English Health Geography

The situation as of 1 October 2006

Health administration in England was significantly restructured in 2006.

On 1 July 2006 the number of Strategic Health Authorities (SHAs) reduced from 28 to 10. The boundaries of the new SHAs are coterminous with Government Office Regions (GORs), with the exception of the South East GOR which comprises two SHAs (which are constituted from groups of local authorities). SHAs continue to report to the Department of Health.

On 1 October 2006 the number of Primary Care Organisations (PCOs) reduced from 303 to 152. The PCOs are made up of 148 Primary Care Trusts and 4 Care Trusts. The majority of the new PCOs are defined in terms of local authority districts. Of the 152 PCOs: 130 comprise one or more whole local authority districts; 16 comprise one or more whole local authority districts plus whole wards; three comprise only whole wards within a single local authority district; two comprise one or more whole local authority districts and part wards (ie. whole parishes); and one comprises whole and part wards (ie. whole parishes) within a single local authority district. PCOs report to the SHAs.

July 2003 to June 2006

The structure for health administration in England came into effect on 1 July 2003. There were 28 Strategic Health Authorities (SHAs), which were constituted from groups of local authorities and performance managed the Primary Care Organisations (PCOs).

As of 1 October 2005 there were 303 PCOs including 299 Primary Care Trusts (PCTs) and 4 Care Trusts (CTs) based on the PCT model (this meant that they fulfilled all PCT functions and also delivered the health services usually provided by local authorities). The PCOs were (mostly) aligned with the administrative boundaries existing at the time of the last major health reorganisation on 1 May 2002.

April 2002 - June 2003

During this period the Directorates of Health and Social Care (DHSCs) formed an additional top layer to the present structure. There were 4 DHSCs, each covering one or more Government Office Regions (GORs). DHSCs were part of the Department of Health rather than the NHS.

April 1999 - March 2002

A major reorganisation of English health geography occurred on 1 April 2002. Before this there were 8 Regional Offices (ROs), which were part of the Department of Health. These were divided into approximately 100 Health Authorities (HAs), which in turn were split into PCOs. When PCOs were first established in 1999 there were 481 Primary Care Groups (PCGs) but by 2002 a significant number had converted to PCTs. The numbers of both HAs and PCOs varied slightly through this period.

Health geography before April 1999

The RO/HA structure shown (but without the PCOs) was introduced in April 1996. Before this a structure of Regional and District Health Authorities (RHAs and DHAs) had been in place since 1982.

Health area names & codes

Names and codes of health areas. This includes:

• names and codes of current and former UK health areas; and
• look-up tables relating the former HAs to the current SHAs, and SHAs to the former DHSCs.

This page last revised: Tuesday, 30 May 2007