The NHS: An Overview

The NHS is by some distance the largest employer in the UK, with more than two million people on the payroll. Even when considered on the world stage, it’s well in the top five, beaten by large contenders like the US Department of Defense, China’s People’s Liberation Army, and weighty private concerns McDonald’s Walmart.

Today we are taking a longer look at the NHS to try and understand the structure of the organisation, the different specialisms that make it up, and how it interacts with the larger welfare state.

NHS Institutions

The NHS is made up of far more than doctors and nurses. While these are the frontline staff you will encounter when you first go to an appointment, there is an army of specialists behind them, performing detailed tests, interpreting the results and enacting treatment.

Diagnosis and treatment requires those in radiography jobs, statistics jobs, back room laboratory technicians, surgeons, occupational therapists and pain specialists. Some of these jobs require the standard training all doctors follow, starting with a five year degree, two year foundation course within the NHS, and then finally specialist training as the doctors acquire the unique skills needed to be a surgeon, a psychiatrist, an anaesthetist and so on.

Most of these specialists work within the structure and framework of an NHS institution like a hospital or doctor’s surgery – this is key to making the whole system work. While some particularly specialist procedures may require referral to other institutions, the majority of diagnosis and treatment can be done within the same building (or at least on the same ‘campus’), boosting efficiency and cutting down on travel for people who are, after all, sick or injured!

NHS staff not affiliated with a hospital or surgery will normally be found working within the structure of another public body, for example, cooperating with the prison service to see to the health needs of prisoners or working within schools.


It’s not just clinical staff who are employed by the NHS. A vast institution like this can’t function without support: without holidays being tracked and administered, without recruitment, without repairs to buildings and equipment and without requisitions, whether that’s of bandages, syringes and essential medication or simply of pens and prescription pads.

There’s an army of administrators and support staff propping up the clinicians who diagnosis and treat people, and if you’re considering working for the NHS you don’t have to submit to costly training: there’s room for almost anyone to contribute with almost any skillset!

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