The Health and Social Care Act (2012) paved the way for far-reaching reforms to how patient care in the English NHS is organised, managed and delivered. The changes were formally implemented on 1 April 2013. This slideshow outlines the main changes to management, accountability and funding structures resulting from the Act. The first slides show the old and new structure in overview, together with a slide detailing the transitional arrangement. Further slides compare the earlier arrangements that were in place for funding, regulation and monitoring, advice and performance management, and patient and public participation, with the new system at both the national and local level. The final slide outlines the new medical education and training arrangements. You are welcome to download and use individual slides in your own presentations providing suitable acknowledgement is given. To find out more about our work on the NHS reforms, visit our dedicated project page. You can also access an interactive timeline showing the complete history of the NHS, putting the current reforms in historical context.

1. Last updated: August 2013 © Nuffield Trust
The new NHS in England:
structure and accountabilities

2. © Nuffield Trust
The NHS in transition: mapping the changes
• The Health and Social Care Act is changing the NHS’:
• Structure
• Accountabilities
• Funding arrangements
• Working relationships
The following slides show the principal changes.

3. The NHS in England before the reforms

4. NHS April 2013 onwards

5. New funding arrangements

6. Providers: regulation and accountability

7. Commissioners: performance management and guidance

8. How patients and members of the public can influence their
health and social care services

9. Medical and professional education and training

10. © Nuffield TrustLast updated: August 2013
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