To build a sustainable future, hospices are increasingly working within and alongside their local health and care systems. But it can be difficult to start engaging and co-ordinating with statutory systems.

On this page you’ll find an overview of the statutory providers in the UK and an explanation of how health services are commissioned.

This page takes around 5 minutes to read.

Statutory sector providers of health and care

How health services are commissioned


Commissioning: the purchaser / provider split

The way statutory health providers are funded has changed over the years. Having a basic knowledge of this will help you understand how the commissioning system behaves and why. 

In 1990, the Government introduced into UK legislation a split between the purchasers (commissioners) and providers of healthcare. This established the internal market and competition for service contracts.

Services were competitively tendered and awarded to NHS and private providers through formal contracting arrangements. Instead of block contracts, tariffs were devised to pay for units of activity. GP practices continued to be paid by ‘capitation’ (depending on the number of their registered patients).

In 1999, most healthcare was devolved from Westminster. Powers were given to the Northern Ireland Assembly, Scottish Parliament and Welsh Senedd. Since this time, healthcare structures have developed differently across the UK nations.

However, the structures and systems in all the UK nations are now moving back towards more integrated models of commissioning and providing health and social care. 

The structure of health and care systems

Now that you understand how health and care services are commissioned and delivered, you need to know how the health and care system is structured in each UK nation. This will help you understand who you need to engage with.