Overview of the New Health and Care System

Overview of the new health and care system

Ministers and the Department of Health

Public Health NHS Social Care

NHS Care Quality Commission Public Health England Monitor NHS National England TDA* Healthwatch England

4 Regional 4 Regions 4 Regions Teams

27 Local Managers and inspectors Regional 15 Local Centres Area Teams

Health and Wellbeing Boards (members from council, CCGs, Local Healthwatch and others)

Local Healthwatch

Local Authorities Clinical Commissioning Groups Local Authorities Local NHS providers including: NHS foundation trusts & NHS trusts Public health providers Primary care providers Social care providers Private and voluntary sector providers

Patients, service users and the public *NHS Trust Development Authority More about the NHS Trust Development Authority

Website: http://tinyurl.com/on58f45

The Local Government Ombudsmen in England investigate complaints about local authorities and certain other bodies including all types of adult social care providers. There are currently two Local Government Ombudsmen in England, each dealing with complaints from different parts of the country.

The Parliamentary and Health Service Ombudsman investigates complaints about government departments and other public organisations and the NHS in England, including NHS-funded services by private providers. The complaints process is currently being revised.

The Local Government Ombudsmen and the Parliamentary and Health Service Ombudsman have powers to work together. With the consent of the complainant, the Ombudsmen can share information, carry out joint investigations and produce joint reports where complaints fall within the remit of both Ombudsman schemes. In practice, the Ombudsmen consider and agree proposals to conduct joint investigations where the matters complained about are so closely linked that a joint investigation would be the most effective.

More about the Ombudsmen

Local Government Ombudsman: http://tinyurl.com/68f2xr

How to make a complaint about local government or a social care provider: http://tinyurl.com/84676tg

Parliamentary and Health Service Ombudsman: http://tinyurl.com/psvb9bf

How to make a complaint about the NHS: http://tinyurl.com/omju4gf

Fig 4 Regulation and oversight of health, social care and public health (Adapted from King’s Fund organograms on NHS structures)

Commissioners of health, Providers of health social care & public health Contract with and social care services Clinical Commissioning Private providers Groups (CCGs) £££ Care Quality Voluntary sector Commission providers NHS England GPs and other £££ primary care providers

Foundation Trusts Quality inspectorate Local authorities £££ NHS Trusts for healthcare and social care Monitor providers NHS Trust Development ‡ Safeguards choice, prevents anti-competitive behaviour and enables integrated care Authority ‡ Licenses providers Governance & accountability ‡ Manages failure of providers and ensures for NHS trusts and delivery of continuity of services foundation trusts ‡ Sets national tariff ‡ Authorises foundation trusts

Local Government Ombudsmen (Complaints about Local Govt) and social care providers Social care providers Parliamentary and Health Service Ombudsman (Complaints about NHS) Public health Public Health providers England Professional advice

18 A councillor’s guide to the health system in England Health Services in Cumbria

The National Health Service in Cumbria is made up of a complex arrangement of Health Trusts and other bodies. The main bodies that you will come into contact with as a member of Health scrutiny are detailed below. It is important to note that this list is not exhaustive however, and this toolkit will be regularly reviewed and updated to reflect any developments as appropriate. Health Services Commissioning Structure

Department of Health

National Commissioning Board Public Health England

NHS North Cumbria County Council

Border Local Area Team (LAT) Children’s Adult and Services Local Services

Cumbria Clinical Commissioning Group Public Health Cumbria County Council

Cumbria Clinical Commissioning Group

National Commissioning Board

Cumbria Clinical Commissioning Board

Eden Carlisle Copeland Allerdale Furness South Lakes Locality Locality Locality Locality Locality Locality

Clinical CCC Commissioning Group Cumbria DAAT (Drug and Alcohol Action Team)

North Cumbria Cumbria University Greater University Partnership NHS Hospitals of Manchester West Hospitals NHS Foundation Trust Morecambe Bay Mental Health Trust (NCUH) (CPFT) NHS Foundation Trust (GMW) Trust (UHMBT) Run: Run: Run: Run: ‡ Cumberland ‡ NHS Mental ‡ Adult alcohol Infirmary, Health services ‡ Furness and drug Carlisle ‡ Community General, treatment and ‡ West NHS Services Barrow rehabilitation Cumberland ‡ Westmorland programmes Hospital, General, Whitehaven Kendal ‡ Royal Lancaster Infirmary, Lancaster

20 Scrutiny Toolkit 2013

Organisation Information The University Hospitals Established in October 2010, and it provides services from three principal of Morecambe Bay NHS sites two of which are in Cumbria: Foundation Trust (UHMBT) ‡ Furness General Hosptial (FGH) in Barrow ‡ Westmorland General Hospital (WGH) in Kendal, ‡ 5R\DO/DQFDVWHU,Q¿UPDU\ 5/, LQ/DQFDVWHU

The Trust also provides out-patient services in Cumbria at the Ulverston Health Centre and a range of community facilities. North Cumbria University Provides services for the north of Cumbria. Hospitals Trust (NCUHT) The Trust is currently (April 2013) in the process of becoming “acquired” by Northumbria Healthcare NHS Foundation Trust. There has been a delay in the acquisition process however this is intended to go ahead later this year. NCUHT provides services from two principal sites: ‡ &XPEHUODQG,Q¿UPDU\&DUOLVOH ‡ West Cumberland Hospital (WCH), Whitehaven Cumbria Partnership Provides mental health services across Cumbria. Foundation Trust Clinical Commissioning Groups of GPs, nurses and other professionals who (from April 2013) are Groups (CCGs) responsible for designing local health services in England. They will do this by commissioning or buying health and care services. North West Ambulance Established in 2006 as the result of the merger of the ambulance services Service (NWAS) for Cumbria and Lancashire, Manchester, Cheshire and Merseyside. The 7UXVW+HDGTXDUWHUVDUHLQ%ROWRQDQGWKHUHDUHIRXUDUHDRI¿FHVRQHRI ZKLFKLVLQ&DUOLVOHFORVHWRWKH&XPEHUODQG,Q¿UPDU\7KHWKUHHFRQWURO centres are based outside the county.

The service provides a 24 hour, 365 days a year emergency service for those in need of emergency medical treatment and a non-emergency service known as the Patient Transport Service. Care Quality Commission The independent regulator of all health and social care services in England. Its role is to make sure that care provided by hospitals, dentists, ambulances, care homes and services in people’s own homes and elsewhere meets government standards for quality of care. Monitor The independent regulator of NHS foundation trusts. It is independent of central government and directly accountable to Parliament. It determines whether NHS trusts are ready to become NHS foundation trusts, ensures FRPSOLDQFHDQGVHHVWKDWWKH\DUHZHOOOHGDQG¿QDQFLDOO\UREXVW Healthwatch Healthwatch has replaced LINk and the national Independent Complaints and Advocacy Service (ICAS).

,Q&XPEULD3HRSOH)LUVWKDVEHHQDSSRLQWHGWRUXQWKHFRXQW\¶V¿UVW/RFDO Healthwatch for two years from April 2013.

The role of Healthwatch is to act as an independent consumer champion for patients and users of health and social care. It will also help to support patient and public involvement in the review and development of services.

Healthwatch have powers to ensure the consumers’ voice is heard by those who make the decisions. They tell government bodies and local authorities LQ(QJODQGDERXWWKHLU¿QGLQJVDQGFDQDOVRDVNWKH&4&WRWDNHDFWLRQLI WKH\KDYHVSHFL¿FFRQFHUQV

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