NHS

In your opinion, what would you say were the most significant moments in the history of the Italian Health Service?

the NHS includes:

• National Health Service (England)
• Health and Social Care in Northern Ireland
• NHS Scotland
• NHS Wales

key roles of CCGs

after 2010

The present day NHS is undergoing major changes in its core structure, including who makes decisions about NHS services, service commissioning, and the way money is spent.

2010

1970s

1980s

1978 – the world's first baby is born as a result of in vitro fertilisation (IVF)Louise Brown, the world's first test-tube baby, is born on July 25 1978. Her parents Lesley and John Brown had failed to conceive because of her mother's blocked fallopian tubes.

Dr Patrick Steptoe, a gynaecologist at Oldham General Hospital, and Dr Robert Edwards, a physiologist at Cambridge University, develop a new technique to fertilise an egg outside a woman's body before replacing it in the womb.

1979 – the first successful bone marrow transplant on a child takes place

Professor Roland Levinsky performs the UK's first successful bone marrow transplant on a child with primary immunodeficiency at Great Ormond Street Hospital for Children. Bone marrow is responsible for creating the body's immune system.

1960s

The NHS in 2000 - the new millennium

1986 – first AIDS health campaign. After a number of high-profile deaths, the AIDS advertising campaign sets out to shock, using images of tombstones and icebergs. It was followed early in 1987 by a household leaflet carrying the slogan "Don't die of ignorance".

This campaign was in line with the original NHS intention to improve health and prevent disease, as well as offer treatment.

Watch the original TV ad 'The Aids Monolith' on the National Archives website. Read more information about AIDS and HIV.

pubblicità progresso Italia fine anni 80

1987 – heart, lung and liver transplant

Professor Sir Roy Calne and Professor John Wallwork carry out the world's first liver, heart and lung transplant at Papworth Hospital in Cambridge. Professor Calne describes the patient as "plucky" and she survives for a further 10 years after the procedure. Her healthy heart is donated to another transplant patient.

2011

1960- first UK kidney transplant

The first UK kidney transplant takes place at Edinburgh Royal Infirmary on October 30 1960 and involves an identical set of 49-year-old twins. The procedure is a success, with both donor and recipient living for a further six years before dying of an unrelated illness.

1961 – the contraceptive pill is made widely available

The launch of the contraceptive pill, which suppresses fertility with either progestogen or oestrogen or, more commonly, a combination of both, plays a major role in women’s liberation and contributes to the sexual freedom of the so-called Swinging Sixties. Initially, it is only available to married women, but the law is relaxed in 1967.

Between 1962 and 1969, the number of women taking the pill rises dramatically, from approximately 50,000 to 1 million.

NHS walk-in centres introduced

NHS walk-in centres (WiCs) offer convenient access to a range of NHS services. They used to be managed by primary care trusts (PCTs), but since April 1 2013 this role falls to Clinical Commissioning Groups (CCGs). WiCs are usually run by nurses and are available to everyone. You do not need an appointment or to be registered to visit a walk-in centre. Most centres are open every day of the year and are situated in convenient locations, giving patients access to services outside regular office hours.

There are around seven million attendances at type 3 A&E services (i.e WiCs, Urgent Care Centres and Minor Injury Units) in England, dealing with minor illnesses and injuries.

The NHS Plan

The NHS Plan brings about the biggest change to healthcare in England since the NHS was formed in 1948. It sets out how increased funding and reform will eliminate geographical inequalities, improve service standards and extend patient choice. It outlines the vision of a health service designed around the patient.

1950s

National Health Service

1990s

1953 – DNA structure revealed

On April 25, James D Watson and Francis Crick, two Cambridge University scientists, describe the structure of a chemical called deoxyribonucleic acid in Nature magazine.

1954 – smoking and cancer link established

In the 1940s, the British scientist Sir Richard Doll begins research into lung cancer after incidences of the disease rise alarmingly. He studies lung cancer patients in 20 London hospitals and expects to reveal that the cause was fumes from coal fires, car fumes or tarmac. His findings surprise him and he publishes a study in the British Medical Journal, co-written with Sir Austin Bradford Hill, warning that smokers are far more likely than non-smokers to die of lung cancer. Doll gives up smoking two-thirds of the way through his study and lives to be 92. 

history and key facts

1994 - NHS organ donor card

The NHS Organ Donor Register is launched in October 1994.

1990 – NHS Community Care Act

Now health authorities will manage their own budgets and buy health care from hospitals and other health organisations. In order to be deemed a 'provider' of such health care, organisations will become NHS trusts – independent organisations with their own managements.

1991 – first 57 NHS trusts established

New NHS trusts will aim to encourage creativity and innovation and challenge the domination of the hospitals within a health service increasingly focused on services in the community.

As of March 2014 there are 147 NHS Foundation Trusts

2012

1948

1998

July 5 1948 – The NHS is born

When health secretary Aneurin Bevan opens Park Hospital in Manchester it is the climax of a hugely ambitious plan to bring good healthcare to all. For the first time, hospitals, doctors, nurses, pharmacists, opticians and dentists are brought together under one umbrella organisation to provide services that are free for all at the point of delivery.

The central principles are clear: the health service will be available to all and financed entirely from taxation, which means that people pay into it according to their means.  

This service will go on to become one of the largest single e-health services in the world, handling more than half a million calls each month. It is the start of a growing range of convenient alternatives to traditional GP services – including the launch of NHS walk-in centres, which offer patients treatment and advice for a range of injuries and illnesses without the need to make an appointment.

The NHS Direct service closed in 2014. Instead, you can call NHS 111, a new non-emergency number that was introduced to make it easier for people to access local NHS healthcare services in England. You should call 111 when you need medical help fast but it’s not a 999 emergency.

The NHS is undergoing major changes in its core structure. The new health and care system became fully operational on April 1 2013. It delivers the ambitions set out in the Health and Social Care Act.

• Public Health England,
• the NHS Trust Development Authority
• Health Education England

took on their full range of responsibilities at the same time.

NHS England is an independent body, separated from the government. Its main aim is to improve health outcomes for people in England. It will do this by creating the culture and conditions for health and care services and staff to deliver the highest standard of care and ensure valuable public resources are used effectively to get the best outcomes for individuals, communities, and society now and for future generations.

Locally, clinical commissioning groups, made up of doctors, nurses and other health professionals, buy services for patients, while local councils formally took on their new roles in promoting public health. Health and wellbeing boards bring together local organisations to work in partnership and Healthwatch England provides a powerful voice for patients and local communities.

http://www.salute.gov.it/portale/salute/p1_3.jsp?tema=Tu_e_il_Servizio_Sanitario_Nazionale

From what you have learnt so far, in your opinion, what are the main differences between the British and Italian National health services?

what is different in terms of

• administration
• finance
• erogation of services

All services are often referred to as "the NHS", although only the English NHS is officially called the "National Health Service"

General practice

http://www.nhs.uk/Pages/HomePage.aspx

General practitioners (GPs) work in primary care and are part of a clinical commissioning group (CCG) which have responsibility for purchasing healthcare from secondary healthcare providers, such as acute/hospital and community/mental health trusts and the independent and voluntary sector.

Changes to the healthcare system in England means that the NHS will need more GPs in the future and the number of training places is increasing. It is anticipated that up to 50% of all specialty training places in the future will be in general practice.

What is the tone of Michael Moore’s questions?

Why is Michael Moore focussing on the Doctor’s wage, what does he find bizarre?

What is an average wage for a doctor? How can a doctor get paid more?

What does the new system mentioned by the doctor entail?

Call 111 when it's less urgent than 999

NHS 111 is a new service that's being introduced to make it easier to access local NHS healthcare services in England. NHS 111 is a fast and easy way to get the right help, whatever the time. NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones.

When to use it

You should use the NHS 111 if:

• you need medical help fast but it's not a 999 emergency
• you think you need to go to A&E or need another NHS urgent care service
• you don't know who to call or you don't have a GP to call
• you need health information or reassurance about what to do next
• For less urgent health needs, contact your GP or local pharmacist in the usual way.
• If a health professional has given you a specific phone number to call when you are concerned about your condition, continue to use that number.

The NHS 111 service is staffed by a team of fully trained advisers, supported by experienced nurses and paramedics. They will ask you questions to assess your symptoms, then give you the healthcare advice you need or direct you straightaway to the local service that can help you best. That could be

A&E,

an out-of-hours doctor,

an urgent care centre or a walk-in centre,

a community nurse,

an emergency dentist

a late-opening chemist.

Where possible, the NHS 111 team will book you an appointment or transfer you directly to the people you need to speak to.

If NHS 111 advisers think you need an ambulance, they will immediately arrange for one to be sent to you.

CCGs

CCGs work with closely with NHS England, who has three roles in relation to CCGs.

1. Assurance: NHS England has a responsibility to assure themselves that CCGs are fit for purpose, and are improving health outcomes.

2. NHS England must help support the development of CCGs.

3. NHS England are also direct commissioners, responsible for highly specialised services and primary care. As co-commissioners, CCGs work with NHS England’s Local Area Teams to ensure joined-up care.

Clinical commissioning groups (CCGs)

are one of the main components of the government’s reforms to the health and social care system. In April 2013, these newly established, clinically led organisations replaced primary care trusts as the commissioners of most services funded by the National Health Service (NHS) in England, and now control around two-thirds of the NHS budget. All general practices in England are now legally obliged to be a member of a CCG. The intention is to encourage clinicians to play a greater role in deciding how funds are spent in order to shape services to meet

local needs.

CCGs are:

Membership bodies, with local GP practices as the members;

Led by

• an elected Governing Body made up of GPs,
• other clinicians including a nurse and a secondary care consultant,
• lay members

CCGs are

• Responsible for about 60% of the NHS budget; or £60 billion per year;
• Responsible for healthcare commissioning such as mental health services, urgent and emergency care, elective hospital services, and community care;
• Independent, and accountable to the Secretary of State for Health through NHS England;
• Responsible for the health of populations ranging from under 100,000 to 900,000, although the average population covered by a CCG is about a quarter of a million people.

Isle of Man & Channel Islands have their own, independent Health Services.

CCGs have two important, but distinct, roles:

1. they are responsible for commissioning

secondary and community care services for their local populations.

they have a legal duty to support quality improvement in general practice. This second role has received less attention to date, but is vitally important if CCGs are to achieve their wider objectives and deliver more integrated forms of care.