The NHS has three main components: family practitioner services, community-based services and hospital services. Since it's inception in 1948, the NHS has seen a number of structural changes, most notably in 1974 and 1990. Following the 1997 election, the Labour government sought to evolve the purchaser / provider structure introduced in 1990 whilst rejecting the 'Internal Market'.

Since 1 April 2002, the 302 Primary Care Trusts in England have been responsible for planning services, with performance and standards monitored by 28 Strategic Health Authorities. Wales is in the process of abolishing it's five existing health authorities - local health boards and local authorities will jointly formulate and implement a Health, Social Care and Well Being Strategy for their area. National Assembly regulations and guidance will govern this. In Scotland, health planning is carried out by 15 NHS Boards and in Northern Ireland by Health and Social Services Boards.

The emphasis on a primary care-led NHS resulted in the creation of Primary Care Groups - now Primary Care Trusts - (England), Local Health Groups (Wales) - replaced by Local Health Boards in April 2003, Local Health Care Co-Operatives (Scotland) and Local Health and Social Care Groups (Northern Ireland). These have various levels of responsibility in planning and commissioning health services. NHS Trusts continue to provide services although their number has diminished. A variety of Trust configurations exist across the UK including Primary Care, Acute, Mental Health and Combined Acute and Community Trusts.

The NHS has a buying structure - in hospitals, this ranges from individuals with almost autonomous choice if not budget (e.g. for leading edge cardiac surgery), to those with little choice, e.g. care assistants. Somewhere here are supplies departments and buyers gaining a better deal for the NHS. Whilst pharmaceuticals would typically be approved or not by a committee of interested parties, you only have to enter a major hospital and look at the long list of departments to have an idea of the range of products bought and sold.

Community medicine - There is now more 'guidance' for GPs than ever. NICE, PCOs, HA are all generating an accepted products list and product use protocols for the GP and more recently for Nurses, as their prescribing powers increase.

Best practice medicine has also increased the use of preventative treatments and routine diagnostic tests and procedures, each of these usually creating/expanding the medical sales and pharmaceutical sales opportunities.