NHS England commission specialist services and primary care. Geoffrey Rivett (1998) From Cradle to Grave, 50 years of the NHS. The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. This saves hugely on administration costs that might otherwise involve complex consumable tracking and usage procedures at the patient level and concomitant invoicing, reconciliation and bad debt processing.  NHS trusts responded to the Nicholson challenge—which involved making £20 billion in savings across the service by 2015. Smoking is the greatest cause of avoidable illness and death in England, costs the NHS £2.5bn a year and the economy £11bn. The author's innovative ideas were not only essential to the conception of the NHS, but in fact, his best-selling novels are said to have greatly contributed to the Labour Party's victory in 1945.. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied. 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An innovative blood test that may spot more than 50 types of cancer will be piloted by the NHS in a world-leading programme, chief executive Sir Simon Stevens announced today.  In 2006 car park fees contributed £78 million towards hospital budgets. The streamlining will lead to ward closures including psychiatric ward closures and reduction in the number of beds in many areas among other changes. Quality is assessed by independent bodies such as the Healthcare Commission according to standards set by the Department of Health and the National Institute for Health and Clinical Excellence (NICE). The NHS provides all levels of healthcare from community healthcare to hospital care. There is concern that hospital beds are being closed without increased community provision. Services that don't need a referral include psychological therapies through the Improving Access to Psychological Therapies initiative, and treatment for those with drug and alcohol problems. PCTs disbursed funds to them on an agreed tariff or contract basis, on guidelines set out by the Department of Health. Independent accreditation groups exist within the UK, such as the public sector Trent Accreditation Scheme and the private sector CHKS. For urgent medical help – use the NHS 111 online service, or call 111 if you're unable to get help online. If you are a member of the public looking for health advice, go to the NHS website. Gainsbury added, "Our research finds that, in a lot of these kinds of reconfigurations, you don't save very much money – all that happens is the patient has to go to the next hospital down the road. Under older legislation (mainly the Road Traffic Act 1930) a hospital treating the victims of a road traffic accident was entitled to limited compensation (under the 1930 Act before any amendment, up to £25 per person treated) from the insurers of driver(s) of the vehicle(s) involved, but were not compelled to do so and often did not do so; the charge was in turn covered by the then legally required element of those drivers' motor vehicle insurance (commonly known as Road Traffic Act insurance when a driver held only that amount of insurance). , However, according to the Institute for Fiscal Studies (IFS), compared to the increase necessary to keep up with a rising population that is also ageing, spending will fall by 1.3% from 2009–10 to 2019–20.