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Working in the NHS

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For the NHS, a typical day includes:

  • Over 835,000 people visiting their GP practice or practice nurse
  • Almost 50,000 people visiting accident and emergency departments
  • 49,000 outpatient consultations
  • 94,000 people admitted to hospital as an emergency admission
  • 36,000 people in hospital for planned treatment
  • 28,000 sight tests being carried out
  • 18,000 calls to NHS Direct

The structure of the NHS

Hospitals in the NHS are managed by NHS trusts (sometimes called acute trusts) and are run by a trust board. These trusts make sure that hospitals provide high quality health care and that they spend their money efficiently. Mental health trusts and ambulance trusts have a similar structure, but tend to cover wider areas. There are almost 300 hospital, mental health and ambulance trusts and 152 primary care trusts (PCTs) in England.

Primary care is provided in your local community via your local GP, NHS walk-in centre, dentist, pharmacist and optician. NHS Direct is also responsible for providing healthcare advice and information 24 hours a day via the internet and over the telephone.

All hospital and mental health trusts are dependent on PCTs’ commissioning services such as elective surgery, outpatient visits and other treatments from them, but PCTs also run community-based hospitals and provide services such as district nursing and health promotion.

PCTs still tend to commission many services from their local hospital. However, under the patient choice initiative, anyone needing elective hospital treatment will be offered a choice of where it is carried out, including independent sector treatment centres (ISTCs) run by private companies.

Strategic Health Authorities (SHAs) cover large areas – typically neighbouring counties or large city areas – and are responsible for overseeing other NHS organisations in their area and leading on issues such as workforce development and capacity.

The NHS – a rewarding place to work

There are few careers that are as rewarding as one in the NHS, or that give you the opportunity to work with such a variety of people.

We actively recruit people of all ages, backgrounds and levels of experience. This helps us understand the different needs of the patients and provide the best possible service.

Whichever area you join, you become part of a talented, passionate team of people, committed to providing the best care and treatment to patients. You will also enjoy one of the most competitive and flexible benefits packages offered by any employer in the UK.

Benefits of working in the NHS

Everyone who joins the NHS is guaranteed a salary that matches their ability and responsibilities, and given every opportunity to increase it through training and development.

On top of your basic salary, you will receive at least 27 days holiday each year, plus a range of other benefits including occupational health and counselling services.

Pay and conditions

A new national pay system – Agenda for Change (AfC) – was introduced across the NHS in October 2004 for all directly employed staff, except doctors and the most senior managers. The new pay system offers real benefits for staff including:

  • A standard working week of 37.5 hours
  • Harmonised holiday entitlements of 27 days per year, plus eight general and public holidays, rising to 33 days after ten years of service
  • New pay enhancements to reward out of hours, shift and overtime working
  • Better career and pay progression based on the application of knowledge and skills
  • Annual personal development review to support career aspirations

Other benefits of working in the NHS include training, occupational health services, automatic membership of the NHS Pension Scheme (unless you choose to opt out) and study leave for sponsored courses.

Join one of the UK’s best pension schemes

The NHS Pension Scheme is one of the most generous and comprehensive in the UK. Every new employee automatically becomes a member and you will get an excellent package of pension benefits, fully protected against inflation and guaranteed by the government.

Moving on in the NHS

The NHS is committed to offering development and learning opportunities for all full-time and part-time staff. No matter where you start within the NHS, you’ll have access to extra training and be given every opportunity to progress within the organisation.

You will receive an annual personal development review and development plan to support your career progression and, as part of the Knowledge and Skills Framework (KSF), within Agenda for Change, you will be encouraged to extend your range of skills and knowledge and take on new responsibilities.

For more information on the Knowledge and Skills Framework go to

Career Framework

The Career Framework has been designed to improve career development and job satisfaction for NHS employees. It encourages individuals to learn new skills and take on extra responsibilities that enable them to progress within the organisation. Many people take on additional responsibility within their own area, while others retrain and move in to different roles.

You can read how some find out more about the Career Framework on the Skills for Health website at

Help and advice for existing staff

If you are already working within the NHS and would like some advice on how to progress your career, the Health Learning and Skills adviceline offers advice and information on learning opportunities, funding for studies and the different types of support available to you whilst you’re learning.

Health Learning and Skills advice line staff have been specifically trained in health and social care careers and the service is available by calling, free of charge, 08000 150 850.