HealthManagement, Volume 1 / Issue 1 Spring 2006

Healthcare System

In the UK, the whole population is covered by the National Health System (NHS), which is financed through general taxation and run by the Department of Health. However, responsibility for the purchasing of health care services across the UK rests at the constituent country level: Primary Care Trusts in England, Health Boards in Scotland, local health groups in Wales and Primary Care Partnerships in Northern Ireland. Despite this coverage, there is an increasing trend towards private care and coverage, with 12% of the population contracting additional private health insurance.


Healthcare Facilities, Services & Staff

Throughout the UK, there is a coexistence of public hospitals, private non-profit hospitals and private for-profit hospitals. While hospitals are mainly publicly owned and independently operated, they are organised as hospital trusts with three hierarchical levels: community hospitals, district hospitals, and regional or inter-regional hospitals, as well as a number of specialised hospitals offering advanced treatment.


Primary care services are provided mainly by General Practitioners (GPs), who also act as   “gatekeepers” in providing access to secondary care. Across the UK, there are approximately 3.1 million healthcare and social assistance employees, representing 11% of national employment and 1.4 million employees in the hospital sector, with 67% of all physicians working in hospitals.



Regulation of the healthcare system is decentralised; also carried out at the constituent country level by: the Strategic Health Authorities in England, the Area Health Boards in Scotland, the Local Health Boards in Wales and the Health and National Services Boards in Northern Ireland.


The Role of IT

The NHS has been undergoing drastic changes in the way it operates in order to improve the services it provides and give patients more control over their healthcare. On 1 April 2005 the Department of Health created NHS Connecting for Health – which is responsible for the delivery of the National Programme for IT. Tasked with creating a multi-billion pound IT infrastructure in order to increase efficiency and effectiveness in healthcare services across the UK, the National Programme for IT is responsible for:

+ creating an NHS Care Records Service to improve the sharing of patient records across the NHS with their consent;

+ making it easier and faster for Gps and other primary care staff to book hospital appointments for patients;

+ providing a system for the electronic trans mission of prescriptions, and

+ ensuring that the IT infrastructure canmeet NHS needs now and in the future.


More information on the NHS Connecting for Health Programme is available on their website at