enjoy the same-level health care, which also makes the NHS the largest public Health Care System in the world. One thing worth mentioning
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There were 147 NHS Foundation Trusts in total by March 2014. They are authorised and regulated by Monitor, the independent regulator of NHS foundation trusts, and have more financial independence to retain our surpluses and decide how they utilize this money, compared to other NHS trusts that have not gained a foundational status and are still managed by the NHS Trust Development Authority. Not all the NHS Trusts have become NHS Foundation Trusts yet, as some trusts are in the assessment process. In order to achieve Foundation Trust Status, NHS Trusts have to meet a number of requirements. At the early introduction of foundation trusts, they were regarded as a special unit existing in a way between the public and private sectors, as it is originally designed to be a "patient-led" NHS that can get the local people get fully involved and listen to the patients’ real needs. However, these foundation trusts are not as autonomous as expected, and even behave more like public sectors, as the plans to give financial autonomy to these foundation trust proposed by Alan Milburn being …show more content…
The Council of Governors holds the Board of Directors to account for the performance of the Trust including ensuring the Board of Directors acts within the terms of the licence. Governor feedback information about the Trust to members and the local community through a regular newsletter and information placed on the Trust’s website.
The Council of Governors consists of elected and appointed governors. More than half the governors are public governors elected by community members of the Trust. Elections take place once every year, or on other occasions. As for the Council of Governors, it is generally made up of public governors, appointed governors and staff governors. These governors connect the Board of Directors closely with the public and patients. Governors have statutory role. The governors have control over the direction of the FT even without the Board of Directors' permission. The governors can appoint the chair and directors. Moreover, the board of governors can has the rights to appoint or remove trust auditors. The Council of Governors has in place a process for the appointment of the
School governors are a group of people (usually between 10 – 20) who run the school. They are made up of various people who have links with the school and the community. There should be at least one parent and one staff member as well as the Head Teacher. Usually there is a support staff member, a local authority member and a local community governor who work or live in the area. Governors work alongside the Head and are based on different committees and are responsible for different areas of school management – school site, personnel issues or community cohesion. They will usually meet in these committees and report to the full governing body. Their main duties are to set aims and objectives, adopt policies
Today’s changes to the NHS have been called the most radical in the whole of the 60 years that it’s been in existence. In today’s NHS charities and private firms are now involved much more widely, in areas such as mental health and end of life care. Although they do have a much smaller role in hospital setting than they used to have. One of the biggest changes is that doctors now have budgets from which they buy healthcare, it could be from NHS trusts or private sectors, the new scheme is called GP
Key reforms Power to commission services will be devolved to GPs working in consortia. National and regional specialised services will be the responsibility of the new NHS Commissioning Board, not GP consortia. GP consortia will have a duty to work in partnership with local authorities, for example in relation to linking up health and social care. The new NHS Commissioning Board will take over current CQC responsibility for assessing NHS commissioners and will hold GP consortia to account. Role of CQC will be strengthened as the quality inspectorate for health and social care. Monitor will become the economic regulator for health and social care from April 2012.
On the 1st of October 2009, single local health organisation was created, which is responsible for delivering healthcare within geographical area, instead of the Trust and the local health board system. The current NHS services through seven health boards replacing twenty-two and three NHS Trusts replacing seven in Wales. An example of a health board is the Cardiff and Vale University. This health board has Executive Directors, the employees of the University Health Board (UHB), and Independent Board Members (IMs), who were appointed to the UHB Board by the Minister for Health and Social Services. One of the reason for the change was to ensure that all the patients are provided with good services and to make sure that all the individuals’ needs are
The role of the board of directors is to oversee their operations that consists of community-based volunteers. They work with other community members that are composed of youths and graduates of their shelter programs. Also, to provide resources, allocate funds, monitors the activities of management, as well as electing outside individuals to serve as officers of the organization.
The NHS came around in July 5, 1948. The Health Minister Aneurin (also known as Nye) Bevan purely nationalised the existing system across the UK. The groundbreaking change was to make all services freely available to everyone. Half of Scotland’s landmass was already covered by a state-funded health system serving the entire community and directly run from Edinburgh. Additionally, the war years had seen a state-funded hospital building programme in Scotland on a scale unknown in Europe. This was combined into the new NHS. Scotland also had its own individual medical tradition, this is centred on its medical schools rather than private practice. The legislation that empowered the UK to have the NHS is National Health Service Act (1948), this despite opposition from doctors, who maintained on the right to continue treating some patients privately. The NHS ensured that Doctors, hospital, dentists, opticians, ambulances, midwives and health visitors were available, free to everybody. This Reason why we have health services is because it developments a view that health care was a right, not something given unreliably by charity, also two-party’s agreement that the existing services were in a mess and had to be sorted out, it stopped financial difficulties for the voluntary hospitals and After the second world war it ensured the creation of an emergency medical service as part of the war effort
Starting with the organizational structure of the NHS, it is basically an umbrella organization that comprises of four regional branches, in particular, NHS (England), NHS Scotland, Health and Social Care in Northern Ireland and NHS Wales. The financing for all these institutions comes from a universal source, particularly the tax-payer money of residents of UK, although they operate to an extent as self-governing institutions. The treasury allocates money to the department of Health, which in turn allocates money to NHS England (Understanding the new NHS). In other words, the top executives of these four institutions take decisions independently for day to day operations although they abide by broader governing directives applicable to the UK region as a whole. Governance is an important aspect of the operating of the NHS, for without it exploitation by private vested interests is likely to happen. (National Health Service (NHS): A study of its Structure, Funding and Regulation, Strengths and Weaknesses, n.d.)
Their aims are to aid people who are applicable to use their service. They are non-profit and are Governmental, which means that the Government funds the NHS by using a portion tax-payers’ money.
The National Health Service (NHS) was planned as a three-tier structure. With the Minister of Health at the top and below were the three tiers designed to interact with each other to suit the needs of the patient. These tiers were voluntary and municipal hospitals supervised by Regional hospital boards, family doctors, dentists, opticians and pharmacists who were self-employed professionals contracted to the NHS to provide services so that patients did not pay directly and local health authorities like community clinics that provided services such as immunisations, maternity care and school medical services controlled by a local authority Medical Health. The NHS in England is undergoing some big changes, most of which took effect on April 1 2013. This included the abolition of primary care trusts (PCTs) and strategic health authorities (SHAs), and the introduction of clinical commissioning groups (CCGs) and Health watch England.
The governors: they are a team of people who run the school. There can be any number from 10 to 20 people of different backgrounds and vocations. There should be at least one parent governor and at least one staff governor in addition to the head teacher. There will be a local authority governor and a local community governor. Governors will work with the head and the senior leadership team.
It also monitors the quality of services provided and develops new policies. The performance of the NHS is also monitored by the Health-Care Commission, an independent executive agency that performs annual reviews and ratings, and investigates complaints.
The National health services (NHS) provides a comprehensive healthcare services across the entire nation. It is considered to be UK’s proudest institution, and is envied by many other countries because of its free of cost health delivery to its population. Nevertheless, it is often seen as a ‘political football’ as it affects all of us in some way and hence everyone carry an opinion about it (Cass, 2006). Factors such as government policies, funding, number of service users, taxation etc all make up small parts of this large complex organisation. Therefore, any imbalances within one sector can pose a substantial risk on the overall NHS (Wheeler & Grice, 2000). This essay will discuss whether the NHS aim of reducing the nations need
The National Health Service (NHS) was started in 1948 by Aneurin Bevan, the minister of health at the time. It was based on three core principles that still underpin the NHS today. It was set up to ensure that everyone could have access to healthcare, despite their financial circumstances (NHS 2013a). Although the NHS has achieved what it set out to do, it is now in major financial difficulty, with debt that could reach £1bn by the end of 2014 (Campbell 2014).
Joshua Kennon (2007), stated that “The board of directors is the highest governing authority within the management structure at any publicly traded company and is usually made up of the directors who are elected for a specific number of years by the shareholders”. According to Wikipedia,” A board of directors is a body of elected or appointed members who jointly oversee the activities of a company or organization”.
The chairman and the directors of the Board including the Managing Directors are appointed by the Government. The Managing Director, being the chief executive, conducts and manages the affairs and business of the corporation in accordance with the provisions of the Act, regulations, Government instructions and the resolutions of the Board. He is also guided by the sound commercial principles and business practices.