The English National Health Service (NHS) is a taxpayer funded healthcare system established in 1948 and provides healthcare services to everyone who lives in the UK and remains free of charge at the point of use. Funding is largely allocated to 195 local Clinical Commissioning Groups (CCGs), clinically led statutory NHS bodies. At the time of referral, patients have a legal right to choose the provider. NHS-funded hospital care is provided by (135) acute trusts that are responsible for ensuring that high-quality care is provided. The private healthcare sector (with private healthcare insurance held by around 11 per cent of the population) is increasingly offering an equivalent range of services, including primary care. The NHS continues to perform well in international comparisons. However, recent developments – such as the increase of waiting lists, staff shortages and loss of efficiency – put the system’s original principles seriously to the test.