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Your County Your NHS
Authorities and trusts are the different types of organisations that run the NHS at a local level. The whole of England is split into 10 strategic health authorities (SHAs). Our local SHA is NHS East Midlands, set up in 2002 to develop plans for improving health services in our area and to make sure their local NHS organisations are performing well. Within each SHA, the NHS is split into various types of trusts that take responsibility for running the different NHS services in your local area. The different trust types are:
Acute trusts
Derby Hospitals are managed by acute trusts, which make sure that hospitals provide high-quality healthcare, and that they spend their money efficiently. They also decide on a strategy for how the hospital will develop, so that services improve.
Acute trusts employ a large part of the NHS workforce, including nurses, doctors, pharmacists, midwives and health visitors, as well as people doing jobs related to medicine – physiotherapists, radiographers, podiatrists, speech and language therapists, counsellors, occupational therapists and psychologists. There are many other non-medical staff employed by acute trusts, including receptionists, porters, cleaners, specialists in information technology, managers, engineers, caterers and domestic and security staff.
Some acute trusts are regional or national centres for more specialised care. Others are attached to universities and help to train health professionals. Acute trusts can also provide services in the community, for example through health centres, clinics or in people's homes.
Ambulance trusts
East Midlands Ambulance Service provides emergency access to healthcare. If you call for an emergency ambulance the calls are prioritised into:
- Category A emergencies, which are immediately life-threatening, or
- Category B or C emergencies, which are not life-threatening.
The emergency control room decides what kind of response is needed and whether an ambulance is required. For all three types of emergency, they may send a rapid-response vehicle, crewed by a paramedic, equipped to provide treatment at the scene of an accident. Over the past five years the number of ambulance 999 calls has gone up by a third...
Mental health trusts
Derbyshire Mental Health Services provide health and social care services for people with mental health problems. Mental health services can be provided through your GP, other primary care services or through more specialist care. This might include counselling and other psychological therapies, community and family support or general health screening. For example, people suffering bereavement, depression, stress or anxiety can get help from primary care or informal community support. If they need more involved support they can be referred for specialist care.
Primary care trusts
Primary care is the care provided by people you normally see when you first have a health problem. It might be a visit to a doctor or a dentist, an optician for an eye test, or just a trip to a pharmacist to buy cough mixture. NHS walk-in centres and the NHS Direct phone line service are also part of primary care. All of these services are managed for you by your local primary care trust (PCT). In the city, we are Derby City PCT and across the county, Derbyshire County PCT
Your PCT will work with local authorities and other agencies that provide health and social care locally to make sure that your local community's needs are being met. PCTs are now at the centre of the NHS and control 80% of the NHS budget. As they are local organisations, they are best positioned to understand the needs of their community, so they can make sure that the organisations providing health and social care services are working effectively.
For example, your PCT must make sure there are enough services for people within their area and that these services are accessible. It must also make sure that all other health services are provided, including hospitals, dentists, opticians, mental health services, NHS walk-in centres, NHS Direct, patient transport (including accident and emergency), population screening, and pharmacies. They are also responsible for getting health and social care systems working together for the benefit of patients.