Strategic Health Authority

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Strategic Health Authorities (SHA) are part of the structure of the National Health Service. England is split into 28 Strategic Health Authorities, set up in 2002. The previous 'Health Authorities' were renamed in 2002, and merged to form the new authorities [1] [2].

Each SHA is responsible for enacting the directives and implementing fiscal policy as dictated by the Department of Health at a regional level. In turn each SHA area has various NHS trusts which take responsibility for running the different NHS services locally.

Contents 1 Types of Trust 2 Map 3 1998-2002 Health Authorities 4 Pre-1996 RHAs

Types of Trust

• Acute Trust ("NHS trust")
• Ambulance Trust
• Care Trust
• Mental Health Trust
• Primary Care Trust (PCT)

Map

Image:England Strategic Health Authorities Numbered.png

1. Avon, Gloucestershire and Wiltshire SHA
2. Bedfordshire and Hertfordshire SHA
3. Birmingham and The Black Country SHA (West Midlands minus Coventry)
4. Cheshire and Merseyside SHA
5. County Durham and Tees Valley SHA
6. Cumbria and Lancashire SHA
7. Dorset and Somerset SHA
8. Essex SHA
9. Greater Manchester SHA
10. Hampshire and Isle Of Wight SHA
11. Kent and Medway SHA
12. Leicestershire, Northamptonshire and Rutland SHA
13. Norfolk, Suffolk and Cambridgeshire SHA
14. North and East Yorkshire and Northern Lincolnshire SHA
15. North Central London SHA
16. North East London SHA
17. North West London SHA
18. Northumberland, Tyne and Wear SHA
19. Shropshire and Staffordshire SHA
20. South East London SHA
21. South West London SHA
22. South West Peninsula SHA
23. South Yorkshire SHA
24. Surrey and Sussex SHA (Surrey, East Sussex, West Sussex)
25. Thames Valley SHA (Oxfordshire, Berkshire, Buckinghamshire)
26. Trent SHA (Derbyshire, Nottinghamshire, Lincolnshire)
27. West Midlands South SHA (Warwickshire, Worcestershire, Herefordshire, Coventry) †
28. West Yorkshire SHA

† known as the 'Coventry, Warwickshire, Herefordshire and Worcestershire SHA until 2004 [3]

The London breakup is

• North Central London - Barnet, Camden, Enfield, Haringey, Islington
• North East London - Barking and Dagenham, City, Hackney, Havering, Newham, Redbridge, Tower Hamlets, Waltham Forest
• North West London - Brent, Ealing, Hammersmith and Fulham, Kensington and Chelsea, Harrow, Hillingdon, Hounslow, Westminster
• South East London - Bexley, Bromley, Greenwich, Lambeth, Lewisham, Southwark
• South West London - Croydon, Kingston, Merton, Richmond, Wandsworth, Sutton

1998-2002 Health Authorities

Prior to 2002 the health authorities were

Region	Health Authorities
East of England	Bedfordshire, Cambridgeshire, Hertfordshire, Norfolk, North Essex, South Essex, Suffolk
East Midlands	Leicestershire, Lincolnshire, North Derbyshire, North, Nottinghamshire, Northamptonshire, Nottingham, Southern Derbyshire
London	Barking & Havering, Barnet & Enfield & Haringey, Bexley & Bromley & Greenwich, Brent & Harrow, Camden & Islington, Croydon, Ealing & Hammersmith & Hounslow, East London & The City, Hillingdon, Kensington & Chelsea & Westminster, Kingston & Richmond, Lambeth & Southwark & Lewisham, Merton, Redbridge & Waltham Forest, Sutton & Wandsworth
North East England	County Durham & Darlington, Gateshead & South Tyneside, Newcastle & North Tyneside, Northumberland, Sunderland, Tees
North West England	Bury & Rochdale, East Lancashire, Liverpool, Manchester, Morecambe Bay, North Cheshire, North Cumbria, North-West Lancashire, Salford & Trafford, Sefton, South Cheshire, South Lancashire, St Helens & Knowsley, Stockport, West Pennine ‡, Wigan & Bolton, Wirral
South East England	Berkshire, Buckinghamshire, East Kent, East Surrey, East Sussex & Brighton and Hove, Isle of Wight & Portsmouth & South East Hampshire, North & Mid Hampshire, Oxfordshire, Southampton & South West Hampshire, West Kent, West Surrey, West Sussex
South West England	Avon, Cornwall & Isles of Scilly, Dorset, Gloucestershire, North and East Devon, Somerset, South and West Devon, Wiltshire
West Midlands	Birmingham, Coventry, Dudley, Herefordshire, North Staffordshire, Sandwell, Shropshire, Solihull, South Staffordshire, Walsall, Warwickshire, Wolverhampton, Worcestershire
Yorkshire and the Humber	Barnsley, Bradford, Calderdale & Kirklees, Doncaster, East Riding & Hull, Leeds, North Yorkshire, Rotherham, Sheffield, South Humber, Wakefield

‡ also included part of High Peak in Derbyshire (East Midlands)

Health Authorities were established in 1996. There were a few changes between then and the final form shown above. There were originally separate authorities for Barnet and Enfield & Haringey, for Bexley & Greenwich and Bromley, for East & North Hertfordshire and South Hertfordshire, and for the Isle of Wight & Portsmouth and South-East Hampshire. [4] Also, the area of Norfolk and Cambridgeshire was partioned between three authorities : Cambridge & Huntingdon, East Norfolk, and North West Anglia. North West Anglia included from Cambridgeshire: Peterborough, Fenland, part of Huntingdonshire, and from Norfolk: King's Lynn and West Norfolk and part of Breckland. [5] [6]

Also, "East Riding and Hull" was originally known as "East Riding", [7]], "County Durham and Darlington" was originally known as "County Durham" [8]

Pre-1996 RHAs

From 1974 to 1994 the NHS in England was administered by 14 Regional Health Authorities. The regions closely followed the areas of the previous Regional Hospital Boards established in 1947, but in many cases they were renamed.

RHB 1947 -74	RHA 1974 - 94	Area
East Anglian	East Anglian	Cambridgeshire, Norfolk, Suffolk
Newcastle	Northern	Cleveland, Cumbria, County Durham, Northumberland, Tyne and Wear
North East Metropolitan	North East Thames	Essex, north east London
Manchester	North Western	Lancashire, Greater Manchester, Glossop
North West Metropolitan	North West Thames	Bedfordshire, Hertfordshire, north west London, Spelthorne
Liverpool	Mersey	Cheshire and Merseyside
Oxford	Oxford	Berkshire, Buckinghamshire, Oxfordshire, Northamptonshire
South East Metropolitan	South East Thames	Kent, East Sussex, south east London
South West	South Western	Bristol and district, Cornwall, Devon, Gloucestershire, Somerset
South West Metropolitan	South West Thames	Surrey (less Spelthorne), south west London, West Sussex
Sheffield	Trent	Derbyshire, Leicestershire, Lincolnshire, Nottinghamshire, South Yorkshire
Wessex	Wessex	Bath, Dorset, Hampshire, Isle of Wight, Wiltshire
Birmingham	West Midlands	Hereford and Worcester, Shropshire, Staffordshire, Warwickshire, West Midlands
Leeds	Yorkshire	Humberside, North Yorkshire, West Yorkshire

Below the regions were District Health Authorities, established under the National Health Service Act 1977. These were as follows in 1991:[9]

Regional Health Authoritiy	District Health Authorities
Northern	Hartlepool, North Tees, South Tees, East Cumbria, South Cumbria, West Cumbria, Darlington, South West Durham, Northumberland, Gateshead, Newcastle, North Tyneside, South Tyneside, Sunderland, North Durham
Yorkshire	Hull, East Yorkshire, Grimsby, Scunthorpe, Northallerton, York, Scarborough, Harrogate, Bradford, Airedale, Calderdale, Huddersfield, Dewsbury, Leeds, Wakefield, Pontefract
Trent	North Derbyshire, Southern Derbyshire, Leicestershire, North Lincolnshire, South Lincolnshire, Nottingham, Barnsley, Doncaster, Rotherham, Sheffield, North Nottinghamshire
East Anglian	Cambridge, West Suffolk, East Suffolk, North West Anglia, Norwich, Great Yarmouth and Waveney, Huntingdon
North West Thames	North Bedfordshire, South Bedfordshire, North West Hertfordshire, South West Hertfordshire, Barnet, Harrow, Hillingdon, Hounslow & Spelthorne, Ealing, Riverside, Parkside, East & North Hertfordshire
North East Thames	Basildon & Thurrock, Mid Essex, North East Essex, West Sussex, Southend, Barking & Havering & Brentwood, Hampstead, The City & Hackney, Newham, Tower Hamlets, Enfield, Haringey, Redbridge, Waltham Forest, Bloomsbury and Islington
South East Thames	Brighton, Eastbourne, Hastings, South East Kent, Canterbury & Thanet, Dartford & Gravesham, Maidstone, Medway, Tunbridge Wells, Bexley, Greenwich, Bromley, West Lambeth, Camberwell, Lewisham & North Southwark
South West Thames	North West Surrey, West Surrey & North East Hampshire, South West Surrey, Mid Surrey, East Surrey, [[Chichester, Mid-Downs, Worthing, Croydon, Kingston & Esher, Richmond & Twickenham & Roehampton, Wandsworth, Merton & Sutton
Wessex	Dorset, Portsmouth & South East Hampshire, Southampton & South West Hampshire, Winchester, Basingstoke & North Hampshire, Salisbury, Swindon, Bath District, Isle of Wight
Oxford	East Berkshire, West Berkshire, Aylesbury Vale, Wycombe, Milton Keynes, Kettering, Northampton, Oxfordshire
South Western	Bristol & District, Cornwall & Isles of Scilly, Exeter, North Devon, Plymouth, Torbay, Gloucester, Somerset
West Midlands	Bromsgrove & Redditch, Herefordshire, Kidderminster & District, Worcester & District, Shrosphire, Mid Staffordshire, North Staffordshire, South East Staffordshire, South Warwickshire, East Birmingham, North Birmingham West Birmingham, Coventry, Dudley, Sandwell, Walsall, Wolverhampton, North East Warwickshire, South Birmingham
Mersey	Chester, Crewe, Halton, Macclesfield, Warrington, Liverpool, St Helens & Knowsley, Southport & Formby, South Sefton, Wirral
North Western	Lancaster, Blackpool & Wyre & Fylde, Preston, Blackburn & Hyndburn & Ribble Valley, Burnley & Pendle & Rossendale, West Lancashire, Chorley & South Ribble, Bolton, Bury, North Manchester, Central Manchester, South Manchester, Oldham, Rochdale, Salford, Stockport, Tameside & Glossop, Trafford, Wigan
Wales	Clwyd, Gwent, Gwynedd, Mid Glamorgan, Powys, South Glamorgan, West Glamorgan, Pembrokeshire, East Dyfed

An Order in 1994 re-organised these into 8 Regional Health Authorities [10] [11] [12], as follows

• Northern and Yorkshire - Cleveland, north Cumbria, Durham, Humberside, Northumberland, North Yorkshire, Tyne and Wear and West Yorkshire
• Trent - most of Derbyshire, Leicestershire, Lincolnshire, Nottinghamshire, South Yorkshire
• Anglia and Oxford - Bedfordshire, Berkshire, Buckinghamshire, Cambridgeshire, Norfolk, Northamptonshire, Oxfordshire, Suffolk
• North Thames - Essex, Hertfordshire, North London
• South Thames (South East Thames & South West Thames) - East Sussex, Kent, Surrey, West Sussex, South London
• South and West (Wessex and South Western) - Avon, Cornwall, Devon, Dorset, Gloucestershire, Hampshire, Isle of Wight, Isles of Scilly, Somerset, Wiltshire
• West Midlands - Hereford and Worcester, Shropshire, Staffordshire, Warwickshire, West Midlands
• North West (Mersey & North West) - Cheshire, Greater Manchester, Lancashire, Merseyside, south Cumbria, and Glossop from Derbyshire

See [13] for exact breakdown of 1996 Health Authorities.