Healthcare in England

6 mins read

On this page, we look at the structure of healthcare services in England and explain how to access healthcare services for your child.

In this article

The structure of healthcare in England

As you navigate healthcare services, it can be useful to know how the system’s structure and which organisation is ultimately responsible for the services your child receives.

Big changes are happening in the structure of the NHS in England at the moment. This means that some of the terms you might be familiar with have changed. Watch a short Kings Fund animation on changes happening in the NHS.

NHS England

NHS England is the body that leads the NHS. It promotes health and care for all. It helps NHS organisations work in partnership to deliver continuous improvement; better outcomes for patients and communities; and value for money for taxpayers.

Read more about NHS England.

NHS regions

NHS England has seven regional teams that support new integrated care systems (see below) to provide more joined-up care. They are responsible for the quality and financial performance of all NHS organisations in their area.

Read more about NHS regions and find your regional team.

Integrated care systems (ICS)

Integrated care systems (ICS) are partnerships of organisations that come together to plan and deliver joined-up health and care services.

ICS are made up of:

There are 42 ICSs spanning the whole of England.

See a King’s Fund diagram showing how the different components of ICSs work together.

What is the integrated care board?

On 1 July 2022, the Health and Care Act legally established integrated care boards (ICBs) in each of the 42 geographical areas. These replaced the 106 clinical commissioning groups (CCGs) that previously ‘bought’ and planned healthcare for local people.

The ICB is the body legally responsible for planning how to meet the health needs of people in the area. ICBs manage a share of the NHS budget and arrange local health services.

ICBs look after large populations, typically 1-3 million people. The former CCGs that commissioned healthcare typically did so for around 200,000 people each.

Find your local ICB.

What is the integrated care partnership?

The integrated care partnership (ICP) is a joint committee formed of the integrated care board (ICB) and the local authorities in the integrated care system (ICS) area. It brings together the NHS and local authority leaders to better integrate health (NHS), social care (local authorities) and wellbeing services.

The ICP is a broad alliance of partners involved in improving care, health and wellbeing of people in the ICS. Its main job is to produce a strategy – a type of long-term plan – on how to improve the health and wellbeing of people living in the ICS.

What are primary care networks?

Primary Care Networks (PCNs) are groups of general practitioners (GPs) who work together to provide a wider range of services to patients across the network.

Each PCN covers 30,000 to 50,000 patients. NHS England wants PCNs to offer more care locally so that patients don’t need to attend so many hospital outpatient appointments.

PCNs allow GPS to offer patients a wider range of services, lsuch as physiotherapy, social prescribing and more efficient access to community mental health teams.

What are Provider Collaboratives ?

These are partnerships that bring together two or more NHS trusts, including NHS hospitals and mental health services, to work together for the benefit of their patients and populations.

Collaboratives encourage health services and hospitals to work together rather than compete for resources and patients. Some of the more advanced collaboratives are for specialist mental health, learning disability and autism services.

See a list of all NHS Trusts and a list of all Provider Collaboratives.

What is a place-based partnership?

These are committees that lead detailed design and delivery of integrated health and care services across a smaller area within the integrated care system ICS. In most cases, ‘places’ will have the same boundaries as the local authority.

Place-based partnerships include NHS executives, local councils, community and voluntary organisations, residents, people who use services, carers and other community partners focussed on people’s health and wellbeing.

Read more about place-based partnerships.

What are Health and Wellbeing boards?

These are formal local authority committees involving key political, professional, clinical and community leaders.

They have a statutory duty to assess and plan for the needs of their local population to address health inequalities and lead Place Partnerships.

Integrated care boards and integrated care partnerships must have regard to Health and Wellbeing Board assessments and plans when making funding decisions.

UK Health Security Agency (UKHSA)

This ‘executive agency’ replaced Public Health England in 2021. The agency is responsible for protecting people from health threats. This includes the impact of infectious disease and chemical, biological and nuclear incidents. It is sponsored by the Department of Health and Social Care.

Read more about the UKHSA.

Local authority health responsibilities

Local authorities receive money from the Department of Health and Social Care (DHSC – see below) to help local people stay well mentally and physically. This includes weight management and stop smoking services. Local authorities also run most sexual health and drug and alcohol misuse services.

Department of Health and Social Care (DHSC)

The DHSC is the government department that advises ministers on shaping health and social care policies and legislation.

The DHSC holds NHS England and 23 other agencies and public bodies to account for delivering government policy.

Read more about the DHSC.

How to access health services

Primary care services

GPs, dentists, health visitors and opticians are part of what is known as primary care. These are health services you access directly without a referral.

Under the new integrated care systems (ICS – see above), most GPs have organised themselves into primary care networks (PCNs) with other GPs in the local area.

Read more about primary care services.

Secondary and tertiary care

Secondary care describes the sort of services you might be referred to if your child needs to be seen by someone with more specialist knowledge. Tertiary care is the specialist end of the NHS, and you might use these services if your child has a very complex or rare condition.

NHS 111

NHS 111 is an NHS phone service that will give you advice and will direct you to the most appropriate service.