Legislation changing the way NHS is run in England came into force on 1 April 2013.
Clinical commissioning groups are new local organisations, to which all GP practices in an area must belong. CCGs are responsible for deciding how local hospital and community health services are provided.
CCGs are overseen by NHS England. In turn, it is accountable to the Health Secretary. The government sets NHS England a mandate every three years, outlining what it is expected to achieve and prioritise.
See the full explanation of the structure of the new NHS
As well as changes to the way the NHS is run, there is a squeeze on NHS finances. With pressure on public sector spending coming at the same time as rising demand and advances in medical care, the whole of the NHS is expected to do more for less.
In England, there is a target to save £20 billion – four per cent of the overall NHS budget - between 2012 and 2015. This is affecting the NHS in many different ways.
The NHS made £5.8 billion in savings in 2012, half of it from freezing staff pay. Government, NHS organisations and staff are all looking at ways of making further savings and increasing quality.
These include changes to the way NHS services are provided, changes to staffing and ways of working, and the use of new technologies. There continues to be much debate about where and how sustainable savings can be achieved.