Date

Provider Organisation

Commissioner Organisation

Intermediate Management Tier

1985 (1)

Acute Unit, Hounslow & Spelthorne Health Authority

Hounslow & Spelthorne Health Authority

North West Thames Regional Health Authority

1992

Acute Unit, Ealing, Hammersmith & Hounslow District Health Authority

Ealing, Hammersmith & Hounslow District Health Authority (2)

North West Thames Regional Health Authority

1993

West Middlesex University Hospital NHS Trust (3)

Ealing, Hammersmith & Hounslow District Health Authority

North West Thames Regional Health Authority

1994

West Middlesex University Hospital NHS Trust

Ealing, Hammersmith & Hounslow Health Agency (4)

North Thames Regional Health Authority (5)

1996

West Middlesex University Hospital NHS Trust

Ealing, Hammersmith & Hounslow Health Authority (6)

North Thames Regional Office of the NHS Management Executive (7)

1999

West Middlesex University Hospital NHS Trust

Ealing, Hammersmith & Hounslow Health Authority

London Regional Office of the NHS Executive (8)

2002

West Middlesex University Hospital NHS Trust

Hounslow PCT (9)

North West London Health Authority (9)

NOTES

1  Up to 1990/91, health services were delivered (provided) and funding allocated through a single Health Authority structure - hospitals were managed by Health Authorities. The 1990 legislation created NHS Trusts and separated the provider function from the commissioning function. Commissioning Authorities were set up to purchase healthcare from providers. Also in 1990, the functions of the Regional Health Authority were slimmed down and some functions transferred to Health Authorities. Family Health Services Authorities (FHSA) were also in place to manage the provision of GP services;

2  Several health authorities merged to form a new District Health Authority. West Middlesex Hospital was a Directly Managed Unit of the DHA;

3  West Middlesex Hospital was a third-Wave NHS Trust and was established in April 1993;

4  Several District Health Authorities operated with the FHSAs as a single commissioning organisation;

5  North West Thames and North East Thames Regional Health Authorities merged in April 1994 to form North Thames Regional Health Authority;

6  The Family Health Services Authorities (FHSA) which dealt with primary care and GP funding were merged with the other local commissioning District Health Authorities to create single healthcare commissioning authorities. This superseded the Health Agency arrangements which had been in place in several areas;

7  Regional Health Authorities were abolished. The intermediate management tier function was then undertaken by Regional Offices of the NHS Management Executive, which was part of the Department of Health;

8  North Thames and South Thames Regional Offices were merged into a single London Regional Office following the publication of the Turnberg Report in 1998. The LRO operates on a sectoral basis across London (North Central, North West, North East, South East and South West);

9  Under 'Shifting the Balance of Power', responsibility for commissioning health services is transferred to Primary Care Trusts (PCTs). Many of the roles of the London Regional Office are transferred to merged Health Authorities which match the former LRO sectors. In October 2002 (subject to legislation) North West London Health Authority will become North West London Strategic Health Authority.