National Health Service

The National Health Service (NHS) is the conglomerate name for the publicly funded healthcare systems of the United Kingdom, comprising NHS England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS".[2] The original three systems were established in 1948 (NHS Wales/GIG Cymru was founded in 1969) as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay.[3] Each service provides a comprehensive range of health services, provided without charge for people ordinarily resident in the United Kingdom apart from dental treatment and optical care.[4] In England, NHS patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt.[5]

Logos of the
National Health Service

Logo of the NHS in England[lower-alpha 1][1]

Logo of HSC in Northern Ireland

Logo of NHS Scotland

Logo of NHS Wales

Taken together, the four services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion.[6] In 2014, the total health sector workforce across the United Kingdom was 2,165,043 making it the fifth largest employer and largest non-military public organisation in the world.[7][8][9]

When purchasing consumables such as medications, the four healthcare services have significant market power that influences the global price, typically keeping prices lower.[10] A small number of products are procured jointly through contracts shared between services.[11] Several other countries either copy the United Kingdom's model or directly rely on Britain's assessments for their own decisions on state-financed drug reimbursements.[12]