NHS Financial, Legal and Regulatory Frameworks

How the NHS works now

The structure of the NHS changes frequently – the most notable recent example is the Health and Social Care Act of 2022, which abolished clinical commissioning groups and established integrated care systems. As such, we would advise caution when reading sources which have not been recently updated, as the information contained may be out of date.

The King’s Fund: This influential organisation promotes improvement in health and social care by providing insight, analysis and events. They have several excellent resources on how the NHS works, as well as up-to-date analysis of current issues in the NHS. Their ‘NHS in a nutshell’ series can be read here.

The Nuffield Trust: This organisation provides research and commentary on health and social care. There are a number of useful resources arranged by topic which can be found here.

The Structure of the NHS in England Research Briefing: This document, published in 2023 in the House of Commons Library and accessible here, provides an overview of how the NHS in England functions. It also highlights key issues facing the NHS including patient safety and performance challenges.

NHS Finance Explained: This 7 minute video by One NHS Finance, accessible here, explains the flow of funding in the NHS in England. As part of this, it clearly explains the structure of the NHS in England and particularly focuses on what has changed since the Health and Social Care Act of 2022.

How the NHS will work in the future and current ‘hot topics’

The government’s 10-year plan: This summary by the King’s Fund, accessible here, brings together resources on the three ‘big shifts’ the Starmer government want to see in health and care over the next 10 years: from hospital to community services, from treating sickness to preventing it, and from analogue to digital.

Darzi report: This report on the state of the NHS in England was commissioned by Wes Streeting, the Secretary of State for Health and Social Care and conducted by Lord Ara Darzi. Its findings were published in September 2024 and can be found here. The report provides insight into the current challenges facing the NHS, as well as the likely priorities for the Labour government going forward.

NHS Long Term Workforce Plan: This document, published in 2023 and accessible here, sets out a plan to build a sustainable NHS workforce in the context of an ageing population. It is summarised by the King’s Fund here.

NHS Long Term Plan: This document, published in 2019 and accessible here, set out key priorities for the NHS over the next 10 years. It is summarised by the King’s Fund here.