I hope to start greying-out these duplicitous organisations during 2010/11. At last there is hope that  the many parasites on delivering patient care will be destroyed forever. The Axe is falling on some of these bodies. The risk is that many functions are transferred to other bodies, so in effect merging, and simply going to ground, ready to sprout up again when the rains come. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_117691

Also, the demise of both Health Authorities and Primary care Trusts will be a huge step forward. The risk, assuming that the same staff employed in the new GP commissioning consortia, is that the consortia will become Micro Primary Care Trusts, M-PCTs.  M-PCTs will merge for economies of scale over time, thus recreating Primary Care Trusts, PCTs.  We have seen it all before in Hertfordshire alone, going from two Authorities to one, then eight PCTs, then merged to four PCTs, then 1.5 PCTs back to one PCT over the last 15 years. There have been previous cycles since the 1960s.   The organisations listed below morphed, merged, mutated and spawned and changed names in Darwinian efforts to survive, which they did with great success.  Can the coalition government finally kill them off?  History is not on the coalition's side.

PCTs are not alone in doing job that never needed doing.  There are no such things as PCTs in Australia, just Local Government,  otherwise known as States, which does some central planning but does not fuss, bother, control and regulate primary care. Professionalism works well on its own; Australians live longer and Australians like their health service.

This page and list below was started in 2003 as an attempt to list the last Government's organisations and initiatives that impacted on NHS Medical Practice and Primary Care (General Practice).   A few of these bodies were called Arms Length Bodies (aka Quangos) and the NHS ones alone were to cost £1,779,923,000 in 2005. I never found more up to date figures. 

• The past political make up of all Government Quangos in 2009 is here
• Scroll down of click here to see the full list of organisations and offices we found to 2010.
• Please send any suggestions, additions and corrections to me Dr Gerard Bulger by clicking HERE

Additions 2008 to the list:

1. June 2008: Independent Safeguarding Authority  to help prevent unsuitable people from working with children and vulnerable adults.

2.  August 2008: National Information Governance Board to provide leadership and promote consistent standards for information governance across health and social care.

3. September 2008  NHS Centre for Involvement  lead organisation for supplying advice and guidance about LINks. The members of the NCI consortium are all actively involved.  Astonishingly the site sports the Plain English Campaign Logo  

4. NHS Improvement is a newly formed national improvement programme working with clinical networks and NHS organisations to transform, deliver and sustain improvements across the entire pathway of care in cancer, cardiac, diagnostics and stroke services".    NHS improvement is different from NHS Modernisation, a term that became out of date .  NHS improvement is different from  the following:
5. NHS Institute for Innovation and Improvement   which "supports the NHS to transform healthcare for patients and the public by rapidly developing and spreading new ways of working, new technology and world-class leadership". 
6. NHS ELECT  is a network of NHS organisations funded by subscription NHS Trusts and by a Service level agreement and contracts with DH. Its partners include Ascent Health, Dr Foster and Capsticks.  It staff are NHS employees.  Its structure, constitution were not given on its web page, nor are its board members (Jan 08) "NHS Elect is a network for NHS organisations seeking to provide or commission cost effective, clinical services within the context of the increasingly contestable market for publicly funded healthcare"
7. NHS Innovation Council:  This is funded 50/50 by the NHS and Wellcome Trust.  It does not have a web site. The original press releases on DH and Wellcome web sites have been taken off but now in an archive here

Earlier additions in 2007:

1. Community Health Profiles: seems to bring together data from other sources.
2. Public Health Observatories 12 sites found via their association web site
3. Care Services Improvement Partnership found 11th November 2006. "The Care Services Improvement Partnership (CSIP) is commissioned by the Department of Health and other agencies to help services implement national policies for local benefit".
4. UKChip 14th October 2006 "The UK Council for Health Informatics Profession"  An NHS sponsored body to create a profession and registration system.. 
5. 23rd September 2006 National Institute for Health Research  first board meeting was in May 2006.  This is an NHS centralised research control and command system.  They state  "The Institute will be established on a phased basis as each of its key work areas are introduced. It will provide the framework through which we will position, manage and maintain the research, research staff and infrastructure of the NHS in England. Its work will focus on meeting the needs of the research community, patients and the public" Within this is the "old" (1999 vintage)
6. Integrated Childrens' System: The National Database on every child in the UK. A good response to this is here  I see in July 2010 it is on it way out.
   
7. 18th July 2006 I was pointed to the Improvement Foundation.  By July 2010 it seems to be dead. This was an NHS funded consultancy.Their web site stated:  "The Improvement Foundation, which is a not for profit company limited by guarantee, incorporates the work of the National Primary Care Development Team (NPDT), which was originally established in February 2000 to run the National Primary Care Collaborative. The purpose of our work is to develop capacity and capability in public services to use continued improvement methods for the benefit of service users. We do this by engaging front-line staff in quality improvement and helping them deliver rapid, systematic and sustainable improvement for people and communities. Our ongoing aim is to develop a wide cohort of people, both professionals and community members who have the knowledge and skills to apply quality improvement methods to their own local priorities. Our hope is that these people will form the basis of a sustainable movement within public services"  This may be another not for profit company that seems to have wasted tax payers money. The other was SecureHealth Care, set up and funded by Labour Governement to look after prison health went down with its good intententions and £500,000 debt in 2009.
   
8. The NHS Integrated Improvement Programme  If you want to know what this organisation does please translate the following from their web site:   "The NHS Integrated Service Improvement Programme (ISIP) promotes collaboration across local health communities to make the most of investments in people, process, technology and other local initiatives. ISIP is an NHS-led approach to transforming patient care, reconciling local imperatives with national priorities and focusing improvements to deliver an efficient, patient-led NHS."   It must be for the chop.

Many of these organisations listed below were created since 1997. The are constantly evolving; it can be difficult to keep up  Each entry in the list below is a link. The organisations represented here may have been established with the best of intentions, and some had laudable aims. Most have pompous and ridiculous names.   Over 127 organisations have been found to date.  Some of the organisations had a reproductive capacity, the worst offender was the Modernisation Agency.  That agency has since been closed, or rather morphed into different organisations.   Those organisations that have died are greyed out.

Some of  the offices listed below are now to be known as "Arms Length Bodies" ALBs.  The DH document is  on the changes is here.   Then there was the  Implementation plan on Arms Length Bodies .

The last government's official list on Arms Length Bodies (ALBs) was given in a Parliamentary Answer 23rd May 2005. Click here and scroll down to Mr Dobson   The list was pruned (DH 4/2004) then "closed",  but in fact they morphed and merged into different organisations.

Total cost of NHS ALBs in 2005/6 was expected to be £1,779,923,000

 The list of 100+ organisations that have something to say about primary care are listed below:

1. Advisory Bodies (Main list)
2. Agenda for Change (HR and pay)
3. Association of Public Health Observatories Links to Public the regional Public health observatories
4. Audit Commission 
5. Better Regulation Executive      Regulate the regulators
   
6. Business Services Authority  An umbrella organisation that includes NHS logistics,  PPA,  NHS pensions,
7. Cabinet Office Demoted role with change of deputy PM in 2007
8. Care Services Improvement Partnership CSIP
9. The Clinical Knowledge Summaries service (CKS)  via NHS Funded Sowerby Centre
10. Choose and Book
11. Commission for Health Improvement    (CHAI or CHI) Now Healthcare Commission
12.  Commission for Patient and Public Involvement in Health  (Budget £33m: Closure announced 5 months after official launch) Born 2003 Died 2008
13. Committee on Medical Aspects of Radiation in the Environment  (COMCARE: Health Protection Agency )
14. Commission for Racial Equality  now  Equality and Human Rights  Commission
15. Commission for Social Care Inspection
16. Community Health Profiles
17. (NHS) Connecting for Health   (aka National Programme for IT)
18. Controls Assurance Support Unit Now Health Care Standards Unit   (DOH)
19. Council for HealthCare Regulatory Excellence audit fitness to practice procedures of the regulators
20. Clinical Governance Support Team (Spawn of Modernisation Agency) no longer updated Feb 2008
21. Criminal Records Bureau (CRB) All G.P.s and their employees now fully checked
22. Counter Fraud and Security Management Service (CFSMS A special health authority, now part of BSA)
23. Data Protection Information Commission
24. Developing Patient Partnerships (DOH funded)
25. Diagnostic and Treatment Centres (was a spawn of NHS Estates: domain seems to have vanished- takes you to DH website.   April 2008 domain now used by earch engine.
26. Disability Discrimination Act  effects on GP surgery buildings and access and work conditions. GPs are employers.
27. Digital  NHS TV   (£15 Million project now NHS Direct Interactive, so now part of NHS Direct)
28. European Agency for the Evaluation of Medicinal Products
29. Employment Tribunals
30. End of Life Care Programme
31. Equal Opportunities Commission now merged as equality and Human Rights
32. Family Health Services Appeal Authority
33. Food Standards Agency
34. Freedom of Information Act  G.P. surgeries, despite being private independent contractors have to comply
35. Future Leaders  (NHS management)
36. General Practice Recruitment Office
37. General Social Care Council (GSCC)   
38. GP Appraisal  (Spawn of Spawn of Modernisation Agency)
39. Health Action Zones (Closed 2005 domain now a search site) 
40. Health Care Commission
41. Health Development Agency   Now part of NICE
42. Health Professions Council  (Allied Professions registration)
43. Health Protection Agency
44. Health and Safety Executive
45. Health and Social Care Information Centre
46. Health & Social Care in Criminal Justice Programme
47. Health Technology Assessment
48. Healthy Communities Collaborative  (Spawn of NPCDT via HDA)
49. Home Office (Section 8 Asylum and Immigration Act 1998)
50. Independent Reconfiguration Panel The IRP is an independent, advisory non-departmental public body (NDPB)      
51. Independent Safeguarding Authority  preventing unsuitable people working with children
52. Inland Revenue (G.P.s as businesses)
53. Integrated Care    (The site did have this verbiage as explanation: Integrated working takes place at all levels within an organisation and is a complex process. It is important therefore to consider organisational development processes that will support and develop integration. Organisational development as a long-term effort to improve the organisation's visioning, empowerment, learning and problem-solving processes through the collaborative management of organisational culture)  I am still not clear  what it does on its new site Sept 2006.
54. Integrated Childrens' System   The New National Childrens' database see  "detect criminals from birth"
55. Information Centre (NHS)      G.P.s' Quality Outcome Framework (QOF) results are on this site here 
56. Information Policy Unit (DOH)
57. Improving Working Lives (DOH)
58. Improvement Foundation
59. Joint Committee on Vaccination and Immunisation (JCVI)
60. LiNKS  Local Involvement Network (LINk)
61. Medicines Commission
62. Medicines and Healthcare products Regulatory Agency
63. Modernisation Agency  (dissolved or morphed into other organisations)
64. Modernising Medical Careers (MMC)
65. National Care Standards Commission Now spit into two: CSCI aand CHAI now changed its name since)
66. National Clinical Assessment Authority  (Doctor performance)
67.  National Confidential Enquiry into Maternal and Child Health (CEMACH)    
68. National Confidential Enquiry into Patient Outcome and Death (NCEPOD)
69. National Confidential Enquiry into Suicide and Homicide by people with mental illness (NCISH)
70. National Health Service University Now something else Inst for Innovation and Improvement
71. National Clinical Governance Support Team (Spawn of Modernisation Agency)
72. National Clinical Audit Support Programme (Spawn of CHI via NHSIA)
73. National Collaborating Centre for Primary Care  (now nice)   
74. National Collaborating Centre  Mergers
75. National Electronic Library for Health
76. National Information Governance Board
77. National Institute for Biological Standards and Control  NIBSC
78. National Institute for Clinical Excellence
79. National Institute for Health Research
80. National Prescribing Centre
81. National Specialist Commissioning Advisory Group (NSCAG)
82. National Patient Safety Agency
83. National Primary Care Development Team
84. National Primary Care Collaborative (Spawn of NPCDT ) 
85. National Primary and Care Trust Development Programme (NatPact)
86. National Radiological Protection Board (NRPB) Now moved to Health Protection Agency
87. National Travel Health Network and Centre (DOH funding run by National Hosp Tropical Diseases)
88. National Treatment Centre for Substance Misuse
89. National Workforce Information Site
90. NHS Centre for Involvement
91. NHS Confederation  
92. NHS Direct
93. NHS ELECT
94. NHS Employers
95. NHS Estates
96. NHS Evidence
97. NHS Improvement
98. NHS Information Authority....
99. NHS  Innovation Council        funded 50/50 with Wellcome trust
100. NHS Institute for Innovation and Improvement
101. NHS Integrated Improvement Programme
102. NHS JOBS
103. National Knowledge Service mission:collect, organise, and deliver knowledge where and when it is needed!
104. NHS Leadership...
105. NHS Leadership Council
     
106. NHS Leadership Qualities (Spawn of Modernisation Agency)
107. NHS Litigation Authority
108. NHS Networks
109. NHS Plus (Occupational Health)
110. National Research Register  (register of NHS research projects)
111. National Service Frameworks   (DOH)
112. Nutrition Forum Now part of Food Agency
113. Office of The e-Envoy (spawn of No 10)
114. Office of  The Deputy Prime Minister  (urban renewal, social exclusion)
115. Out of Hours   
116. Ofsted   (Childcare registration systems)
117. Patients Forum
118. Patient Information Advisory Group PIAG
119. Parliamentary Ombudsman (Part of the complaints system)
120.  Pensions Agency NHS
121. Practice Based Commissioning
122. Prescribing Support Unit  (Now moved and claims to be part of National and Social Care Information Centre)
123. Primary Care Trusts  (PCTs)
124. Primis (spawn NHSIA and IPU; now at Nottingham University
125. Prodigy (Guidelines)
126. The Service Delivery and Organisation Programme
127. Skills for Health  (operating under licence to the Government, not sure what that means)
128. Social Exclusion Unit  Office of Deputy Prime Minister
129. Strategic Health Authorities (SHAs)
130. Trading Standards   (registering of weighing machines located in GP surgeries)
131. THOTH:  Training Hub for Operative Technologies in Healthcare    accelerate the adoption of new healthcare technologies in the NHS and beyond.
     
132. UKChip  The UK Council for Health Informatics Professions: NHS sponsored
133. UK Council for Health Informatics Professions  ex NHSIA funded)
134. UK Resilience (Civil Contingencies Act)  Spawn of Cabinet Office
135. Walk-In Centres
136. Web Information Sharing Environment WISE (ex NHS Modernisation now part of NHS Institute for Innovation and Improvement.)
137.  Workforce Development Confederations  Now moved to be National Workforce Information site
138. WORKORCE REVIEW TEAM  The Workforce Review Team (WRT) is a national body working on behalf of the NHS in England.

 Enquiries and Reports impacting on NHS:

1. http://www.the-shipman-inquiry.org.uk/
2. http://www.victoria-climbie-inquiry.org.uk/
3. http://www.bristol-inquiry.org.uk/bristol.htm
4. Sir Liam Donaldosn's Report on Protecting Patients
   

In April 2004 The labour  Government attempted to streamline and even close of some of the organisations that it had created, including some of the very new ones. In practice that process was one of merger and morphing, rather than of outright closure. An example of the process was put succinctly by The Health Service Journal 2nd June 2005:
"Dame Yve Buckland will chair the New NHS Institute for Innovation and Improvement,  The institute which has changed its name from the National Institute for Learning, Skills and Innovation starts work on 1 July and takes over the work of The Modernisation Agency, NHSU leadership centre, and National Innovation Network"   Dame Bucklands's Institute finally hasd web space here  In 2010 is still exists and is ripe for closure.

The NHS Modernisation web sites were for a while callled WISE but that link is now dead. We were the none wiser for it. For a crash course in NHS speak, and to get an idea of what occupied these organisations see "Towards a Million Change Agents"

The Commission for Patient and Public Involvement in Health's closure was announced just 5 months after its official launch, its budget was £33m. Reason for CPPIH closure is not certain, although spawning sites such as PPIFO may not have been what the Government had in mind, so close to a General Election at the time.

Suggestions for this list please by clicking here

Dr Gerard Bulger

July 2010

Click for an NHS PCT Office's pictures

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