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The NHS: An Ever-Changing Health Service - Recent Developments

A look at some of the recent developments in the NHS.
Written on 6/27/13

An Ever Changing Health Service: Recent Developments in the NHS

Whenever the NHS features in the news, public reaction is fierce. The institution is beloved by, and essential to, millions of people - so any proposed changes are always met with considerable interest, discussion and argument.

The NHS was founded in 1948 as a publically funded health service - inevitably, over the course of its lifetime, it has seen significant change. As a large and complex organisation, second only to the Chinese military and Wal-Mart in number of employees, any changes to the structure of the NHS affect a huge section of the population.

Given the sources of its funding, changes to the NHS quickly become political hot topics and must go through extensive debate in Westminster. The ageing population of Britain and the rising cost of treatments means that the organisation must evolve to meet the challenges of the modern world.


In 2013, the most controversial topic of change facing the NHS is structural - and concerns the abolition of what are known as Primary Care Trusts (PCTs): bodies which control and direct local spending on medical care - for dentists, hospitals, tests and medicines. Under the structural changes, PCTs will be replaced by Clinical Commissioning Groups (CCGs) - which are GP rather than health manager led bodies.

In reality, the changes to NHS structure will not have an immediate impact on patients, who will continue to visit their GP or the hospital as before. However, the removal of Primary Care Trusts alters the way funding is directed into patient care - now, CCGs, led by GPs, decide whether or not to fund hospital services.

Greater local control

The reasoning behind the change follows the logic that GPs, rather than management bodies are better placed to decide local funding priorities. Many doctors are positive about the changes and are keen to get involved in decisions regarding their patients' hospital care - others fear that factoring in care costs may compromise the doctor-patient relationship.

The structural changes also have consequences for the way the NHS is run. Before April, 2013, the Secretary of State would pass policies down to Strategic Health Authorities (SHAs) who would implement them through PCTs. The new system abolishes SHAs and passes responsibilities for  overseeing the NHS to a newly-formed Clinical Commissioning Board.

With more control over policy and funding, GPs and local councils hope to be able to acquire and pay for specialist services and react to the needs of their specific areas. Local problems, such as obesity, health and well-being and heart disease will be given much more of a focus under the new structure - and local health groups will be set up to promote community awareness of problems.   

Private competition

Further changes are on the cards for the NHS. The provision of healthcare services has been opened up to competition from private organisations that can match the standards of the NHS in terms of quality, safety and price. A new regulator, called Monitor, has been set up to oversee the introduction of these private bodies into the UK's healthcare system.

It is important to remember, the NHS restructure will not change 'front-line' care. The service remains free at point of patient use - and the way you receive your prescription, go for treatment and book GP appointments is exactly the same as it always was.