The new NHS and how patients can find their way through the maze


You will have heard much over the last two years about the restructure of the NHS resulting from the Government’s Health and Social Care Act of 2012. Some organisations have been abolished, new organisations have been created, and some organisations have changed their role and responsibilities.

On the 1st April 2013, the NHS switched over from the old system to the new. This briefing will help to explain what changes have happened and how this may affect patients’ access to information advice and support.  This briefing is specifically about Manchester, but the pattern is similar across England.

Greater Manchester Commissioning Support Unit

The new world

The vast majority of the changes to the NHS concern those organisations who commission services on your behalf i.e. those who plan, fund, arrange and monitor health services delivered in your area. The providers of services, for example hospitals or GP practices, will not be affected by these changes.

Primary Care Trusts have until April commissioned almost all your local health services. On the 31st March 2013, they were abolished and their responsibility transferred to a number of different organisations:

  • Clinical Commissioning Groups (CCGs) – These are new organisations are led by local GPs. Their role is to commission:
  • Hospital Services
  • Community services such as district nursing or physiotherapist
  • Mental Health services
  • Learning Disability Services
  • NHS England (formerly the Commissioning Board (NCB) ) – This is a new, national organisation which has an ‘area team’ covering Greater Manchester. Their role is to deliver the Department of Health’s ambitions for the NHS by working with commissioners and providers of services across the country. They will also directly commission:
  • GP practices
  • Dentists
  • Pharmacists
  • Optometrists
  • Specialised services such as HIV care or heart transplants
  • Local Authorities – Under the changes, councils will become responsible for commissioning public health services. These are services which help you live healthier lives and help prevent ill health. There are a wide range of these but examples include:
  • Heath improvement work such as the Stop Smoking Service or weight management services
  • School nursing
  • Sexual health services
  • Drug and Alcohol Support services
  • Public Health England – This is a national body which will work closely with local authorities’ public health teams, carrying out a range of activities to protect and improve the nation’s health. Their work will include:
  • Co-ordinating work to combat infectious diseases such as flu
  • Co-ordinating work to combat infections acquired in hospitals such as MRSA
  • Deliver national publicity campaigns to prevent ill health

This link takes you to an interactive diagram of the new health and care system from April 2013. It illustrates the statutory bodies that will make up the new system, oriented around people and communities and where they receive their local health and care services. Clicking on any of the organisations will provide you with more information about their specific role.

Further information

With such a range of new organisations, there is a danger that people don’t know where to go for up to date news and information about health services.  Organisations are taking positive steps to promote health services to the public.  For instance, the three Manchester Clinical Commissioning Groups are trying to make this as simple as possible for local people by keeping their information resources city-wide. These include:

  • An e:bulletin to be produced on a monthly basis and provide information about NHS services across Manchester
  • The NHS Manchester website  will become a website for the 3 Clinical Commissioning groups so you will only have to go to one site to get local health information and updates
  • The NHS Manchester social media sites (Twitter, Facebook and Pinterest) will continue to cover the whole of Manchester and will feature news from each Clinical Commissioning Group
  • Additionally, If you wish to contact any of the Manchester Clinical Commissioning Groups you can use just one e:mail address to get through to us:
  • National websites such as NHS Choices will continue to provide a range of information about all health services and common health conditions.
  • The new national phone line, 111, has been launched. This replaced NHS Direct and provides health advice by phone to people who require it urgently.

Patients’ views count

You will have seen a lot of coverage of the NHS in national and local media recently. The terrible events at Mid Staffordshire hospital, which led to a large number of people receiving unacceptable care, have highlighted the importance of listening to, and acting upon, the views and experiences of patients using health services.

The Clinical Commissioning Groups have a key role to play in this and want to hear much more from you about the services in the city, both good and bad.


Sometimes patients may wish to complain about, or need to resolve a problem with, a local service. They can do this in two ways. They can either:

  • Contact the service directly. You will need to ask the service itself the best way to do this. Or,
  • Complain to the commissioners of the service as follows:
  1. If it is about hospital services, community services or mental health services, patients should contact the Patient Services Team at Greater Manchester Commissioning Support Unit (GMCSU).
  2. If it is about Primary Care services, (GP practices, Dentist, Pharmacists or Optometrists) patients should contact NHS England.
  3. If it is about Public Health services, patients should contact the Local Authority.

This may seem confusing but please be assured that if you contact any of the numbers above you will be advised on how best to raise your concerns.

The GMCSU Patient Services team

The three Manchester CCGs are all supported by the GMCSU Patient Services team.

Patient Services provides the following functions directly to patients for and on behalf of the CCG in relation to services they commission:

  • Information advice and informal resolution of patient enquiries – this is the service familiarly and formerly known as PALS.
  • Complaints resolution.
  • Responding to MP enquiries.
  • Replying to requests made under the Freedom of Information (FOI) Act.
  • Dealing with any claims made against the CCG.

The Patient Services team has a central base at St James House and this office is the focal contact point for all enquiries.  If patients wish to speak to a member of the team you can ring 0161 212 6270. The Patient Services team has dedicated email addresses for specific areas of their work:

All postal enquires can be sent to St James’s House, Pendleton Way, Salford M6 5FW.

Patient Services is staffed from 9am – 5pm Monday to Friday excluding bank holidays.  A confidential answerphone is available outside these times.  We aim to return calls and acknowledge emails by the next working day.

Patient enquiries about primary care

NHS England is now responsible for commissioning primary care services (GPs, dentists, opticians, pharmacy) and as such they are the first point of contact for all patient feedback, enquiries and complaints about these services.

Should patients have an enquiry or complaint about primary care services this should in the first instance be sent to the NHS England Contact Centre. The contact details for the NHS England Contact Centre are:

  • Phone           0300 3112233
  • Email  
  • Post             NHS Commissioning Board, PO Box 16738, Redditch B97 9PT

The NHS England Contact Centre opening hours are 8am to 6pm Monday to Friday excluding bank holidays.

If you are at all unsure about what action to take on receipt of an enquiry or complaint about primary care, please call the GMCSU Patient Services team on 0161 212 6270 and we will be happy to discuss this with you.

Independent Complaints Advocacy

Some patients require help and support to make their complaint.  The Independent Complaints Advocacy (ICA) service provides advice on how to make a complaint, support to empower patients to make their complaint and where necessary support at local resolution meetings.

The contact details for ICA are:

  • Phone           0808 801 0390
  • Email  
  • Post             5th Floor, Arthur House, Chorlton Street, Manchester, M1 3FH

Further information on the role of ICA can be found on their website


Healthwatch is the independent consumer champion for health and social care in England. Healthwatch England works with a network of 152 local Healthwatch organisations to ensure that the voices of consumers and those who use services reach the ears of the decision makers.

More information on the role of Healthwatch generally can be found on their website together with details of any local  Healthwatch .

Patient Experience

There are many other ways that patients can share their experience of health services if they do not wish to contact services directly or make a complaint.  The following are some examples and where to find further information: