In 2002, following a rationalisation, the Commander-in-Chief Fleet moved the majority of his staff to Portsmouth and handed over the Northwood site to the Chief of Joint Operations.
The Spearhead Lead Element (SLE), sometimes referred to as the Spearhead Land Element, is the principal high-readiness component of the British Armed Forces under the operational control of the Permanent Joint Headquarters.
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The hospital was formerly an RAF hospital, but following the establishment of the Defence Medical Services organisation, it is now a tri-service establishment under the authority of the Permanent Joint Headquarters at Northwood.