It is important to understand the structure of the NHS, as you may be asked about it during an interview. You need to be aware of many different organisations, so in this guide, we will go over the various organisations you need to know. Then, we’ll look at a question and model answer relating to the structure of the NHS.
Written by Sharon Daniel
What Is The NHS Structure?
In basic terms, the NHS Structure is how the UK’s primary healthcare is currently set up. It features organisations and departments for the different needs throughout healthcare.
Significant changes to the structure of the NHS occurred in 2012 with the introduction of the Health and Social Care Act. Here are some of the critical organisations you need to know:
Primary Care
This is the first stage of referral and the first person a patient sees, such as a GP. They can perform certain medical procedures, such as vaccinations, and can help manage chronic conditions, such as asthma.
Secondary Care
You access secondary care via a referral from primary care. It is usually provided by hospital specialists, such as a consultant in cardiology.
Tertiary care
Tertiary care can be accessed via a referral from secondary care. It provides very specialised services, such as complex surgical treatments.
Quaternary Care
Patients with very rare conditions use extremely specialised care services, which are not commonly available.
Department of Health
They deal with funding and decide policies relating to healthcare in the UK.
Clinical Commissioning groups (CCGs)
They receive funding, which they use to fund care in the local area through primary, secondary and tertiary services. There are multiple CCGs across the country.
NHS Foundation trusts
When the CCGs commission care services, the foundation trusts carry out the care, such as the ambulance services.
NHS England
The governing body that oversees healthcare. The Department of Health can’t interfere with its decisions.
National Institute for Health and Care Excellence (NICE)
Provide recommendations for treatment options to treat different conditions. They help with regulating clinical practice guidelines
Health Education England
Help to ensure that members of the NHS workforce are trained correctly and committed to lifelong training and education.
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Regional Devolution in the NHS
Each country in the UK has its own NHS services, so each country has the power to run its country’s NHS system the way it sees fit.
There have been talks about having even more regional devolution, which would see specific regions have more control over their own NHS operations. This was tested in Manchester in 2016, where Manchester had control of its healthcare spending and decisions. Some key points from this were that more money was invested into paediatric mental health services, and 6000 people who were out of work due to poor health were supported in returning to work.
Example Medicine Interview Question - The NHS Structure
Questions relating to the structure of the NHS could involve asking you about the structure of the NHS and, following that, asking about the challenges facing the NHS.
Example Interview Question
How is the NHS structured today?
Model Answer
The structure of the NHS is constantly changing, and particularly significant changes were made following the Health and Social Care Act 2012.
In terms of levels of care, there is primary, secondary, tertiary and quaternary care. Primary care is the first stage of a referral and includes GPs. Secondary care is used following a referral from primary care. It involves specialists in hospitals, such as dermatologists.
Tertiary care is a specialised service accessed via a referral from secondary care. They can provide services such as specialised surgery. Quaternary services are uncommon, but they are highly specialised services. For example, they can be used to treat patients with rare conditions.
On a more government level, there is the Department of Health, which deals with funding and policies related to healthcare in the UK. NHS England oversees healthcare, and the Department of Health can’t interfere in their decisions.
Other organisations include the clinical commissioning groups, which decide what services need funding in the local area through the use of primary, secondary, and tertiary services. NICE provides recommendations for treatment options and regulates clinical practice guidelines. Health Education England UK is also involved in training the NHS workforce and ensuring commitment to lifelong training and education.
The structure of the NHS is complex, but it is made up of care services, governmental organisations such as the Department of Health and NHS England, and other organisations such as clinical commissioning groups, NICE, and Health Education England.
This answer explains the critical parts of the NHS. It starts with an explanation of the Health and Social Care Act. Each organisation is named within the body of the answer, and its role is described. The conclusion summarises the points made throughout the answer, making it easier for the interviewer to remember what you discussed during your answer.
This question was very much based on factual knowledge, but you may be asked more complicated questions that require more opinionated thought. Examples could include:
- What are your thoughts on the current NHS structure?
- How would you improve the structure of the NHS?
- What major issues do you see within the structure of the NHS?
These questions would be much harder to answer for most applicants, so it’s less likely that you’ll encounter these. However, it’s important to understand the topic, so I hope this guide has helped you feel more prepared.
If you’d like to learn about more medicine topics for your interview, be sure to check out our library of free guides. If you want to learn even more about how to succeed in an interview, you can access our pool of expert tutors when you join 6med with our Interview Tutoring Bundles or Medicine Mastery Bundles. Each one offers you the tools you need to effectively prepare for the medicine application, so discover them today or book a consultation to speak with our team.
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