We are an acute trust. This page gives a simple overview of the different types of organisations and services that together make up the national health service in England.
The difference between primary and secondary care
Primary care is the local healthcare that we receive from GPs, NHS-walk-in centres, dentists, pharmacists and optometrists. These are the services that most often bring people into contact with the NHS. They are provided and managed by primary care trusts.
Secondary (or “acute”) care is the healthcare that people receive in hospital. It may be unplanned emergency care or surgery, or planned specialist medical care or surgery. If you go to hospital for planned medical care or surgery, this will usually be because your GP, or another primary care health professional, has referred you to a specialist. We are a secondary care provider.
How people receive NHS healthcare
The NHS provides all of its healthcare services through organisations known as “trusts”. There are five main types of NHS trust:
- NHS primary care trusts
-
NHS hospital trusts, which are often referred to as acute trusts
- NHS ambulance services trusts
- NHS mental health trusts
- NHS care trusts
Primary care trusts (PCTs)
There are 152 primary care trusts in England, each of which is responsible for health care services in its local area. They work with local authorities and other agencies to meet the community’s needs for healthcare and social care. As well as providing these local services, your local primary care trust also buys, or “commissions”, other kinds of healthcare services for local people - for example, certain kinds of hospital treatment. Our local PCTs are NHS Hounslow and NHS Richmond.
Acute (hospital) trusts
NHS hospitals are managed by acute trusts, of which there are 169 in England. While some acute trusts run one large hospital, others run several hospitals within an area. West Middlesex is a single hospital acute trust. Some acute trusts also provide specialist services in the community – for example, through health centres, clinics or in people’s homes.
Acute trusts sometimes provide very specialised care. For example, they may be regional or national centres of excellence for a specialty such as heart surgery, or be attached to universities and help to train health professionals. West Middlesex is a university hospital.
Ambulance services trusts
There are 11 ambulance trusts in England, which run the services that respond to emergency (999) calls for healthcare. These services are equipped to provide treatment at the scene of an accident. In many areas of the country they also provide transport to get people to hospital for planned treatment. Our local ambulance trust is the London Ambulance Service, although patients may be brought into our hospital from other ambulance services.
Mental health trusts
Unlike primary care services, which usually treat milder mental health problems, England's 58 mental health trusts provide specialist care for people with more severe problems. Their services can be based in hospitals or in the community, and range from psychological therapy through to very specialised medical and training services. At West Middlesex we have the Lakeside Mental Health Unit on our site, which is run by West London Mental Health Trust.
Care trusts
Care trusts provide healthcare and/or social care, including mental health services and primary care services. At the moment there are only a small number of care trusts, set up if the NHS and local authorities decide that it would benefit local services if they worked in partnership over health and social care.
Foundation trusts
Foundation trusts differ from other NHS trusts in that they are run by local managers, staff and members of the public. This means that they often respond better to the needs of local people. Foundation trusts have more freedom than other NHS trusts about how they use their funds and how they operate, but they are still subject to our annual assessments. Most foundation trusts run acute hospitals, although some mental health trusts have been made foundation trusts. West Middlesex is not a Foundation Trust.
Other organisations that are part of the NHS
Strategic health authorities
There are 10 strategic health authorities in England and their role is to manage NHS trusts in their areas on behalf of the Department of Health. Strategic health authorities develop plans for improving and increasing health services in their area where necessary, and make sure local health services perform well. We come under the strategic health authority of NHS London.
Special health authorities
Special health authorities provide a health service to the whole of England, not just to a local community – for example, the National Blood Authority, or NHS Direct.
