What you can do:

Holding local bodies to account

Staying in touch with what decisions are being made about your local NHS is crucial. You can track these through the meetings and minutes of your local NHS bodies. Traditionally their meetings are open to the public but are poorly attended, speaking rights vary and are usually at the discretion of the chair. NHS bodies are obliged to enter into consultation over major strategic changes. If you are in regular contact with these bodies you will find out about this process and the associated meetings and be able to encourage others to attend too.

Useful websites:

Department of Health http://www.dh.gov.uk/Home/fs/en
NHS http://www.nhs.uk/

Need more information? - Freedom of Information

In cases where you are looking for information concerning a PCT, SHA, or the Department of Health more broadly, and you have been unable to get that information from the relevant body, the UK Freedom of Information Act should be able to help you.

Unless the particular public body has a valid reason, as defined by the Act, to withhold the information requested, they are obliged to provide it to you within 20 days, subject to certain exemptions and extensions.

For a comprehensive explanation of how the Act works and how it can be utilised, see the website of the Campaign for Freedom of Information at http://www.cfoi.org.uk/pdf/foi_guide.pdf.

Primary Care Trusts (PCTs) are locally organised bodies which, together, are responsible for around 75% of the allocated NHS budget. They work with local authorities and other agencies that provide health and social care locally to make sure that the local community's needs are being met. Areas of responsibility include GP practices, dental surgeries and pharmacies. They are therefore ideally placed to tell you about the condition of local services, and current developments within the NHS in your area.

To identify your local PCT call NHS Direct on 0845 4647 or visit the NHS website at http://www.nhs.uk/England/AuthoritiesTrusts/Pct/townSearch.aspx, where you will then be directed to the PCT's website (under the General Contact heading on the right hand side bar). Whether you speak to NHS Direct or visit your PCT's website, contact details of relevant individuals within the PCT should be easily available.

You should be able to find information (either on the PCT website or through NHS Direct) about board meetings - when and where they are held, whether they are open to the public, minutes of previous meetings and agendas of forthcoming meetings. It is possible that some information, e.g. forthcoming agendas, is not immediately accessible via the PCT website, and might need to be requested from the board secretary. Also. if you have a question which does not relate to a specific item on the agenda of the particular board meeting, you might be required to submit this in writing in advance. You should therefore check the procedures of your PCT.

NHS: a Glossary

The pace of current reform to the NHS is very rapid. Below are explanations of some of the new structures and organisations to appear.

Healthcare Commission

The Healthcare Commission promotes improvement in the quality of both the NHS and independent healthcare. The Commission has a statutory duty to assess the performance of healthcare organisations, award annual performance ratings for the NHS and coordinate reviews of healthcare by others.

The Commission is also required to regulate the independent healthcare sector through registration, annual inspection, monitoring complaints and enforcement. It should also consider complaints about NHS organisations that the organisations themselves have not resolved.

The Commission is required to pay particular attention to the availability of, access to, quality and effectiveness of healthcare; the economy and efficiency of the provision of healthcare; the availability and quality of information provided to the public about healthcare; the need to safeguard and promote the rights and welfare of children and the effectiveness of measures taken to do so

Health authorities

England's 95 health authorities ceased to exist from April 2002 and passed many of their responsibilities to primary care trusts. They were replaced by 28 larger health authorities. These have been known as 'strategic health authorities' since October 2002. Now they face a process of merger to reduce the numbers still further.

The strategic health authorities are responsible for developing strategies for local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between The Department of Health and the NHS. They are also supposed to ensure that national priorities, such as programmes for improving cancer services, are integrated into local plans.

National Institute for Clinical Excellence (NICE)

NICE is a new body set up in April 1999 to promote the highest quality of treatment and technology in the NHS and the cost-effectiveness of NHS services. It gives advice on best clinical practice to the NHS, to those commissioning NHS services (strategic health authorities and primary care groups / trusts), and to patients and their carers.

NICE is a partnership between the Department of Health, the NHS, health professionals and patients. Guidelines set by NICE will be used across the country, helping to end geographical variations in care that have grown up in recent years.

National service frameworks (NSF)

NSFs help establish clear national standards for services to improve quality and reduce unacceptable variations in standards of care and treatment. There are NSFs for coronary heart disease, mental health, older people, and the NHS Cancer Plan. NSFs for children, diabetes, and renal (kidney) services are also being developed.

www.doh.gov.uk/nsf/coronary1.htm
www.doh.gov.uk/nsf/mentalhealth
www.doh.gov.uk/olderpeople.htm
www.doh.gov.uk/nsf/renal.htm
www.doh.gov.uk/nsf/children.htm
www.doh.gov.uk/nsf/diabetes/index.htm
www.doh.gov.uk/cancer/cancerplan.htm

NHS trusts

Hospital trusts are found in most large towns and cities, and usually offer a general range of services to meet most people's needs. Some trusts also act as regional or national centres of expertise for more specialised care, while some are attached to universities and help to train health professionals.

Trusts can also provide services in the community - for example through health centres, clinics or in people's homes.

Except in the case of emergencies, hospital treatment is arranged through your GP. This is called a referral. Appointments and treatment are free.

Together, NHS trusts employ the majority of the NHS workforce including nurses, doctors, dentists, pharmacists, midwives, health visitors and staff from the professions allied to medicine, such as physiotherapists, radiographers, podiatrists, speech and language therapists, counsellors, occupational therapists and psychologists. There are many other staff including receptionists, porters, cleaners, IT specialists, managers, engineers, caterers, and domestic and security staff.