All funding for individual candidates comes from that persons local Primary Care Trust (PCT) and the application process is explained in Pathways.
These local PCTs are headed up by their respective Strategic Health Authorities (SHA) who in turn report to the Department of Health (DoH). A major re-organisation of these structures within the NHS in England took place during July 2006 to Oct 2006.
(Scotland has its own Health Executive –see here, and Wales has its own Health Commission Wales –see here).
In England the former 28 Strategic Health Authorities (SHA) have been regrouped into ten new SHA’s. These are London, South East Coast, South Central, South West, East of England, East Midlands, West Midlands, Yorkshire and Humber, North East England and, North West England. Each of these new authorities serves an average of 5 million people (ranging from 2.5M for the North East to 7.4M in London). In parallel the former 302 Primary Care Trusts (PCT) have also been reduced and regrouped into 152 consolidated PCT’s. The stated aim of these changes is to slim down the management structure and make service provision and financial control more effective.
A local PCT can be identified here . This website has a search facility and lists all the PCTs , giving each PCT own website with address and contact details.
A regional SHA can be identified here .
A map of the areas covered by these SHAs can be seen here.
Cochlear implant treatment is a specialised medical service and as such has, to date, been supervised by Specialised Commissioning Groups (SCG) both at the SHA level and the Local PCT level. Formerly these bodies proliferated and there was evidence of a lack of cohesion. Following a major review of the role on the effectiveness of SCGs , the Carter Report was submitted to the Minister of Health in May 2006. Subsequently the DoH has adopted the reccomendations which were implemented in 2007. All the former Local SCGs have been closed down and there are now just 10 SCGs, one for each SHA. In terms of governance, SCG’s decisions will be made on behalf of all PCTs within the matching SHA and such decisions will be binding on all PCT members in that SHA. Thus regional commissioning of cochlear implant treatment and funding now exists and it is expected and hoped that this will lead to more equitable provisioning.
A report on the DoH implementation plan of the Carter Report can be seen here. To date there have been no coordinated Commissioning Policies or Guidelines. The NCIUA has participated in a project under the DoH , together with all the major deaf organisations and User Groups, to fill this vital gap. The result, a comprehensive publication, Cochlear Implant Services - Commissioning Guidelines, has been sent to the Chief Executives of the 10 SHAs and can be seen here.