NHS Improvement consolidates various organizations to oversee and support the performance of NHS providers, ensuring accountability and intervention when necessary. As of April 2016, Greater Manchester leaders are taking control of regional health and social care budgets, with more areas pursuing similar devolution. By 2017/18, most Clinical Commissioning Groups (CCGs) are expected to fully manage primary medical care services under delegated arrangements.

1. NHS Improvement
• Brings together Monitor and the NHS TDA, along with: NHS England’s Patient Safety Team; the Advancing Change
Team; NHS Interim Management and Support’s two Intensive Support Teams; and the National Reporting and
Learning System
• Oversees foundation trusts, NHS trusts and independent providers
• Supports providers and local health systems to improve
• Holds providers and boards to account and, where necessary, intervenes
Clinical commissioning
groups (CCGs)
NHS England
Private providers
Providers of NHS services
NHS trusts
Foundation trusts
Voluntary sector
GPs
Local authorities
Care Quality Commission
Independent regulator
for quality
Monitor
The financial regulator of foundation trusts
NHS Trust Development Authority (NHS TDA)
Responsible for overseeing the performance management
and governance of NHS trusts
£££
Contract with
£££
£££
The new NHS: how providers are regulated
and commissioned
Governors
}

2. Public Health
England
Department of Health
Public
health
Local
authorities
Community
services
Clinical
commissioning
groups
Mental health
services Hospital services
Specialist
services
Primary
care
Health and
wellbeing board
Local health and
wellbeing strategy
NHS England and regional teams
Greater Manchester
health and
social care devolution
arrangements**
Commissioning guidance
The Mandate
Commissioning
plan
Seek views
Represented on
Represented on
Local
Healthwatch
NICE
The new NHS: who can influence
commissioning of services
Commissioning
support units
Expert
advice
Clinical
senates
Strategic clinical
networks
** From 1 April 2016, leaders in
Greater Manchester are taking
greater control of the region’s health
and social care budget. This includes
taking on delegated responsibility
for several commissioning budgets
previously controlled by NHS England.
Other areas are also pursuing
‘devolved’ arrangements.
==
* Screening/immunisation programmes run by NHS England. == In 2016/17 a total of 114 CCGs will have assumed full responsibility for the commissioning of primary medical care services under delegated
commissioning arrangements. Nearly all CCGs are expected to have taken on delegated arrangements by 2017/18.
*

3. Public
Health
England Department of Health Health Education England
Parliament
Regulators:
NHS Improvement,
Care Quality Commission
£120.4 billion
£5.0 billion
£106.8 billion
NHS England and regional teams (4)
£2.1 billion Sustainability
and Transformation Fund
Public
health
Local
authorities (152)
Better Care
Fund
Community
services
Clinical commissioning
groups (209)
Mental
health Hospital services Primary care
Specialised
services
£3.4
billion
£15.7
billion
£1.1 billion*
The new NHS: how the money flows
£71.9 billion
£12.8
billion
* Screening/immunisation programmes run by NHS England. ** In 2016/17 a total of 114 CCGs will have assumed full responsibility for the commissioning of primary medical care services under delegated
commissioning arrangements. Nearly all CCGs are expected to have taken on delegated arrangements by 2017/18.
£3.4 billion
**

4. Department of Health
Health Education England (HEE)
13 local education and training boards (LETBs)
Deaneries Health service providers Education providers
How the money flows – medical and
professional education and training
£5.0 billion*
*Allocation for 2016/17