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How we fit into the NHS

The NHS is made up of a wide range of organisations specialising in different types of services for patients.


Significant changes to the structure of the NHS came into effect on 1 April 2013.  New organisations were created and others such as primary care trusts (PCTs) and strategic health authorities (SHAs) were abolished.

A guide to the healthcare system in England explains organisations in the healthcare system and how they work together.

Alternatively, the King's Fund, an independent charitable organisation, has produced a brief animation explaining the new structure of the NHS. 

The organisations and their roles

Clinical commissioning groups (CCGs)

NHS England

Local authorities

Health and Wellbeing Boards

Public Health England


Clinical commissioning groups (CCGs)

Clinical commissioning groups are responsible for planning, organising and buying (or ‘commissioning’) local health services and healthcare to meet the needs of their local communities.  

There are more than 200 clinical commissioning groups (CCGs) across the country.

All GP practices belong to a CCG and the groups also include other health professionals, such as nurses and hospital doctors. They come together to ensure the best possible health care and treatment for their population. CCGs plan and buy most local health services including:

  • Planned hospital care
  • Rehabilitative care
  • Urgent and emergency care
  • Community health services
  • Mental health and learning disability services.

To do this clinical commissioning groups work with patients and health and social care partners such as local hospitals, local authorities, and local community groups, to ensure services meet local needs. 

Find about more about Bedfordshire Clinical Commissioning Group

NHS England

NHS England is a national organisation with a local area team covering Bedfordshire, Hertfordshire and South Midlands. Its main role is to ensure that the overall system of planning and buying NHS services works well and that the NHS delivers better outcomes for patients.

NHS England oversees the operation of CCGs making sure they successfully plan and buy services for their local population. It also looks at how well CCGs operate their budgets, engage with their local populations, and deliver the pledges, rights and values in the NHS Constitution.

NHS England also plans and buys health services at a national level. These include:

  • Specialised services (such as those for rare diseases)
  • Prison health services
  • Some services for members of the armed forces.
  • 'Primary Care' - eg GP services, dentists, pharmacy and optometry.

Local authorities

Local authorities Bedford Borough Council and Central Bedfordshire Council work closely with Bedfordshire CCG, to support people to lead healthier lives and ensure the public is protected from threats to their health such as a flu pandemic.

They are responsible for commissioning a range of services to prevent ill health and help people to make healthy lifestyle choices including:

  • Sexual health services
  • Drug and alcohol misuse services
  • Stop smoking services
  • NHS Health Checks
  • Children’s vaccinations 

Local authorities health profiles

Health profiles provide summary health information to support local authority members, officers and community partners to lead for health improvement

  • Click here to view the health profile for Central Bedfordshire
  • Click here to view the health profile for Bedford Borough

Health and Wellbeing Boards

Health and wellbeing boards have been introduced within every local authority area, to encourage improvements to local health and wellbeing. These bring together those who buy services across the NHS; Public Health; social care; and children's services, plus elected councillors and patient representatives to understand the needs of their local communities and plan the right services to meet these needs.

Find out about:

Bedford Health and Wellbeing Board

Central Bedfordshire Health and Wellbeing Board

Public Health England

Public Health England is a national organisation that works with local authorities to improve health and wellbeing. It has national responsibility for protecting the public against future threats to health.


Healthwatch is an independent body set up to enable patients and the public to have their say about the NHS. It has local groups in Healthwatch Bedford Borough and Healthwatch Central Bedfordshire 

Find out more about the NHS including different types of NHS trusts.



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