There is a deceptively simple question at the heart of the English NHS – and one that frequently baffles pharma clients at HSJ Information: who is actually in charge?
For much of its history, the answer, while never perfectly clear, followed a recognisable chain of command. Ministers set direction, NHS England managed the system, commissioners commissioned and providers delivered.
For those seeking to work with the NHS, including pharma, the task was to understand that hierarchy and engage with it.
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