NHS England

{{Main|History of the National Health Service (England)}}

{{Expand section|with=information about the reasons for establishing NHS England|small=no|date=May 2025}}

File:Amanda Pritchard.gif

NHS England is the operating name of the NHS Commissioning Board and, before that, the NHS Commissioning Board Authority.{{cite web|url=http://www.england.nhs.uk/about/ |archive-url=https://web.archive.org/web/20130406154902/http://www.england.nhs.uk/about/ |title=About us |publisher=NHS England |archive-date=2013-04-06 |access-date=2022-07-25 |website=england.nhs.uk}} It was set up as a special health authority of the NHS on 31 October 2011,{{Cite legislation UK |type=si |year=2011 |number=2237 |si=The NHS Commissioning Board Authority (Establishment and Constitution) Order 2011 |article= |date=12 September 2011|accessdate=13 March 2025}} as the forerunner to becoming a non-departmental body on 1 April 2013. It was rebranded as NHS England on 26 March 2013,{{cite web|url=https://www.england.nhs.uk/2013/03/nhs-england/ |title=NHS England Chairman welcomes new name |access-date=2012-04-11 |date=2013-03-26 |publisher=NHS England |website=england.nhs.uk}} although its legal name remains the NHS Commissioning Board.

Sir David Nicholson, who became Chief Executive at the establishment of the Board, retired at the end of March 2014 and was replaced by Simon Stevens. One of Stevens' first acts was to announce a restructure of the 27 area teams, in response to a requirement to reduce running costs, which would reduce staffing by around 500.{{cite news|title=Exclusive: NHS England to cut hundreds of posts in restructure|url=http://www.hsj.co.uk/news/commissioning/exclusive-nhs-england-to-cut-hundreds-of-posts-in-restructure/5073389.article#.VBtGTxLGBJ0|access-date=18 September 2014|publisher=Health Service Journal|date=29 July 2014}} The 27 teams outside London were reduced to 12 in 2015.{{cite news|title=Revealed: NHS England's new area team structure|url=http://www.hsj.co.uk/news/commissioning/revealed-nhs-englands-new-area-team-structure/5075148.article#.VEqx5SsoKzY|access-date=24 October 2014|publisher=Health Service Journal|date=1 October 2015}} Amanda Pritchard, the Chief Operating Officer of NHS England, was promoted to Chief Executive on 1 August 2021.{{cite news |title=Amanda Pritchard appointed as NHS England chief executive |url=https://www.hsj.co.uk/leadership/amanda-pritchard-appointed-as-nhs-england-chief-executive/7030602.article

|access-date=28 July 2021 |publisher=Health Service Journal |date=28 July 2021}}

NHS England produced a planning document – the Five Year Forward View – in October 2014 which envisaged development of new models to suit local needs. In conjunction with the other central regulators, the organisation established what is called a "success regime" in south and mid Essex, North Cumbria and north east and western Devon in June 2015. It was intended to tackle "deep rooted and systemic issues that previous interventions have not tackled across [a] whole health and care economy".{{cite news|title=Mackey: Success regime not working fast enough|url=http://www.hsj.co.uk/topics/quality-and-performance/mackey-success-regime-not-working-fast-enough/7001993.article|access-date=11 March 2016|publisher=Health Service Journal|date=29 January 2016}}

In 2016 it organised the geographical division of England into 44 sustainability and transformation plan areas, with populations between 300,000 and 3 million. These areas were locally agreed between NHS Trusts, local authorities and clinical commissioning groups (CCGs). A leader was appointed for each area, who is to be responsible for the implementation of the plans which are to be agreed by the component organisations. They will be "working across organisational boundaries to help build a consensus for transformation and the practical steps to deliver it".{{cite news|title=The leaders chosen for 41 of England's STPs|url=http://www.hsj.co.uk/sectors/commissioning/revealed-the-leaders-chosen-for-41-of-englands-stps/7003640.article|access-date=8 April 2016|publisher=Health Service Journal|date=30 March 2016}}

In April 2017 it introduced a capped expenditure process, applied to NHS commissioners and providers in the 13 areas across England with the largest budget deficits. It was intended to reduce their spending by around £500 million, and health leaders were told to "think the unthinkable".{{cite news|title='Secret plans' detail severe cuts across the NHS|url=http://www.onmedica.com/NewsArticle.aspx?id=c8ce1445-6dbe-41ab-a71a-f90561233daf|access-date=3 September 2017|publisher=OnMedica|date=28 July 2017}}

In 2022 there were seven regional teams and 10,640 full time equivalent staff.{{cite news |title=The Integrator: The swollen centre |url=https://www.hsj.co.uk/integrated-care/the-integrator-the-swollen-centre/7032551.article |access-date=25 July 2022 |publisher=Health Service Journal |date=1 June 2022}}

NHS England allocates funding (£69.5 billion in 2016/2017) to CCGs in accordance with a funding formula. Until 2016, progress towards the amount indicated by the formula from the historical allocation was slow, and CCGs which were above their allocation did not suffer a reduction. From April 2016, however, CCGs with more than 10 per cent above their fair share were to receive "flat cash" – an effective reduction. This would also ensure than no CCG was more than 5 per cent below its target allocation in 2016/2017.{{cite news|url=http://www.hsj.co.uk/topics/finance-and-efficiency/major-allocations-shakeup-means-real-terms-cuts-for-some-ccgs/7001224.article|title=Major allocations shakeup means real terms cuts for some CCGs|date=17 December 2015|access-date=28 February 2016|publisher=Health Service Journal}}

In October 2016 it introduced the Operational Pressures Escalation Levels (OPEL) system for the management of operational difficulties in English hospitals, replacing the system of red and black alerts which was locally defined. OPELs range from 1 (normal) to 4 (a major crisis requiring external intervention either regionally or nationally).{{Cite web|url=https://www.england.nhs.uk/publication/operational-pressures-escalation-levels-framework/|title=Operational Pressures Escalation Levels Framework|date=6 December 2018|website=NHS England|access-date=2020-04-21}}{{cite news|last1=Edwards|first1=Nigel|title=Black alert? Or many shades of OPEL|url=https://www.nuffieldtrust.org.uk/news-item/black-alert-or-many-shades-of-opel|access-date=12 May 2017|publisher=Nuffield Trust|date=6 January 2017}} This is intended, among other things, to enable comparisons of trends over time and between areas.{{cite news|title=How many hospital black alerts were there this week?|url=https://fullfact.org/health/how-many-hospital-black-alerts-were-there-week/|access-date=12 May 2017|publisher=Full Fact|date=13 January 2017}}

In view of the coronavirus pandemic, the Secretary of State for Health and Social Care directed the NHS Commissioning Board to buy services from the private sector, thereby bypassing CCGs. The Exercise of Commissioning Functions by the NHS Commissioning Board (Coronavirus) Directions 2020 came into force on 20 March 2020, and were revised to widen the definition of independent providers on 27 March.{{Cite web|url=https://www.gov.uk/government/publications/the-exercise-of-commissioning-functions-by-the-nhs-commissioning-board-coronavirus-directions-2020|title=The Exercise of Commissioning Functions by the NHS Commissioning Board (Coronavirus) Directions 2020|date=20 April 2020|website=GOV.UK|language=en|access-date=2020-04-21}} The directive also allowed NHS England to exercise functions normally carried out by CCGs, as the Board deemed appropriate. The direction was in place until the end of 2020.{{Cite web|url=https://www.hsj.co.uk/nhs-england-takes-over-ccg-powers/7027203.article|title=NHS England takes over CCG powers|last=Brennan|first=Sharon|date=23 March 2020|website=Health Service Journal|language=en|access-date=2020-03-25}}

{{See also|General medical services}}

Applications by GPs to reduce their catchment area are dealt with by NHS England.{{cite news|title=NHS England rejects one in four requests to shrink GP catchment areas|url=http://www.pulsetoday.co.uk/political/practice-boundaries/nhs-england-rejects-one-in-four-requests-to-shrink-gp-catchment-areas/20008296.article#.VFazJ5_raKI|access-date=2 November 2014|publisher=Pulse|date=27 October 2014}}

In November 2014, Mr Justice Popplewell declared that NHS England "has acted unlawfully by reason of its failure to make arrangements for the involvement of patients in primary care commissioning decisions as required by the National Health Service Act 2006". The case involved the decision to scrap the minimum practice income guarantee. Richard Stein, a partner at Leigh Day, said the declaration could mean that patients would have to be involved in discussions on changes to the GP contract.{{cite news|title=NHS England primary care decisions 'unlawful', High Court rules|url=http://www.hsj.co.uk/news/exclusive-nhs-england-primary-care-decisions-unlawful-high-court-rules/5077054.article#.VI4neyusUk4|access-date=15 December 2014|publisher=Health Service Journal|date=24 November 2014}}

NHS England awarded a four-year contract to Capita to become sole provider of administrative services including payment administration, management of medical records, and eligibility lists for practitioners for GPs, opticians and dentists across the UK in June 2015.{{cite news|title=Capita is awarded NHS England admin contract worth up to £1bn|url=http://www.cityam.com/218577/capita-awarded-nhs-england-admin-contract-worth-1bn?ITO=related-content|access-date=26 June 2015|publisher=City AM|date=23 June 2015}}

The organisation was reported to be developing a strategy to support the use of personal health records in June 2015. This, it is hoped, could achieve up to £3.4 billion in annual efficiency savings by 2020.{{cite news|title=NHS developing PHR adoption strategy|url=http://www.digitalhealth.net/news/45076/|access-date=11 July 2015|publisher=Digital Health|date=9 July 2015}} In April 2016 it published an index of digital maturity, where each of the 239 NHS trusts assessed its own "readiness", "capabilities" and "enabling infrastructure".{{cite web|title=Digital Maturity Assessment|url=https://www.england.nhs.uk/digitaltechnology/info-revolution/maturity-index/|publisher=NHS England|access-date=1 November 2016}}{{cite news|title=First digital maturity index scores in full|url=http://www.hsj.co.uk/topics/technology-and-innovation/revealed-first-digital-maturity-index-scores-in-full/7003962.article|access-date=19 June 2016|publisher=Health Service Journal|date=12 April 2016}}

In 2018 the NHS app was unveiled, with public backing from Matt Hancock, who presented it as the key to a radical overhaul of NHS technology.{{cite news |title=Matt Hancock's plan for an NHS tech revolution is doomed to fail |url=https://www.wired.co.uk/article/nhs-matt-hancock-technology-innovation |access-date=8 September 2018 |publisher=Wired |date=8 September 2018}}

The NHS Long Term Plan set a target for all secondary care providers to move to digital records by 2024, which "will cover clinical and operational processes across all settings, locations and departments and be based on robust, modern IT infrastructure services for hosting, storage, networks and cyber security."{{cite news |title=Secondary care to 'fully digitise' by 2024 |url=https://www.hsj.co.uk/technology-and-innovation/secondary-care-to-fully-digitise-by-2024/7024117.article? |access-date=11 February 2019 |publisher=Health Service Journal |date=7 January 2019}}

In 2020 the NHS awarded an emergency contract to Palantir Technologies for the creation of a Covid Data Store system for a statutory fee of £1. Palantir then won a £23.5 million contract with the NHS to continue with its work in December 2020. Palantir's involvement with the NHS was subject to criticism from civil liberties groups, including Open Democracy.{{Cite web |date=2020-12-21 |title=Palantir awarded £23m deal to continue work on NHS Covid-19 Data Store |url=https://www.digitalhealth.net/2020/12/palantir-awarded-23m-deal-to-continue-work-on-nhs-covid-19-data-store/ |access-date=2023-04-21 |website=Digital Health |language=en-GB}}

In 2023 the NHS began a procurement process for a Federated Data Platform (FDP).{{Cite web |last=Clark |first=Lindsay |title=NHS England patient data platform procurement, FDP, is live |url=https://www.theregister.com/2023/01/11/nhs_england_launches_procurement_for/ |access-date=2023-04-21 |website=www.theregister.com |language=en}} An FDP would enable every hospital trust and integrated care system (ICS) to have their own platform through which they could connect and share information between them where helpful.{{Cite web |title=NHS England » Digitising, connecting and transforming health and care |url=https://www.england.nhs.uk/digitaltechnology/digitising-connecting-and-transforming-health-and-care/ |access-date=2023-04-21 |website=www.england.nhs.uk}} The FDP would build on the work done with the Covid Data Store .The contract to provide the FDP would be worth up to £480 million.{{Cite web |last=|date=2023-01-11 |title=£480 million NHS Federated Data Platform tender opens |url=https://htn.co.uk/2023/01/11/480million-nhs-federated-data-platform-tender-opens/ |access-date=2023-04-21 |website=htn |language=en-US}} Palantir are widely thought to be the frontrunners to win.{{Cite news |date=2023-02-28 |title=UK consortium takes on Palantir for £480mn NHS data contract |work=Financial Times |url=https://www.ft.com/content/11f250df-5125-4bab-bbee-3c4324685c55 |access-date=2023-04-21}} This has prompted further criticism from civil liberties groups.{{Cite web |title=Why Palantir's latest NHS land-grab is such bad news |url=https://www.opendemocracy.net/en/palantir-foundry-faster-data-flows-nhs-cori-crider-foxglove/ |access-date=2023-04-21 |website=openDemocracy |language=en}}

Specialised services are those provided in relatively few hospitals and accessed by comparatively small numbers of patients, but with catchment populations of usually more than one million. These services tend to be located in specialised hospital trusts that can recruit a team of staff with the appropriate expertise. NHS England is responsible for commissioning £19.3 billion of specialised services in 2021-2 and for dealing with individual funding requests in respect of the specialist services it commissions. There are proposals to move some of this commissioning to integrated care systems. The Shelford Group expressed concerns in May 2022 about services "where the numbers and evidence base supports the planning and provision of care being done at a population size larger than a typical ICS footprint."{{cite news |title=Big hospitals warn NHSE of dangers of ICS takeover |url=https://www.hsj.co.uk/finance-and-efficiency/big-hospitals-warn-nhse-of-dangers-of-ics-takeover/7032453.article |access-date=30 June 2022 |publisher=Health Service Journal |date=17 May 2022}}

In 2015 there was criticism of delays in deciding on a policy for the prescription of Everolimus in the treatment of tuberous sclerosis. Twenty doctors addressed a letter to the board in support of the charity Tuberous Sclerosis Association saying "around 32 patients with critical need, whose doctors believe everolimus treatment is their best or only option, have no hope of access to funding. Most have been waiting many months. Approximately half of these patients are at imminent risk of a catastrophic event (renal bleed or kidney failure) with a high risk of preventable death."{{cite news|last1=Lintern|first1=Shaun|title=Policy delays risk 'preventable deaths', doctors warn NHS England|url=http://www.hsj.co.uk/news/policy-delays-risk-preventable-deaths-doctors-warn-nhs-england/5084158.article#.VTVrEyFVhBd|access-date=20 April 2015|publisher=Health Service Journal|date=14 April 2015}}

It authorises and pays for treatment of narcolepsy with sodium oxybate by means of individual funding requests on the basis of exceptional circumstances. In May 2016 the High Court ordered NHS England to provide funding to treat a teenager with severe narcolepsy. The judge criticised their "thoroughly bad decision" and "absurd" policy discriminating against the girl when hundreds of other NHS patients already receive the drug. The Department of Health is also paying for the treatment of people whose narcolepsy was caused by the swine flu vaccine Pandemrix in 2009–10 by means of private prescriptions outside the National Health Service.{{cite news|title=Judge criticises NHS England for 'totally irrational' drug decision|url=http://www.hsj.co.uk/newsletter/sectors/commissioning/judge-criticises-nhs-england-for-totally-irrational-drug-decision/7004512.article?WT.tsrc=email&WT.mc_id=Newsletter308|access-date=4 May 2016|publisher=Health Service Journal|date=4 May 2016}}

In May 2022 it produced guidance that said 65 of the 154 services they commissioned were ready and suitable to be devolved to the integrated care systems. It is expected that most will be jointly commissioned with their neighbours, rather than on their own.{{cite news |title=ICSs face test to take on billions worth of services |url=https://www.hsj.co.uk/policy-and-regulation/icss-face-test-to-take-on-billions-worth-of-services/7032545.article |access-date=25 July 2022 |publisher=Health Service Journal |date=31 May 2022}}

The organisation's responsibilities include arbitration in disputes between clinical commissioning groups and NHS trusts.{{cite news|title=Mapped: Quarter of area teams resort to NHS England arbitration|url=http://www.hsj.co.uk/news/mapped-quarter-of-area-teams-resort-to-nhs-england-arbitration/5083396.article|access-date=1 May 2015|publisher=Health Service Journal|date=19 March 2015}}

{{Reflist}}

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{{NHS England |state=expanded}}

{{Department of Health (United Kingdom)}}

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Category:Department of Health and Social Care

Category:Non-departmental public bodies of the United Kingdom government

Category:National Health Service (England)

Category:2011 establishments in England

Category:Government agencies established in 2011