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Explaining the health and care system: keeping people and communities at the heart of our new animation

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How does the health and care system work? It is a question that is simple to ask but notoriously difficult to answer.

Back in 2013, we at The King’s Fund set ourselves the challenge of doing just that. In the wake of the 2012 Health and Care Act we launched our first animated guide to the NHS – a whistle-stop tour of the key bodies and organisations that made up the health service and a tongue-in-cheek explanation of the reformed health and care system.

And it worked. So much so that four years later in 2017 we published another, updated guide to the NHS, to reflect how things were working in practice. Together the two animations have been viewed more than 600,000 times. They are to date our most popular pieces of digital content and demonstrate the appetite among people working in the health and care system for content that makes sense of it.

And now in 2022, we have published a new version of the animation. So, what’s changed in health and care?

On one hand, much of the story feels strikingly familiar. A complicated set of reforms in the shape of the 2022 Health and Care Act is bringing significant (if less headline-grabbing) changes to the health and care system. Once again, we are trying to wrap our heads around a confusing set of acronyms describing the partnerships developing between different bodies and organisations. (If navigating the world of ICPs, ICBs and ICSs feels like wading through alphabet spaghetti, you are not alone.)

'Once again, we are trying to wrap our heads around a confusing set of acronyms describing the partnerships developing between different bodies and organisations.'

But on the other hand, much has changed. The growing emphasis on collaboration, rather than competition, the focus on providing joined-up or ‘integrated’ care – these changes have led to a fundamental shift in the structure and culture of the health and care system. Meanwhile the impacts of the global Covid-19 pandemic have put further pressure on an already overstretched and understaffed health service.

So, while the purpose of the animation has remained unchanged, our approach – like the story of the NHS itself – has evolved.

First, this time round we wanted to give a sense of how the latest set of changes fit in the wider history of the NHS, from its inception to the present day. It is often said that knowing where we have come from can help us make sense of where we are going. This applies to the NHS.

Second, we wanted to put people at the very heart of the animation. Ultimately, these changes are about people. They are about people being able to access the care they need, when and where they need it and how health and care staff, communities, local government, charities and others can work together to achieve that. The reforms alone will not tackle all the deep-rooted issues facing the NHS. But it is hoped that they will provide a framework through which people and organisations can work more closely together to provide joined-up care for patients.

And third, we wanted to make collaboration – people working together – a central theme throughout the animation. There is no blueprint for how the collaboration promised under the reforms will work in practice and no one way to make these changes happen. None of this will be easy and it is impossible to overstate the scale of the challenges facing the NHS, its staff and its partners. But these changes are an opportunity for people to work with one another in different ways to better meet the needs of the communities they serve.

'The NHS and the wider health and care system is made up of people, places, and communities.'

Often the history of the NHS is a series of names and dates; a story of politicians and policy-makers, faceless bodies and organisations, that appear and disappear like the ebb and flow of the tide. They all, to different degrees, leave their mark and it is right that they are part of the story. But it is not the whole story.

The NHS and the wider health and care system is made up of people, places, and communities. It is a story that is being written and re-written every day, in doctor’s surgeries, in people’s homes, in telephone conversations, in hospital corridors, allotments, community centres, and in the multitude of places where care is given and received. We hope we have reflected some of that in the animation.

How does the NHS in England work and how is it changing? Still from the animation
Animation

How does the NHS in England work and how is it changing?

Watch our animation to discover the key organisations that make up the NHS and how they can collaborate with partners in the health and care system to deliver joined-up care.

Watch the animation