🏥 Structure of the NHS (2026) — Summary Diagram

UK GOVERNMENT

Department of Health & Social Care (DHSC)
Secretary of State: Wes Streeting MP

Roles & Functions

• NHS England reintegrated (brand retained)
• Unified policy + operational control
• Reduced bureaucracy
• Centralised health data strategy

🧭 7 NHE ENGLAND REGIONS

Strategic Functions

• Strategic facilitators (not managers)
• Oversee regional-scale delivery
• Bridge between national policy & ICBs

🏢 Office of Pan-ICB Commissioning

Purpose: Commission services too large for one ICB, too small for national control
Examples: Specialist diagnostics, cross-border pathways

🧩 26 ICB CLUSTERS (↓ from 42)

Role: Strategic Commissioners — Populations of 2.5 million+

Key Features

• 50% administrative cost reduction
• Shared HR, Finance, IT infrastructure
• Market shaping & long-term planning
• Delegated specialised commissioning
• National standards enforce equality of access

⬇ ‘LEFT SHIFT’ — FRONTLINE DELIVERY

(Hospital → Community · Sickness → Prevention)

🏘️ Neighbourhood Health Service

Primary Care Networks (PCNs)

• GP surgeries are part of approx 1,250 Primary Care Networks (PCNs) in England. Cover patient populations of 30,000 to 50,000 people. Employ (with self-referral pathways):
  • Clinical pharmacists
  • MSK Physiotherapists
  • Mental health practitioners (talking therapies)
  • Social prescribing link workers
• GPs to end ‘8am scramble’ with online triage

Neighbourhood Health Centres

• GP + diagnostics + community services
• 12 hours/day, 6 days/week
• Same-day access & on-site testing
• Also ends ‘8am scramble’

Community & Mental Health Services

• 18-week waiting target
• 24/7 crisis access
• Parity of esteem

🏥 SECONDARY & TERTIARY CARE

NHS Trusts & Foundation Trusts

• High-acuity & specialist surgery
• Emergency care
• Financial surplus goal by 2030
• Performance league tables

Priority Areas

• Children’s Surgical Hubs
• Maternity Safety Framework
• Elective recovery (elective backlog, waiting times & productivity)

🔗 DIGITAL & DATA SPINE (National Integration)

NHS App → ‘Digital Front Door’

Single Patient Record (interoperable nationwide)

• AI consultation scribes
• Facilitate self-referral pathways (see PCN/GPs, and e.g. smoking cessation, weight loss)
• Population health analytics
• Paperless integration
• NHS Digital merged into DHSC

🧠 NATIONAL REGULATORY AND SPECIALIST BODIES

🌅 STRATEGIC VISION — 10-Year Health Plan (2025–2035)

Transformation Priorities:

1️⃣ Analogue → Digital
2️⃣ Hospital → Community
3️⃣ Sickness → Prevention

Funding tied to:

• Productivity & outcomes
• Population health management

🌍 DEVOLVED NATIONS — Comparative Overview