Originally called the
NHS Commissioning Board, but very quickly renamed as
NHS England, it was created by the 2012 Health and Social Care Act . NHSE replaced Strategic Health Authorities , and it controls Local Area Teams .
It is a largely unaccountable arms-length commissioning board that controls around £100-billion of NHS funds. Even its relationship to the Department of Health has been described as
opaque. It is headed by a man who is ideologically committed to health service privatisation - Simon Stevens . In practice, this means NHSE, an unelected body, can and does set out radical proposals to change the NHS without any discussion in parliament and without any explicit political mandate.
NHS England has been taken to court for making executive decisions about the NHS that depart from the 2012 Health and Social Care Act. These include cutting the 'minimum practice income guarantee' for rural GPs and imposing charges in 'primary care (GP) services' without any consultation of patients, public and local authorities.
NHS England Chairman Malcolm Grant has complained of
meddling by government ministers in the running of the NHS. He suggested that
post-2015 NHS user charges would have to be considered. He is also on the record saying
I don't use the NHS.
NHS England makes a show of holding its board meetings in public, but these meetings are only concerned with a small part of their business. Much of the day-to-day work is delegated to NHS England's network of Local Area Teams.