- 1974-1989 (Creation)
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York Health District represented the lowest (and non-statutory) tier of management under the 1974 reorganisation of the National Health Service (NHS). It was one of four districts (the others being Northallerton, Scarborough and Harrogate) under North Yorkshire Area Health Authority.
In 1974, York Health District was responsible for the day-to-day management and co-ordination of 22 hospitals and institutions and 14 health centres and clinics in and around York (numbers of hospitals decreased after the opening of the new York District Hospital in 1976). The health district formulated plans and policies for its area and assessed local needs and services.
The health district was managed by the York Health District Management Team, composed of officers based in the district. The team was responsible jointly to the area health authority but it was responsible directly and not through the area team. Individual district management team officers were also accountable directly to the area authority and not through their area counterparts.
The district management team was composed of a district administrator, a district finance officer, a district nursing officer, a district community physician, and the chairman and vice chairman of the district medical committee. These represented the different skill groups providing patient care and supporting services. Under each of them was an integrated functional hierarchy.
The district administrator was responsible for institutional and support services, including medical records, supply, catering, domestic and laundry services and portering, and for general administrative services such as planning, information, personnel and the secretariat. Under the district administrator were the district building and engineering officers, who were also technically accountable to the area works officer. The district administrator co-ordinated with the district pharmaceutical officer, who was also accountable to the area pharmaceutical officer. The district administrator also co-ordinated with the officers for the paramedical services, who were direct area health authority appointees.
A number of other administrative officers were directly responsible to the district administrator. These included the general administrator (information and planning), the general administrator (operational services), and the district personnel officer.
In addition, management levels below district level were co-ordinated by means of division into sectors managed by sector administrators under the district administrator. Each sector included a group of hospitals and institutions, arranged on a functional basis.
There were five sectors within York District. The New Hospital Sector (Sector 1) included City, County, Fairfield, Military, and Poppleton Gate Hospitals. From early 1977 this became the York District Hospital Sector when the latter opened and replaced these hospitals. The Geriatric and Maternity Sector (Sector 2) included St Mary's, Acomb, Bungalow, Fulford and Maternity Hospitals and the Community Midwifery Service. City Hospital replaced St Mary's as the main geriatric hospital in 1979. The Mental Illness Sector (Sector 3) included Clifton Hospital, Bootham Park and Naburn Hospitals, Moorlands and Deighton Grove. The Mental Handicap Sector (Sector 4) contained Claypenny, Rawcliffe Hall and Whixley Hospitals and the hostels at Bubwith and Tadcaster. In 1976 Rawcliffe Hall was transferred to Scunthorpe Health District in Humberside Area Health Authority. The Community Health Sector (Sector 5) included St Monica's Hospital at Easingwold, Selby War Memorial Hospital, and all the community health services except for midwifery.
The second member of the district management team, the district finance officer, was responsible for financial services and for the production of a unified district budget.
The third member of the team, the district nursing officer, was responsible for a unified hospital and community nursing service. Nursing was divided into a number of divisions under the district nursing officer. These comprised the General Division, the Midwifery and Geriatric Division (including domiciliary midwifery), the Community Division, the Mental Illness Division, the Mental Handicap Division, and the Education Division.
The fourth member of the team, the district community physician, had two main roles: the co-ordination of preventive services; and the co-ordination of plans for the operational health care services. He had operational control of the doctors in public health who were attached to the area medical officer. He liased with the district dental officer who was accountable to the area dental officer.
He also had an advisory role to district doctors and to the District Medical Committee. Part of the planning role of the district community physician was to co-ordinate the multi-disciplinary health care planning teams, with support from district administration. In 1975 York Health District planned health care planning teams on obstetrics, geriatrics, paediatrics, mental illness, and mental handicap. Each of these teams had a core of 10-12 members, including representatives from hospitals, community health, social services, general practitioners, and, where relevant, voluntary organisations. The role of the planning teams was an evaluating as well as a planning one, developing schemes and recommending and implementing them.
The fifth and sixth members of the district management team were the chairman and vice chairman of the District Medical Committee. This committee consisted of representatives of general practitioners, of medical and dental consultants grouped on a functional basis, of doctors working in public health, of dentists, and of some paramedical services. The committee gave medical advice to the Area Medical Advisory Committee. The District Medical Committee was separate from the existing Medical Executive Committee and its divisions which represented the functional groupings of consultants.
In the 1982 restructuring of the NHS, the health district became the basis for the new district health authority.
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