The NHS is an exciting and challenging place to work.

The NHS was established by the NHS Act 1946 and was launched and has treated patients since 1948

The NHS is also Europe's largest employer with over 1.7 million employees across ​the UK.

Although there have been many structural and policy developments since 1948, the underlying principles have not changed. These are that the NHS services are:
  • available to everyone
  • free at the point of need (or use)
  • based on clinical need, not the ability to pay

All of the major political parties remain comitted to these core principles. Other enduring characteristics of the NHS are that:

  • it is funded through taxation
  • it manages within overall resource limits determined by the Government each year
  • finite resources have to be matched with infinite demand for health services
  • there is an expectation that "efficiency savings" can be made, often as a result of structural or technical developments
  • there is intense political, public and media interest in, and scrutiny of, the NHS

Fundamental changes are leading to transformation of our NHS service, making the NHS even more responsive to the challenges of new technologies and our growing patient expectations (the UK population is living longer and our services are needed as much as ever). Whilst for the past several years the NHS has received extraordinary real terms growth, the global economic situation, change in government and pressures on public sector funding will result in challenges for the NHS in maintaining its services and reducing its costs.

The current NHS Structure in England
NHS Health Structure in England
In October 2014, the Five Year Forward View was published. This sets out the transformational changes needed by the NHS in order to meet the anticipated £30bn funding gap by 2020/21 arising from the difference between existing funding and that needed to meet expected demand.

It was developed and contributed by organisations that deliver and oversee heathcare services including NHS England (NHSE), Public Health England, Monitor, Health Education England (HEE), Care Quality Commission (CQC) and the NHS Trust Development Authority (TDA). Experts and international experience and advice were used to ​set out the reasons for transformational change and the way that change may be achieved.