replacing the previous decision-making structures of 43 separate boards and trusts. In April 2004, Scotland's health care system became an integrated service under the management of NHS boards. Local authority nominees were added to board membership to improve co-ordination of health and social care. The remaining 16 Trusts were dissolved from 1 April 2004. Hospitals are now managed by the acute division of the NHS board. Primary care services such as GPs and pharmacies would continue to be contracted through the NHS board, but from 2004 were considered part of the remit of Community Health Partnerships (CHPs), structures based largely on local authority boundaries and including local authority membership of their boards. By April 2014, there were new joint working arrangements in place between the NHS boards and local authorities came into effect that also included responsibility for social care. There new organisations, which took over from CHPs are called Health and Social Care Partnerships (HSCPs). In 2021 a new national Centre for Sustainable Delivery was established to bring together national programmes for scheduled and unscheduled care, waiting times and best practice – and ensure health boards are implementing them. Regional health boards NHS Argyll and Clyde now no longer operates. Its responsibilities were shared between NHS Highland and NHS Greater Glasgow on 1 April 2006, and the latter was renamed NHS Greater Glasgow and Clyde. The part of the NHS Argyll and Clyde area which transferred to NHS Highland corresponds to the Argyll and Bute council area. Elections to health boards In January 2008, the Scottish Government announced plans for legislation to bring in direct elections as a way to select people for non-executive positions on health boards. The Health Committee of the Scottish Parliament had supported plans for directly elected members as a way that might improve public representation. This plan was abandoned in 2013 after trials in Fife and Dumfries and Galloway resulted in low voter turnout. Special health boards Local health boards are supported by a number of national special health boards providing national services (some of which have further publicised subdivisions), including: Public Health Scotland (Public health (including national health protection) and health education from April 2020) Healthcare Improvement Scotland Scottish Ambulance Service (The single public emergency ambulance service in Scotland) The Golden Jubilee University National Hospital is a special NHS Board in Scotland with the purpose of reducing waiting times using a single modern