Strategic health authority

The functions of the HAs were mostly taken up by 300 primary care trusts (PCTs), and 28 larger strategic health authorities (SHAs) were established (which were reduced in number to 10 in 2006).

"The goal was to create a coherent strategic framework for the development of services across the full range of local NHS organisations, including: A pivotal event seems to have been a loss of financial control in 2005/6 and a failure of the management system to respond quickly or firmly enough.

They were reduced to ten in number[7] by the Strategic Health Authorities (Establishment and Abolition) (England) Order 2006,[8] as amended, and this was expected to produce substantial financial savings.

At the same time there were other important changes that had implications for the functioning of SHAs: The period from 2006 saw financial control being restored and key targets were generally achieved.

However, further questions about the effectiveness of SHAs and the regulatory process more generally were raised by the 2008 scandal at Mid Staffordshire Hospitals Foundation Trust.

During 2009, SHAs were subject to an assurance process to examine their performance, role in developing their systems and to give developmental feedback.