The NHS is a complex system, which can sometimes make it difficult to understand – especially working out who is responsible for what. It’s made up of a wide range of different organisations with different roles, responsibilities and specialities. These organisations provide a variety of services and support to patients and carers.Over recent years there have been changes to the way the NHS is structured and works. The likelihood is that you may not have even noticed this – it won’t have affected how you access your local doctor or hospital. But the changes have affected who makes decisions about health services and who holds the budget to pay for these services.You can find out more about the NHS structure in England and who does what by visiting the NHS website. The King’s Fund has also produced a series of structure diagrams and a short animation about the NHS.