ABSTRACT
Organisations providing NHS services are most simply categorised into those providing services outside the hospital setting (i.e. primary care services such as general practice), and ‘acute’ hospitals, which provide specialist, secondary care services. Some hospitals also provide tertiary care – highly specialised services such as neuro-surgery and thoracic surgery and the treatment of haemophilia. Historically hospitals have accounted for over 50 per cent of the NHS budget for service provision,1 even though they account for only 19 per cent of the daily contacts people have with the NHS (Figure 4.1).2 A key feature of the ‘new’ NHS is the drive to provide alternatives to existing hospital services, with a greater variety of service providers in both secondary and primary care, and alternatives to the provision of secondary care in the traditional hospital setting.
