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1 April 1991

The first NHS trusts

These trusts assumed responsibility for the ownership and management of hospitals, previously managed or provided by regional, district or special health authorities.

July 1991

The Citizen's Charter

The government launched the Citizen's Charter to redefine the relationship between citizens and public service, seeking to set out the rights and entitlements of patients.

November 1992

Private Finance Initiative (PFI) schemes

In 1992, the Conservative government introduced private finance initiatives (PFI). The main objective was to harness the private sector's efficiency, management and commercial expertise.

October 1994

Total purchasing pilot scheme

A total purchasing pilot (TPP) scheme was launched, allowing GPs in a locality to purchase all hospital and community health services for their patients.

January 1995

Health committee report: 'Priority setting in the NHS: purchasing'

The Health Committee published a report on purchasing, endorsing a separation between strategy and operational delivery as an approach to priority setting.

28 June 1995

Health Authorities Act 1995

The Act replaced regional health authorities, district health authorities and family health services authorities with regional NHS executive offices.

October 1996

'Opportunity and choice' white paper

The government set out proposals to give primary care professionals greater flexibility to try different forms of contracting models.

May 1997

The NHS (Primary Care Act)

Leglisation facilitated the piloting of different types of primary care contracting arrangements and established mechanisms for the direct employment of GPs.