under the recent reforms the majority of commissioning is from public providers principally nhs foundation trusts but commissioning authorities are allowed to buy services from any qualified provider including private and nongovernmental providers any qualified provider which was introduced starting from april gives patients the power to choose from a list of approved service providers nhs private and voluntary for care that would then be paid for by their commissioning authority for further details see department of health if department of health lg nhs there are special health authorities which provide a particular health service to the whole of england for example the nhs blood and transport authority and the national institute of clinical excellence nice these bodies are independent from the nhs governance system