Glossary index

• operates effectively, economically and with probity
• makes good use of their resources
• keeps proper accounts.

Accoutable officers are ultimately accoutable to Paliament via the tiers of the NHS. For example, in an NHS trust the accountable officer is the chief executive. They are accountable to Parliament via the Department of Health and Social Care (DHSC) accounting officer and the Secretary of State for Health and Social Care.

In NHS foundation trusts, accountable officers are known as accounting officers and are directly responsible to Parliament.

The chief executive of an NHS foundation trust is designated as the accounting officer and is responsible for ensuring that the FT:

• operates effectively, economically and with probity
• makes good use of their resources
• keeps proper accounts.

The individual is personally accountable to Parliament and can be called to give evidence to the Public Accounts Committee.

The chief executive of an HSC organisation in Northern Ireland is also designated as the accounting officer.

In NHS terms, aggregated costs are the average unit cost of providing defined services to NHS patients in England.

NHS providers are required to submit annual schedules of costs of delivered healthcare to allow direct comparison of the relative costs of different providers for similar services. The results are published each year in the National schedule of NHS costs (NSNC).

Agreement of balances (AOB) is an exercise co-ordinated by the Department of Health and Social Care that requires all NHS bodies in England to agree balances and transactions with other NHS bodies. The exercise takes place in January for balances and transactions to the end of December (also called quarter 3 or month 9) and in April for balances and transactions to the end of March (also referred to as quarter 4 or month 12).

The amounts agreed are:

• income
• expenditure
• payables
• receivables.

A provider body will agree that the amount it is showing as income from a commissioner is the same as that commissioner is showing as expenditure with them. They will also agree that the receivable shown by the provider body is the same as the payable in the commissioner's accounts.

The purpose of the exercise is to allow the accounts for the whole NHS to be added up (consolidated) accurately.

The annual governance statement (AGS) is a key component of a foundation trust's annual report and accounts and is signed by the accounting officer. The AGS is designed to provide assurance in relation to the system of internal control that has been operating throughout the preceding year. NHS trusts and ICBs produce a similar statement known as a governance statement.

AGS can also stand for the Auditor General for Scotland.

Academic health science networks (AHSNs) are partnerships between the NHS, academic organisations, local authorities, industry and the third sector.

Their goal is to improve patient and population health outcomes by translating research into practice and developing and implementing integrated healthcare services.

They are now known as Health innovation networks.

Artificial intelligence (AI) describes digital technologies able to carry out tasks that normally require human abilities – for example, interpreting radiological images.

Part of the Integrated care system in Northern Ireland, the five area integrated partnership boards (AIPBs) work in partnership with stakeholders to identify local needs, agree priorities and identify actions to improve outcomes and reduce health inequalities for their populations. They are coterminous with the five regional HSC trusts and are overseen by the regional ICS partnership forum.

The all Wales medicines strategy group (AWMSG) is the organisation in Wales that deals with the evaluation of new health interventions.

Within healthcare provision alliances refer to several commissioners (NHS or local authority or both) who commission, jointly or independently, a range of services from various providers and have joint responsibility for the delivery of services.

An allocation is the amount of money made available to an integrated care board (ICB) to purchase healthcare for its local population. Allocations are made available annually by NHS England.

Welsh and Scottish health boards and HSC trusts in Northern Ireland also receive an allocation to fund the delivery of services for patients.

The annual governance statement (AGS) is a key component of a foundation trust's annual report and accounts and is signed by the accounting officer. The AGS is designed to provide assurance in relation to the system of internal control that has been operating throughout the preceding year. NHS trusts and ICBs produce a similar statement known as a governance statement.

Agreement of balances (AOB) is an exercise co-ordinated by the Department of Health and Social Care that requires all NHS bodies in England to agree balances and transactions with other NHS bodies. The exercise takes place in January for balances and transactions to the end of December (also called quarter 3 or month 9) and in April for balances and transactions to the end of March (also referred to as quarter 4 or month 12).

The amounts agreed are:

• income
• expenditure
• payables
• receivables.

A provider body will agree that the amount it is showing as income from a commissioner is the same as that commissioner is showing as expenditure with them. They will also agree that the receivable shown by the provider body is the same as the payable in the commissioner's accounts.

The purpose of the exercise is to allow the accounts for the whole NHS to be added up (consolidated) accurately.

Part of the Integrated care system in Northern Ireland, the five area integrated partnership boards (AIPBs) work in partnership with stakeholders to identify local needs, agree priorities and identify actions to improve outcomes and reduce health inequalities for their populations. They are coterminous with the five regional HSC trusts and are overseen by the regional ICS partnership forum.

Artificial intelligence (AI) describes digital technologies able to carry out tasks that normally require human abilities – for example, interpreting radiological images.

In the NHS, assurance refers to the process by which the board and its committees confirm that the organisation is operating as it should. Confidence in operating performance can be found through a number of sources - for example, internal and external audit reports; Care Quality Commission inspections and internal management reports.

The audit committee is a statutory committee of the board of all NHS organisations and has a key role in governance terms. Comprising only Non-executive directors, its role is to review and report on the relevance and rigour of the governance structures in place and the assurances the board receives.

The all Wales medicines strategy group (AWMSG) is the organisation in Wales that deals with the evaluation of new health interventions.

The board is an NHS organisation's pre-eminent group that takes corporate responsibility for the strategies and actions of the organsiation and is accountable to the public and Parliament.

It sets the strategy and objectives for the organisation, monitors their achievement and looks for potential problems and risks that might prevent them from being achieved.

A senior person responsible for protecting the confidentiality of people's health and care information and making sure it is used properly. All NHS organisations must have a Caldicott guardian.

Eight principles for the protection of confidential information:

• justify the purpose
• use confidential information only when it is necessary
• use the minimum necessary
• access should be on a strict need-to-know basis
• everyone with access should be aware of their responsibilities
• comply with the law
• the duty to share information is as important as the duty to protect confidentiality
• inform patients and service users about how their confidential information is used.

In most businesses, capital refers either to shareholder investment funds, or buildings, land and equipment owned by a business that have the potential to earn income in the future.

The NHS uses this second definition, but adds a further condition – that the cost of the building/ equipment must exceed a minimum threshold, normally £5,000. Capital is thus an asset (or group of functionally interdependent assets), with a useful life expectancy of greater than one year, whose cost exceeds the threshold.

This is a single payment to a provider or group of providers for the majority of the care provided to a particular population, such as patients with long term conditions, irrespective of the care provided or the setting it is provided in.

Care clusters are a mental health currency. Patients are categorised over 18 scales, each with 5 ratings, placing them into 1 of 21 clusters. They are being replaced by mental health and neurodevelopmental resource groups (MHNRGs).

A Scottish public body operating independently from Scottish ministers but with accountability to them. It regulates and inspects care services in Scotland to make sure they meet the requirements set out in the Scottish government's health and social care standards.

Between 2012 and 2022 clinical commissioning groups (CCGs) were statutory NHS bodies allocated funds from NHS England to purchase NHS care for the patients registered with their constituent practices. In 2022 the 106 CCGs were replaced by 42 integrated care boards.

Used to measure cost effectiveness the cost effectiveness ratio (CER) is calculated by dividing the cost of the treatment by the unit of outcome – for example, an event free day.

Community Health Partnerships (CHP) is an independent company owned by the Secretary of State for Health and Social Care. It is responsible for delivering NHS local improvement finance trust (LIFT) schemes and is the head tenant for more than 300 NHS properties.

Between 2012 and 2022 clinical commissioning groups (CCGs) were statutory NHS bodies allocated funds from NHS England to purchase NHS care for the patients registered with their constituent practices. In 2022 the 106 CCGs were replaced by 42 integrated care boards.

This term is used to describe commissioning arrangements where two or more commissioning organisations align their commissioning systems and priorities for the purpose of achieving shared outcomes while retaining separate responsibility for managing their own resources to support this.

A co-payment is a payment made by a patient to the NHS to pay towards their care. NHS care is free of charge to patients unless regulations exist to provide for a charge to be made. Such charges include prescription charges and some clinical activity undertaken by opticians and dentists. The specific charges and exemption rules are set by regulations and have always been part of the NHS.

Patients are also entitled to contract with NHS trusts for privately funded care as part of their overall treatment, for example to receive a drug that is not available on the NHS. NHS trusts must ensure that NHS care and chargeable private care are kept separate and provided at different times and places.

A commissioner is an NHS organisation that buys healthcare services. In England, key commissioners are integrated care boards (ICBs), NHS England and local authorities.

The process of ensuring that the health and care services provided effectively meet the needs of the population.

Commissioning involves the negotiation of agreements with service providers (NHS, private and voluntary sectors) to meet the health needs of a particular population. It involves making the best use of allocated resources to:

• improve health and well-being and reduce health inequalities
• secure access for patients to a comprehensive range of services
• improve the quality, effectiveness and efficiency of healthcare services
• increase patient choice by providing patients with the information they need to make informed choices about their healthcare.

The Commonwealth Fund is a non-partisan private foundation that supports independent research on healthcare issues.

• community health services – for example, district nurses and health visitors
• mental health services
• support for people with learning disabilities
• services for physically disabled people
• care for elderly people.

Community Health Partnerships (CHP) is an independent company owned by the Secretary of State for Health and Social Care. It is responsible for delivering NHS local improvement finance trust (LIFT) schemes and is the head tenant for more than 300 NHS properties.

Community planning partnerships (CPPs) are statutory bodies in Scotland that bring together public agencies and the community to plan and deliver better services that make a real difference to people's lives.

A consolidating Act of Parliament is one that brings together several existing Acts on the same subject into one Act. It does not substantially amend the law but may contain minor corrections and improvements.

The involvement of service users in the planning and design of the services they use.

A corporate body - for example, a foundation trust that is the trustee of a charity. Corporate trustees manage most NHS charities.

Although the members of the board act on behalf of the corporate trustee in the administration of the NHS charity, they are not themselves individual trustees.

Cost avoidance is a type of cost reduction but refers specifically to eliminating or preventing future costs arising. Cost avoidance measures may involve some expenditure but at a lower level than the expected future costs to be avoided. They may not formally be part of the CIP programme but instead avoid future cost pressures.

Examples are the avoidance of using locum doctors by making substantive appointments, reducing (non-budgeted) premium pay spend, or increased use of nursing bank staff to avoid higher cost agency premium pay.

Cost centre codes are assigned to financial transactions recorded in an organisation's general ledger. The cost centres used by organisations vary according to their size, structure and range of activities but usually describe where the money was spent, rather than what it was spent on. In an NHS trust cost centres typically relate to wards or departments – for example, the human resources department or drugs advisory team.

• activity/ volume based – these tend to be used for homogenous activities. For example, processing an invoice for £50 involves the same actions as one for £500
• time based – these are used when the amount of time varies for different outputs/ outcomes. For example, an appointment will take more time if the patient has a number of complex issues to be addressed
• resource based – when there is a direct charge for materials, etc. for a particular activity.

Cost effectiveness analysis is used to measure and compare the costs and benefits of various treatments. This allows the relative efficiency of the treatments to be calculated so that healthcare budgets can be allocated appropriately.

Used to measure cost effectiveness the CER is calculated by dividing the cost of the treatment by the unit of outcome - for example, an event free day.

Cost minimisation analysis tries to find the ‘least cost’ approach from all the alternatives available. It is all about doing the same things for less – by using cheaper inputs. It can only be used where there is conclusive evidence that the health outcomes are identical.

Cost reduction means providing a service at the same or better quality for a lower unit cost, through new ways of working that eliminate excess costs. The costs that are reduced could be ongoing or future pay or non-pay expenditure. A simple example is the use of a different orthopaedic prosthesis offering the same or improved clinical quality for a lower unit cost.

Cost reduction savings are typically cash-releasing. Cash can be released on a recurrent, ongoing basis (if, for instance, staff costs are reduced) or a one-off, non-recurrent basis. They differ from non-cash releasing savings, that result in more activity or services for the same cost or for an additional contribution.

Cost utility uses a more complex measure of outcomes such as quality adjusted life years (QALYs) to evaluate different treatments.

Published annually the costs book provides cost information for NHS organisations in Scotland including a detailed analysis of where resources are spent. It is used mainly for benchmarking by healthcare providers to assess efficiency.

Community planning partnerships (CPPs) are statutory bodies in Scotland that bring together public agencies and the community to plan and deliver better services that make a real difference to people's lives.

Commissioning for quality and innovation (CQUIN) ensures that a proportion of a healthcare providers’ income is conditional on delivering quality and innovation. Under the NHS payment scheme, the fixed element of a provider's payment assumes full achievemnt of all CQUIN metrics.

Clinical reference groups (CRGs) are led by clinicians and include other experts (including patients and carers) in order to develop service specifications and act as the primary source of clinical advice. There are three types of clinical reference group: transform, lead and inform, respond and advise.

A capital resource limit (CRL) is an expenditure limit for an NHS organisation limiting the amount that may be expended on capital purchases. It takes account of money owed by and to the organisation in relation to capital and the sale or disposal of assets.

Part of the NHS Executive (Wales), the delivery unit provides professional support to the Welsh government to monitor and manage performance delivery across NHS Wales.

The process of spreading the cost of an asset over its useful life as opposed to recording it as a single item of expenditure when the asset is purchased.

Depreciation is an accounting charge (not involving a cash outlay) that recognises that the value of a capital asset is used up or consumed over its useful life. Accumulated depreciation is the extent to which depreciation has been charged to successive years’ expenditure records since the acquisition of the asset.

Earnings before interest, taxation, depreciation and amortisation (EBITDA) is an expression of an NHS provider's surplus from normal operations and a measure of profitability. It provides an indication of the organisation's ability to reinvest and meet any charges associated with loans it may have. It is calculated as revenue less operating expenses less depreciation less amortisation.

Depreciation is a non-cash expense which recognises that assets are 'used up' during their useful life. The term relates to tangible assets such as property, plant and equipment.

Amortisation follows the same principle as depreciation but is the term used in relation to intangible assets such as patents, intellectual property and software licences.

The emergency ambulance services committee (EASC) was established in 2014 to commission emergency ambulance services in Wales on behalf of the local health boards. It was hosted by Cwm Taf University Health Board. In 2024 it was disbanded and replaced by the NHS Wales joint commissioning committee.

Earnings before interest, taxation, depreciation and amortisation (EBITDA) is an expression of an NHS provider's surplus from normal operations and a measure of profitability. It provides an indication of the organisation's ability to reinvest and meet any charges associated with loans it may have. It is calculated as revenue less operating expenses less depreciation less amortisation.

Depreciation is a non-cash expense which recognises that assets are 'used up' during their useful life. The term relates to tangible assets such as property, plant and equipment.

Amortisation follows the same principle as depreciation but is the term used in relation to intangible assets such as patents, intellectual property and software licences.

The external financing limit (EFL) is one of the key performance targets against which an NHS trust is measured. The EFL is a control on net cash flows and sets a limit on the level of cash that may be:

• drawn from either external sources or its own cash reserves (a positive EFL) or
  
• repaid to external sources to increase cash reserves (a negative EFL).

A target EFL is set at the start of the financial year and the trust is expected to manage its resources to ensure it achieves the target. Trusts must not overshoot their EFL.

The difference between the cash an NHS trust plans to spend in a year and what it can generate itself is known as the external financing requirement (EFR).

The emergency ambulance services committee (EASC) was established in 2014 to commission emergency ambulance services in Wales on behalf of the local health boards. It was hosted by Cwm Taf University Health Board. In 2024 it was disbanded and replaced by the NHS Wales joint commissioning committee.

Funds held by a charity that trustees are legally required to invest or retain.

There are two types of endowment: permanent endowments are invested to earn income that can be spent on the fund's charitable purposes and expendable endowments that may be spent with the consent of the Charity Commission.

The external financing limit (EFL) is one of the key performance targets against which a NHS trust is measured. The EFL is a control on net cash flows and sets a limit on the level of cash that may be:

• drawn from either external sources or its own cash reserves (a positive EFL) or
• repaid to external sources to increase cash reserves (a negative EFL).

A target EFL is set at the start of the financial year and the trust is expected to manage its resources to ensure it achieves the target. Trusts must not overshoot their EFL.

The difference between the cash an NHS trust plans to spend in a year and what it can generate itself is known as the external financing requirement (EFR).

A process undertaken by organisations or systems that are in financial deficit to return to financial balance. It may involve reducing expenditure by making efficiency savings, providing fewer services, securing additional income, or some combination of these.

Provision of safe and quality healthcare services within the resources available that meet the healthcare requirements of the population, and with the flexibility/ capability to maintain those services over the longer term, responding to emerging health challenges and developments.

NHS bodies deliver financial sustainability within a partnership environment. All decisions reflect financial, operational, environmental and societal issues across the local health and care system. Services are delivered in an equitable manner across society and incorporate the relevant environmental factors beyond the health and care setting.

The group accounting manual (GAM) is mandatory accounting guidance for all DHSC group bodies including integrated care boards, NHS trusts, NHS foundation trusts and arm's length bodies.

Mandatory accounting guidance for all DHSC group bodies including integrated care boards, NHS trusts, NHS foundation trusts and arm's length bodies (ALBs).

Health and social care (HSC) is the collective reference for all the public sector organisations involved in the provision of health and social care services in Northern Ireland.

The 14 regional NHS health boards in Scotland plan, commission and deliver NHS services and take overall responsibility for the health of their populations. In addition, there are six special health boards that provide national services across Scotland.

Health economics is a branch of economics – the social science that studies how societies make choices on allocating scarce resources to satisfy unlimited wants. Health economics is concerned with issues relating to efficiency, effectiveness, value and behaviour in the supply and consumption of healthcare.

Part of NHS England, Health Education England (HEE) provides national leadership and oversight on strategic planning and development of the health and public health workforce and allocates education and training resources.

Health related quality of life (HRQoL) is a multi-dimensional concept that includes domains related to physical, mental, emotional and social functioning. It goes beyond direct measures of population health, life expectancy and causes of death, and focuses on the impact health status has on quality of life. HRQoL is assessed through surveys.

The Health Services Safety Investigations Body (HSSIB) is an arm’s length body of the Department of Health and Social Care set up in October 2023 to share learning from patient safety concerns. It investigates and reports on incidents that have implications for the safety of patients within both NHS and independent healthcare providers in England.

Health technology assessment (HTA) is a term that covers the evaluation of all new interventions, and is, in essence, where clinical research and health policy come together. It is concerned with how well an intervention works and whether it is worth the money.

Health utility is a unitary value that reflects an individual's preferences for different health outcomes. It makes use of a sliding scale of preference where a value of 0 equals death and 10 equals perfect health.

Healthcare agreements are contracts agreed between two local health boards or a local health board and an NHS trust.

A public body funded by the Scottish government health and social care department. It supports the delivery of high-quality, evidence-based care and scrutinises services to provide public assurance about the quality and safety of healthcare.

Part of NHS England, Health Education England (HEE) provides national leadership and oversight on strategic planning and development of the health and public health workforce and allocates education and training resources.

Health related quality of life (HRQoL) is a multi-dimensional concept that includes domains related to physical, mental, emotional and social functioning. It goes beyond direct measures of population health, life expectancy and causes of death, and focuses on the impact health status has on quality of life. HRQoL is assessed through surveys.

Health and social care (HSC) is the collective reference for all the public sector organisations involved in the provision of health and social care services within Northern Ireland.

The Health Services Safety Investigations Body (HSSIB) is an arm’s length body of the Department of Health and Social Care set up in October 2023 to share learning from patient safety concerns. It investigates and reports on incidents that have implications for the safety of patients within both NHS and independent healthcare providers in England.

Health technology assessment (HTA) is a term that covers the evaluation of all new interventions, and is, in essence, where clinical research and health policy come together. It is concerned with how well an intervention works and whether it is worth the money.

In England integrated care partnerships (ICPs) are statutory committees of integrated care boards and local authorities within each of the 42 integrated care systems. They bring together NHS leaders, local authorities and other partners to prepare an integrated care strategy which other members of the integrated care system must follow when making decisions and delivering services.

In Northern Ireland integrated care partnerships are committees working with local commissioning groups (LCGs) and HSC trusts to improve the integration of primary care services.

Integrated care systems (ICSs) are geographically based partnerships of health and care organisations that come together to plan and deliver joined-up services and to improve the health of people who live in their area.

The integrated care system Northern Ireland (ICSNI) is a revised structure for the health and social care (HSC) system in Northern Ireland. It is a planning and commissioning system that aims to promote collaboration and partnership working. It consists of a regional ICS partnership forum (RICSPF) and five area integrated partnership boards (AIPBs) that are co-terminus with the HSC trusts.

IFRS is a set of accounting standards according to which organisations prepare their financial statements. They are set by the International Accounting Standards Board (IASB). They have been applied by all government bodies including NHS bodies since 1 April 2009 and are designed to:

• bring consistency and comparability to the financial statements of government departments
• facilitate comparisons between and within the public and private sectors
• enhance public sector accountability.

The index of multiple deprivation (IMD) measures the relative levels of deprivation in 32,844 small areas or neighbourhoods in England, known as lower layer super output areas (LSOAs). It is based on factors including levels of income, employment, education and crime.

Income generation applies to non-NHS contract funding schemes that provide a contribution to an NHS body that can be used for improving health services. Examples include charging for certain patient services or facilities such as a private room and television or telephone.

NHS bodies can also enter into commercial ventures with private companies to generate income from specific services. Income generation schemes are typically cash generating schemes as opposed to cash releasing cost reduction schemes.

The index of multiple deprivation (IMD) measures the relative levels of deprivation in 32,844 small areas or neighbourhoods in England, known as lower layer super output areas (LSOAs). It is based on factors including levels of income, employment, education and crime.

A scheme that operates throughout the UK to allow hospitals to claim for the cost of treating people following personal injuries and road traffic accidents. Claims can only be made where the patient is compensated as a result of an accident or injury and the amount that can be claimed is set out in legislation.

Introduced in Wales in 2014/15 as the intermediate care fund it encourages the development of projects to support integrated care for specific groups of people. It is designed to drive forward joint working between local authority social services, health and housing, along with third and independent sector partners.

In England integrated care partnerships (ICPs) are statutory committees of integrated care boards and local authorities within each of the 42 integrated care systems. They bring together NHS leaders, local authorities and other partners to prepare an integrated care strategy which other members of the integrated care system must follow when making decisions and delivering services.

In Northern Ireland integrated care partnerships are committees working with local commissioning groups (LCGs) and HSC trusts to improve the integration of primary care services.

Integrated care systems (ICSs) are geographically based partnerships of health and care organisations that come together to plan and deliver joined-up services and to improve the health of people who live in their area.

The integrated care system Northern Ireland (ICSNI) is a revised structure for the health and social care (HSC) system in Northern Ireland. It is a planning and commissioning system that aims to promote collaboration and partnership working. It consists of a regional ICS partnership forum (RICSPF) and five area integrated partnership boards (AIPBs) that are co-terminus with the HSC trusts.

Within the NHS in Scotland an integration authority (IA) is the name given to the entity that has responsibility for ensuring that health and social care services are planned, managed and delivered in an integrated manner.

This is the term used to describe the agreement of balances process in Northern Ireland. It is the amounts owed to HSC organisations by other HSC organisations and vice versa. These amounts are agreed by HSC organisations as part of an exercise managed by the Department of Health Northern Ireland.

Internal audit has two aspects – firstly, providing an independent and objective opinion to the accountable officer, governing body and audit committee on the extent to which risk management, control and governance arrangements support the aims of the organisation.

The second aspect provides an independent and objective consultancy service specifically to help line management improve the organisation's risk management, control and governance arrangements. Internal audit can be in-house or bought in from a consortium or accountancy firm.

• bring consistency and comparability to the financial statements of government departments
• facilitate comparisons between and within the public and private sectors
• enhance public sector accountability.

• for sale in the ordinary course of business
• for use in the production process
• as materials or supplies that are consumed in the production of goods or rendering of services.

A joint local health and wellbeing strategy (JLHWS) sets out the vision, priorities and actions needed to improve the health, care and wellbeing of local communities.

A joint local health and wellbeing strategy (JLHWS) sets out the vision, priorities and actions needed to improve the health, care and wellbeing of local communities.

A joint strategic needs assessment (JSNA) is drawn up by a health and wellbeing board (HWB) and identifies the current and future health and wellbeing needs of the local population.

A joint strategic needs assessment (JSNA) is drawn up by a health and wellbeing board (HWB) and identifies the current and future health and wellbeing needs of the local population.

Key lines of enquiry (KLOE) describe a framework used by sector regulators to assess performance of NHS providers.

A local delivery plan (LDP) sets out agreement between the Scottish government and NHS boards in Scotland focusing on strategic priorities. All boards in Scotland are required to publish a rolling three year plan but they are reviewed and updated annually.

Under the NHS payment scheme, a local price is one that is negotiated and agreed between a commissioner and a healthcare provider for a healthcare activity. It only applies if a unit price does not exist or the aligned payment and incentive approach does not apply.

Under the national tariff payment system a local variation was an adjustment to a national price or currency or a payment approach agreed by a provider and commissioner. The proposed variation had to meet documented criteria and be notified to NHS England.

Lower layer super output areas (LSOA) are 32,844 small areas or neighbourhoods in England in which relative levels of deprivation are measured using the index of multiple deprivation.

Lower layer super output areas (LSOA) are 32,844 small areas or neighbourhoods in England in which relative levels of deprivation are measured using the index of multiple deprivation.

Under the NHS payment scheme, the market forces factor (MFF) is an index applied to all NHS bodies in England. It is used to account for geographical (unavoidable) variations in the cost of providing healthcare in different parts of the country.

Mental health and neurodevelopmental resource groups (MHNRGs) are a mental health currency to replace mental health care clusters. Patients are categorised into population groups and settings that are clinically similar and consume similar levels of resources, much like HRGs – a currency used within acute healthcare.

A term used by economists to describe items such as healthcare whose consumption provides benefits to others as well as to the individual consumer. For example, inoculation against a contagious disease provides protection to an individual and the wider population who are protected from catching the disease from those who are inoculated.

Under the NHS payment scheme, the market forces factor (MFF) is an index applied to all NHS bodies in England. It is used to account for geographical (unavoidable) variations in the cost of providing healthcare in different parts of the country.

Mental health and neurodevelopmental resource groups (MHNRGs) are a mental health currency to replace mental health care clusters. Patients are categorised into population groups and settings that are clinically similar and consume similar levels of resources, much like HRGs – a currency used within acute healthcare.

A digital information service containing comprehensive activity, performance and cost data from a wide variety of sources that enables NHS bodies and systems to compare performance to help improve productivity and efficiency.

A term used by economists referring to situations such as healthcare provision where the consumer may increase their take up of services because they are not directly paying the full cost of their treatment. This can have the impact of increasing demand over supply.

The national care service in Scotland (NCS Scotland) is a proposed structure that will transfer responsibility for social care from local authorities to a new national service. It aims to improve the quality of care and ensure that services are standardised across Scotland.

The National Audit Office (NAO) audits all government departments including the Department of Health and Social Care, NHS England and a large number of public sector organisations. The NAO reports to the government on how well these departments and organisations have used their resources in relation to economy, efficiency and effectiveness.

The national cost collection index (NCCI) gives a single figure (effectively a ranking) for each NHS provider organisation, enabling comparison of their activity costs with other providers. It was previously known as the national reference cost index (NRCI).

The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body that is responsible for providing national guidance and quality standards to improve the outcomes of people using the English NHS, other public health and social care services. NICE technology appraisals, clinical guidelines and interventional procedure guidance also apply in Wales.

Under the national tariff payment system a national price was the price set for a defined unit of healthcare. It was the amount paid by a commissioner to reimburse a provider of NHS funded healthcare.

The national tariff payment system (NTPS) was a system of financial flows – a way of moving funds around the health service between commissioners and providers. It enabled healthcare providers in England to be reimbursed for the costs of providing treatment.

First introduced in 2003 as payment by results, it applied to all providers of NHS healthcare services other than primary care and public health. It was replaced in 2022 by a revised and simplified payment scheme, the NHS payment scheme.

The national cost collection index (NCCI) gives a single figure (effectively a ranking) for each NHS provider organisation, enabling comparison of their activity costs with other providers. It was previously known as the National reference cost index (NRCI).

The national care service in Scotland (NCS Scotland) is a proposed structure that will transfer responsibility for social care from local authorities to a new national service. It aims to improve the quality of care and ensure that services are standardised across Scotland.

A non-executive director (NED) is a member of the board of directors but is not employed by the organisation. NEDs are appointed by the organisation's nominations committee (or NHS England for NHS trusts) and are chosen based on their individual skills and what they will bring to the overall composition of the board. They are expected to challenge decisions and strategies.

Multi-disciplinary teams based in a range of settings organised around patient needs - for example, GPs working with hospital based consultants.

The NHS Business Services Authority (NHS BSA) is a special health authority and arm's length body (ALB) of the Department of Health and Social Care that provides a range of central services to NHS organisations, NHS contractors and directly to patients and the general public. These include:

• making payments to dentists and pharmacists
• providing help with health costs such as prescription and dental costs
• managing the NHS pension scheme
• managing the electronic staff records (ESR) programme.

Part of NHS England, NHS Digital collects, analyses and publishes data and information relating to health and social care in England.

It is also responsible for managing the commissioning system and commissioning some services itself – for example, services for members of the armed forces and some specialised services.

NHS Providers is a membership organisation and trade association for NHS hospital, mental health, community and ambulance services. It helps trusts and foundation trusts to deliver high-quality care by enabling them to learn from each other, acting as their public voice and helping shape the system in which they operate.

NHS Shared Business Services (NHSSBS) is a joint venture between the Department of Health and Social Care and a private company Sopra Steria. It provides the following services to NHS bodies:

• finance & accounting
• employment services
• procurement.

The NHS standard contract specifies detailed terms and conditions to be applied between commissioners and providers and is comprised of three chapters:

• the particulars – that create the contract
• service conditions – relevant to the service(s) being commissioned
• general conditions.

In England non-foundation NHS trusts provide mainly hospital-based services. The most common type is an acute hospital trust. Others include mental health and ambulance trusts.

In Wales, there are three NHS trusts that deliver specific services covering the whole country:

• Welsh Ambulance Services NHS Trust
• Velindre University NHS Trust (cancer specialist)
• Public Health Wales NHS Trust.

In Northern Ireland, five NHS trusts deliver health and social care services; the sixth trust provides ambulance services across the country.

NHS Wales joint commissioning committee (NWJCC) is a joint committee of the seven Welsh health boards acting on their behalf to commission specialised and ambulance services across Wales. Set up in 2024 and hosted by Cwm Taf Morganwwg University Health Board, it replaced the emergency ambulance services committee (EASC), the Welsh health specialised services committee (WHSSC) and the national collaborative commissioning unit (NCCU).

The NHS Business Services Authority (NHS BSA) is a special health authority and arm's length body (ALB) of the Department of Health and Social Care that provides a range of central services to NHS organisations, NHS contractors and directly to patients and the general public. These include:

• making payments to dentists and pharmacists
• providing help with health costs such as prescription and dental costs
• managing the NHS pension scheme
• managing the electronic staff records (ESR) programme.

NHS England is an executive non-departmental body working at arm's length from the Department of Health and Social Care. It is accountable to the Secretary of State for Health and Social Care for meeting its legal duties and fulfilling the NHS mandate. NHS England is also accountable for staying within its allocated resources and delivering a wide range of improvements in healthcare.

It is also responsible for managing the commissioning system and commissioning some services itself – for example, services for members of the armed forces and some specialised services.

Introduced in April 2023, the NHS payment scheme is the payment mechanism currently in use. It is designed to support collaborative working and its application is a legislative requirement for all NHS secondary care services.

NHS Shared Business Services (NHSSBS) is a joint venture between the Department of Health and Social Care and a private company Sopra Steria. It provides the following services to NHS bodies:

• finance & accounting
• employment services
• procurement.

The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body that is responsible for providing national guidance and quality standards to improve the outcomes of people using the English NHS, other public health and social care services. NICE technology appraisals, clinical guidelines and interventional procedure guidance also apply in Wales.

The Nolan principles of public life are the key principles of how individuals and organisations in the public sector should conduct themselves. The principles are:

• selflessness
• integrity
• objectivity
• accountability
• openness
• honesty
• leadership.

A non-executive director (NED) is a member of the board of directors but is not employed by the organisation. NEDs are appointed by the organisation's nominations committee (or NHS England for NHS trusts) and are chosen based on their individual skills and what they will bring to the overall composition of the board. They are expected to challenge decisions and strategies.

The national tariff payment system (NTPS) was a system of financial flows – a way of moving funds around the health service between commissioners and providers. It enabled healthcare providers in England to be reimbursed for the costs of providing treatment.

First introduced in 2003 as payment by results, it applied to all providers of NHS healthcare services other than primary care and public health. It was replaced in 2022 by a revised and simplified payment scheme.

NHS Wales joint commissioning committee (NWJCC) is a joint committee of the seven Welsh health boards acting on their behalf to commission specialised and ambulance services across Wales. Set up in 2024 and hosted by Cwm Taf Morganwwg University Health Board, it replaced the emergency ambulance services committee (EASC), the Welsh health specialised services committee (WHSSC) and the national collaborative commissioning unit (NCCU).