The joint authority’s administration is based on a so-called sole manager model. 

The Group Administration acts as central administration.

Specialist health care services are available in five different hospital areas: the HUCH Hospital Area and the Hospital Areas of Hyvinkää, Lohja, Länsi-Uusimaa and Porvoo.

The coordination of the production of services is divided between four HUCH profit units: medicinal, operative, gynaecology and paediatric care, and psychiatry.

The HUS business enterprises are

• HUSLAB, HUS Radiology, Ravioli (business enterprises since 2004)
• HUS Pharmacy, HUS-Desiko, HUS Logistics (business enterprises since January 2008)
• HUS Medical Engineering, HUS ICT Engineering and HUS Servis (business enterprises starting January 2009).

The highest decision-making body in the Helsinki and Uusimaa Hospital District is the Council. The Council has 69 members each of whom has his or her personal deputy.

The Hospital District is managed by the Executive Board, which is supervised by the Council. The Executive Board consists of 15 members, each with a personal deputy, elected by the Council for the duration of its term of office. The University of Helsinki is also entitled to nominate two Board members and their personal deputies.

The Executive Board looks after the interests of the Hospital District, represents the Hospital District and concludes agreements in its name, unless these duties have been delegated to another body or official. In addition to this, the Executive Board discusses the follow-up reports on the Joint  Authority's operations and finance, and decides on eventual measures resulting from these.