A bill to Make provision about health and social care.
Be it enacted by the King’s most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—
Abolition of NHS England¶
1 Abolition of NHS England¶
NHS England is abolished.2 Transfer schemes in connection with abolition of NHS England¶
3 Transfer schemes under section 2: taxation¶
Secretary of State’s functions¶
4 Reducing inequalities¶
For section 1C of the National Health Service Act 2006 substitute—1C Duty as to reducing inequalities
In exercising functions in relation to the health service, the Secretary of State must have regard to the need to—(a) reduce inequalities between the people of England with respect to their ability to access health services, and (b) reduce inequalities between the people of England with respect to the outcomes achieved for them by the provision of health services.
5 Patient involvement and choice¶
In the National Health Service Act 2006, after section 1C insert—1CA Duty to promote involvement of each patient
In exercising functions in relation to the health service, the Secretary of State must promote the involvement of patients, and their carers and representatives (if any), in decisions which relate to—(a) the prevention or diagnosis of illness in the patients, or (b) their care or treatment. 1CB Duty as to patient choice
In exercising functions in relation to the health service, the Secretary of State must act with a view to enabling patients to make choices with respect to aspects of health services provided to them.
6 Promoting innovation¶
In the National Health Service Act 2006, after section 1CB (inserted by section 5 of this Act) insert—1CC Duty to promote innovation
(1) In exercising functions in relation to the health service, the Secretary of State must promote innovation in the provision of health services (including innovation in the arrangements made for their provision). (2) The Secretary of State may make payments as prizes to promote innovation in the provision of health services in England. (3) A prize may relate to— (a) work at any stage of innovation (including research); (b) work done at any time (including work before the commencement of this section). (4) The Secretary of State may establish a committee to give advice about the exercise of the power conferred by subsection (2), and may pay remuneration and allowances to members.
7 Education and training¶
(1) The Secretary of State must exercise functions under the relevant enactments with a view to ensuring that— (a) there are sufficient people with appropriate education and training to meet the workforce needs of the health service, and (b) there is an effective system in place for the planning and delivery of education and training of people to meet those needs.
8 Directions to exercise Secretary of State’s functions¶
For section 7B of the National Health Service Act 2006 substitute—Directions to others to exercise Secretary of State’s functions etc
7B Directions to integrated care boards to exercise Secretary of State’s functions
(1) The Secretary of State may by direction provide for any functions of the Secretary of State which relate to the health service to be exercised by one or more integrated care boards. (2) A direction under subsection (1) may include provision prohibiting or restricting an integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction. (3) In subsection (2), “delegation arrangements” means arrangements made by an integrated care board for the exercise of a function by someone else. (4) The Secretary of State may make payments to an integrated care board in respect of the exercise by it of a function by virtue of a direction under subsection (1). (5) As soon as reasonably practicable after giving a direction under subsection (1), the Secretary of State must publish it. (6) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by an integrated care board of any function by virtue of this section are enforceable by or against it (and no other person).
9 Secretary of State’s power to provide assistance¶
After section 12D of the National Health Service Act 2006 insert—Secretary of State’s power to provide assistance
12DA Secretary of State’s power to provide assistance
(1) The Secretary of State may provide assistance or support to— (a) a person providing or proposing to provide services as part of the health service; (b) a public authority, where the assistance or support is in relation to the education or training of anyone employed, or considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service; (c) a person otherwise carrying out or proposing to carry out activities that the Secretary of State considers to be beneficial to the health service. (2) The assistance that may be provided under subsection (1) includes— (a) financial assistance; (b) making available— (i) the services of a person employed in the civil service of the state, or (ii) any other resources of the Secretary of State. (3) Assistance or support under subsection (1) may be provided on such terms as may be agreed, including terms as to the making of payments by or to the Secretary of State. (4) In this section a reference to a public authority includes a public authority anywhere in the British Islands.
10 Secretary of State's duty as respects variation in provision of health services¶
For section 12E of the National Health Service Act 2006 substitute—12E Secretary of State's duty as respects variation in provision of health services
The Secretary of State must not exercise any functions in relation to the health service for the purpose of causing a variation in the proportion of health services provided by the public or private sector, or the proportion of health services provided by different kinds of legal entity, unless the Secretary of State considers that to do so is in the interests of the health service.
11 General power to direct integrated care boards¶
Powers of direction
14Z61 Directions as to exercise of integrated care board functions
(1) The Secretary of State may give integrated care boards directions as to the exercise of their functions. (2) The directions that may be given include a direction as to— (a) whether or not to exercise a power; (b) when or how a function is, or is not, to be exercised; (c) conditions that must be met before a function is exercised (for example, conditions relating to the provision of information, consultation or approval); (d) matters to be taken into account in exercising a function. (3) Where— (a) provision is made for the exercise of a function to be contingent on an integrated care board having formed an opinion (however the provision is expressed), and (b) the Secretary of State has formed that opinion, a direction may be given under subsection (1) that requires the board to exercise the function without itself forming that opinion.(4) See also section 14Z62 for exceptions to— (a) the power to give directions under subsection (1), and (b) the need to comply with such directions. (5) As soon as reasonably practicable after giving a direction under subsection (1), the Secretary of State must publish it. (6) The fact that the Secretary of State has a function under any other enactment in relation to the exercise of functions by integrated care boards is not to be read as limiting the power conferred by subsection (1). (7) The reference in subsection (6) to a function of the Secretary of State does not include a function of making subordinate legislation. 14Z62 Directions under 14Z61: exceptions
(1) A direction under section 14Z61 may not be given in relation to the appointment or employment of a particular individual. (2) A direction under section 14Z61 may not be given in relation to a decision about the services to be provided to a particular individual for or in connection with the prevention, diagnosis or treatment of illness. (3) A direction under section 14Z61 may not be given in relation to the provision of any drug, medicine or other treatment, or the use of any diagnostic technique, if the direction is inconsistent with a recommendation or guidance given by NICE. (4) An integrated care board is not required to comply with a direction under section 14Z61 in relation to the provision of any drug, medicine or other treatment, or the use of any diagnostic technique, to the extent that the direction is inconsistent with a subsequent recommendation or guidance given by NICE. 14Z62A Performance: significant failure
(1) This section applies where the Secretary of State considers— (a) that— (i) an integrated care board is failing or has failed to discharge any one or more of its functions, and (ii) the failure is significant, or (b) that— (i) there is a significant risk of an integrated care board failing to discharge any one or more of its functions, and (ii) the failure would be significant. (2) The Secretary of State may— (a) direct the integrated care board to cease to perform some or all functions for such period or periods as may be specified in the direction; (b) do either or both of the following— (i) discharge any of the functions to which the direction relates, or make arrangements for any other person to discharge them on the Secretary of State’s behalf; (ii) direct another integrated care board to perform any of the functions on behalf of the integrated care board. (3) The Secretary of State may— (a) direct the chief executive of the integrated care board to cease to perform some or all functions for such period or periods as may be specified in the direction; (b) do either or both of the following— (i) exercise, on behalf of the chief executive, any of the functions that are the subject of the direction, or (ii) direct the chief executive of another integrated care board to perform any of those functions on behalf of the chief executive, in such manner and within such period or periods as may be specified in the direction. (4) The Secretary of State may— (a) terminate the appointment of the integrated care board’s chief executive, and (b) direct the chair of the board as to which individual to appoint as a replacement and on what terms. (5) Where the Secretary of State exercises a power under this section the Secretary of State must publish the reasons for doing so. (6) Before exercising the power conferred by subsection (2)(b)(ii) or (3)(b)(ii) the Secretary of State must consult the integrated care board to which it is proposing to give the direction or to whose chief executive it is proposing to give the direction. (7) Where a direction is given under subsection (3)(a) to the chief executive of an integrated care board, that board must co-operate with any chief executive to whom a direction is given under subsection (3)(b)(ii). (8) For the purpose of this section— (a) a failure to discharge a function includes a failure to discharge it properly, and (b) a failure to discharge a function properly includes a failure to discharge it consistently with what the Secretary of State considers to be the interests of the health service.
Commissioning¶
12 Commissioning functions: responsibility¶
(4) In exercising its functions under this section, an integrated care board must act consistently with the discharge by the Secretary of State of the duty under section 1(1) (duty to promote a comprehensive health service).
(4) In exercising its functions under this section, an integrated care board must act consistently with the discharge by the Secretary of State of the duty under section 1(1) (duty to promote a comprehensive health service).
3B Regulation-making power to require Secretary of State to commission services
(1) Regulations may require the Secretary of State to arrange, to such extent as the Secretary of State considers necessary to meet all reasonable requirements, for the provision as part of the health service of— (a) services or facilities for members of the armed forces or their families; (b) such other services or facilities as may be prescribed. (2) In deciding whether it would be appropriate to prescribe a service or facility under subsection (1)(b) the Secretary of State must have regard to the following— (a) the number of individuals who require the provision of the service or facility; (b) the cost of providing the service or facility; (c) the number of persons able to provide the service or facility. (3) Regulations under this section requiring the Secretary of State to arrange for the provision of services or facilities for a group of people may include provision making the Secretary of State “responsible” for any of those people for the purposes of section 130M(4)(a) of the Mental Health Act 1983 (advance choice documents: England). (4) The reference in subsection (1)(a) to members of the armed forces is a reference to persons who are members of— (a) the regular forces within the meaning of the Armed Forces Act 2006, or (b) the reserve forces within the meaning of that Act.
(3) The arrangements must ensure that high security psychiatric services are provided only at hospital premises at which services are provided only for the people mentioned in subsection (1). (3A) The Secretary of State may give directions to a person who provides high security psychiatric services about the provision by that person of those services. (3B) A direction may be given under subsection (3A) to a person other than a public authority only if the Secretary of State is satisfied that the person would be required to comply with the direction by virtue of a condition of the person’s licence under Chapter 3 of Part 3 of the Health and Social Care Act 2012.
13 Commissioning arrangements: conferral of discretions¶
After section 5 of the National Health Service Act 2006 insert—5A Commissioning arrangements: conferral of discretion
(1) Arrangements made by the Secretary of State or an integrated care board in the exercise of their commissioning functions may confer discretions on a person with whom the arrangements are made in relation to anything to be provided under the arrangements. (2) In this section “commissioning functions” means functions in arranging for the provision of anything as part of the health service.
14 Primary care services¶
Schedule 1—15 Public involvement in commissioning by Secretary of State¶
After section 5A of the National Health Service Act 2006 (inserted by section 13 of this Act) insert—Public involvement
5B Public involvement in commissioning by Secretary of State
(1) This section applies in relation to any health services which are, or may be, provided pursuant to arrangements made by the Secretary of State (“commissioning arrangements”). (2) The Secretary of State must make arrangements to secure that users or potential users of those services are involved (whether by being consulted or provided with information or in other ways)— (a) in the planning of the commissioning arrangements, (b) in the development and consideration of proposals by the Secretary of State for changes in the commissioning arrangements where the implementation of the proposals would have an impact on— (i) the manner in which the services are delivered to the individuals, or (ii) the range of health services available to them, and (c) in decisions of the Secretary of State affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact. (3) The reference in subsection (2)(b) to the delivery of services is a reference to their delivery at the point when they are received by users. (4) The reference in subsection (2) to users or potential users of a service includes any carers or representatives of users or potential users of the service. (5) This section does not require the Secretary of State to make arrangements in relation to matters to which a trust special administrator’s draft or final report under section 65F or 65I relates before the Secretary of State has made a decision under section 65K.
16 Regulations about commissioning by integrated care boards¶
Duties in relation to commissioning
14Z45A Waiting times
(1) Regulations may impose duties on integrated care boards with respect to waiting times for treatments or other services which they arrange in the exercise of their commissioning functions. (2) The regulations may include provision as to arrangements that integrated care boards must make, in the exercise of their functions, to address cases in which a specified treatment or other specified service is not provided within a specified period. 14Z45B Patient choice
(1) Regulations must make provision as to the arrangements that integrated care boards must make, in the exercise of their commissioning functions, for enabling people to whom any specified treatments or other specified services are to be provided to make choices with respect to specified aspects of them. (2) The regulations may make other provision for the purpose of securing that, in the exercise of their commissioning functions, integrated care boards protect and promote the rights of people to make choices in relation to treatments or other services, where those rights— (a) arise by virtue of regulations under subsection (1), or (b) are described in the NHS Constitution. 14Z45C Enforcement of section 14Z45B regulations
(1) The Secretary of State may investigate whether an integrated care board has failed or is likely to fail to comply with a requirement imposed by regulations under section 14Z45B (a “patient choice requirement”). (2) Where an investigation under subsection (1) is being or has been carried out, the Secretary of State may accept an undertaking from the integrated care board that it will, within a period specified in the undertaking— (a) put in place specified measures for the purpose of preventing failures to comply with patient choice requirements or mitigating the effect of such failures, or (b) take specified steps to remedy a failure to comply with patient choice requirements. (3) Where the Secretary of State accepts an undertaking under subsection (2), the Secretary of State may not— (a) continue to carry out any ongoing investigation under subsection (1) so far as relating to matters to which the undertaking relates, or (b) give a direction under section 14Z61 in relation to those matters or a direction under section 14Z62A on grounds relating to the discharge of its functions in relation to those matters, unless the integrated care board fails to comply with the undertaking.(4) If an integrated care board from which the Secretary of State has accepted an undertaking under subsection (2) complies partially with the undertaking, the Secretary of State must take the partial compliance into account in deciding whether to do something mentioned in subsection (3)(a) or (b). (5) Schedule 1C makes further provision about undertakings. (6) The Secretary of State must publish guidance about how the Secretary of State intends to exercise the powers conferred by this section and Schedule 1C. 14Z45D Appeals against individual commissioning decisions
(1) Regulations may confer a right of appeal on a person against a decision by an integrated care board about the treatments or other services to be provided to that particular person. (2) The regulations may in particular make provision— (a) for the establishment of one or more panels to consider appeals; (b) about the composition of a panel and the terms of appointment of members of a panel; (c) for the payment of remuneration or allowances to members of a panel; (d) about the powers of a panel; (e) about procedure (including time limits); (f) about the provision of staff by an integrated care board to assist a panel.
.commissioning functions, in relation to an integrated care board, means the functions of the board in arranging for the provision of anything as part of the health service;
17 Duty to have regard to impact on services in border areas¶
After section 14Z45D of the National Health Service Act 2006 (appeals against commissioning decisions) (inserted by section 16 of this Act) insert—14Z45E Duty to have regard to impact on services in border areas
In making decisions in the exercise of its commissioning functions, an integrated care board must, so far as relevant, have regard to the likely impact of those decisions on the provision of health services to persons who reside in an area of Wales or Scotland that is close to the border with England.
Integrated care boards¶
18 Transfer schemes in connection with integrated care boards¶
In section 14Z28 of the National Health Service Act 2006 (transfer schemes in connection with integrated care boards)—(2) The Secretary of State may, in connection with the establishment of an integrated care board, make a scheme for the transfer of property, rights or liabilities to the board from— (a) an NHS trust established under this Act, (b) an NHS foundation trust, or (c) a Special Health Authority established under section 28. (3) The Secretary of State may, in connection with the variation of the constitution of an integrated care board or the abolition of an integrated care board, make a scheme for the transfer of the board’s property, rights or liabilities to— (a) the Secretary of State, or (b) an integrated care board. (4) The reference in subsection (3) to the variation of the constitution of an integrated care board is to its variation by order under section 14Z25 or under provision included in its constitution by virtue of paragraph 15 of Schedule 1B. (5) The Secretary of State must exercise the power under subsection (3) so as to ensure that on the abolition of an integrated care board, all of the board’s liabilities (other than criminal liabilities) are transferred.
19 Integrated care boards: power to provide assistance¶
For section 14Z48 of the National Health Service Act 2006 substitute—14Z48 Power to provide assistance
(1) An integrated care board may provide assistance or support to— (a) a person providing or proposing to provide services as part of the health service; (b) a person otherwise carrying out or proposing to carry out activities that the board considers to be beneficial to the health service. (2) The assistance that may be provided under subsection (1) includes— (a) financial assistance; (b) making available— (i) the services of a person employed by the integrated care board, or (ii) any other resources of the board. (3) Assistance or support under subsection (1) may be provided on such terms as may be agreed, including terms as to the making of payments by or to the integrated care board.
20 Performance assessments of integrated care boards¶
For section 14Z59 of the National Health Service Act 2006 substitute—14Z59 Performance assessments of integrated care boards
(1) The Secretary of State must conduct a performance assessment of each integrated care board in respect of each financial year. (2) A performance assessment is an assessment of how well the integrated care board has discharged its functions during that year. (3) The Secretary of State must publish a report in respect of each financial year containing a summary of the results of each performance assessment conducted under this section in respect of that year.
21 Membership of integrated care boards¶
In Schedule 1B to the National Health Service Act 2006 (constitution of integrated care boards), in paragraph 8—;(2) The constitution must provide for the ordinary members appointed as mentioned in sub-paragraph (1)(b) to include at least one member nominated by the mayor of each mayoral strategic authority whose area coincides with, or includes the whole or any part of, the integrated care board’s area (if any). (3) The constitution must set out the process for making such a nomination. (4) A mayor nominating an ordinary member as mentioned in sub-paragraph (2) must have regard to any guidance published by the Secretary of State as to the selection of candidates.
(7) In this paragraph— mayoral combined authority means a combined authority for an area for which provision is made in an order under section 107A of the Local Democracy, Economic Development and Construction Act 2009 for there to be a mayor; mayoral combined county authority means a combined county authority for an area for which provision is made in regulations under section 27(1) of the Levelling-up and Regeneration Act 2023 for there to be a mayor; mayoral strategic authority means— (a) a mayoral combined authority, (b) a mayoral combined county authority, or (c) the Greater London Authority.
Integration and planning¶
22 Joint planning by integrated care boards and their partners¶
(3A) In this Chapter “relevant Health and Wellbeing Board”, in relation to an integrated care board, means a Health and Wellbeing Board established by a local authority whose area coincides with, or includes the whole or any part of, the area of the integrated care board. (3B) In this Act “financial year”, in relation to an integrated care board, means— (a) the period beginning with the date on which the integrated care board is established and ending with the 31 March following that date, and (b) each successive period of twelve months beginning with 1 April.
23 Abolition of integrated care partnerships and strategies¶
In the Local Government and Public Involvement in Health Act 2007 omit the following—24 Neighbourhood health plan¶
;(1) This section applies where an assessment of relevant needs is prepared under section 116 by a responsible local authority and each of its partner integrated care boards. (2) The responsible local authority and each of its partner integrated care boards must prepare a plan (a “neighbourhood health plan”) setting out how the assessed needs in relation to the responsible local authority’s area are to be met by the exercise of functions of— (a) the responsible local authority, or (b) its partner integrated care boards. (2A) But the responsible local authority and its partner integrated care boards need not prepare a new neighbourhood health plan if, having considered the assessment of relevant needs, they consider that the existing plan is sufficient.
;(4) In preparing a plan under this section, the responsible local authority and each of its partner integrated care boards must have regard to any guidance issued by the Secretary of State. (5) In preparing a plan under this section, the responsible local authority and each of its partner integrated care boards must involve the people who live or work in the area of the responsible local authority.
116B Duty to have regard to assessments and plans
A responsible local authority and each of its partner integrated care boards must, in exercising any functions, have regard to the following so far as relevant—(a) any assessment of relevant needs prepared under section 116 in relation to the responsible local authority’s area, and (b) any neighbourhood health plan prepared under section 116A by the responsible local authority and its partner integrated care boards.
NHS trusts¶
25 NHS trust accounts¶
11A (1) An NHS trust must keep proper accounts and proper records in relation to the accounts. (2) An NHS trust must prepare annual accounts in respect of each financial year. (3) The Secretary of State may direct an NHS trust to prepare accounts in respect of such period or periods as may be specified in the direction. (4) The Secretary of State may give directions to an NHS trust as to— (a) the methods and principles according to which any accounts under this paragraph must be prepared, and (b) the form and content of any accounts prepared under this paragraph. (5) For the audit of the annual accounts, see the Local Audit and Accountability Act 2014 (and, in particular, section 4 of that Act). (6) Accounts prepared under sub-paragraph (3) are also to be audited under that Act if the Secretary of State so directs. (7) The Comptroller and Auditor General may examine— (a) the annual accounts, or accounts prepared under sub-paragraph (3), and any records relating to them, and (b) any report on them by the auditor. (8) An NHS trust must send to the Secretary of State— (a) a copy of its annual accounts and of any accounts prepared under sub-paragraph (3), and (b) any report of the auditor on them. (9) An NHS trust must comply with sub-paragraph (8) by such date as the Secretary of State may direct. (10) In this paragraph “financial year”, in relation to an NHS trust, means— (a) the period— (i) beginning with the date on which the NHS trust is established, and (ii) ending with the next 31 March, and (b) each successive period of twelve months beginning with 1 April.
(6) In relation to an NHS trust, “accounts” means— (a) the annual accounts of the NHS trust prepared under paragraph 11A(2) of Schedule 4 to the National Health Service Act 2006; (b) any accounts of the NHS trust prepared under paragraph 11A(3) of that Schedule in respect of which a direction has been given under paragraph 11A(6) of that Schedule.
26 Tidying up provisions about audit of NHS trust accounts¶
Special Health Authorities¶
27 Special Health Authorities: establishment and exercise of functions¶
28 Special Health Authorities: staff transfers etc¶
;(8) Regulations may— (a) provide for the transfer of officers from a Special Health Authority to— (i) another Special Health Authority, or (ii) an integrated care board; (b) provide for arrangements under which the services of an officer of a Special Health Authority are placed at the disposal of— (i) another Special Health Authority, (ii) an integrated care board, (iii) a local authority, or (iv) the Secretary of State.
(i) another Special Health Authority, (ii) an integrated care board, or (iii) the Secretary of State;
(a) another Special Health Authority, (b) an integrated care board, or (c) the Secretary of State.
NHS foundation trusts¶
29 Constitution of NHS foundation trusts¶
Schedule 3 makes provision about the constitution of NHS foundation trusts and, among other things—30 Authorisation of NHS foundation trusts¶
In section 35 of the National Health Service Act 2006 (authorisation of NHS foundation trusts) omit subsections (5) and (6) (consultation).31 NHS foundation trusts etc: audit of accounts¶
Schedule 4 contains—32 Abolition of register of NHS foundation trusts¶
In the National Health Service Act 2006 omit—33 Limits on expenditure of NHS foundation trusts¶
For sections 42B and 42C of the National Health Service Act 2006 substitute—42B Limits on expenditure
(1) The Secretary of State may by order impose limits on the expenditure that may be incurred by an NHS foundation trust in respect of a single financial year. (2) The Secretary of State must consult the trust before making the order. (3) The Secretary of State must publish each order under this section. (4) An order under this section may be made at any time during or before the financial year to which it relates. (5) A trust that is the subject of an order under this section must not breach a limit imposed by the order. 42C Guidance in relation to orders under section 42B
(1) The Secretary of State must publish guidance about the exercise of the power to make orders under section 42B, including guidance about— (a) the circumstances in which the Secretary of State is likely to make an order, and (b) the method that the Secretary of State will use to determine a limit. (2) The Secretary of State must have regard to the guidance in exercising the power to make orders under section 42B.
34 NHS foundation trusts: final accounts for predecessors¶
(4A) The NHS foundation trust must prepare accounts for the final accounting period when the body was an NHS trust. (4B) Paragraph 18 of Schedule 7 to this Act, and section 4 of the Local Audit and Accountability Act 2014, apply in relation to those accounts as they apply in relation to the NHS foundation trust’s annual accounts. (4C) In subsection (4A) “final accounting period” means the period— (a) beginning with the later of— (i) the day on which the NHS trust was established, and (ii) 1 April before the day on which the authorisation is given, and (b) ending when the authorisation is given.
(3A) The acquiring NHS foundation trust must prepare accounts for the final accounting period of the acquired NHS foundation trust or NHS trust. (3B) Paragraph 18 of Schedule 7 to this Act and section 4 of the Local Audit and Accountability Act 2014 apply in relation to those accounts as they apply in relation to the NHS foundation trust’s annual accounts. (3C) In subsection (3A) “final accounting period” means the period— (a) beginning with the later of— (i) the day on which the acquired NHS foundation trust or NHS trust was established, and (ii) 1 April before the day on which the application is granted, and (b) ending when the application is granted.
35 Conversion of failing NHS foundation trust into NHS trust¶
Conversion of failing NHS foundation trusts
57B Conversion of failing NHS foundation trust into NHS trust
(1) The Secretary of State may make an order converting a body that is an NHS foundation trust into a National Health Service trust (“NHS trust”) if— (a) it has failed to comply with a condition of its licence under Chapter 3 of Part 3 of the Health and Social Care Act 2012, or (b) it has otherwise failed to comply with any requirement imposed on it by or under any enactment. (2) An order under subsection (1) must specify when it takes effect (see paragraph 5 of Schedule 4 for further provision about matters to be included in the order). (3) In deciding whether to make an order under subsection (1) the Secretary of State must (among other things) consider— (a) the seriousness of the failure, (b) the health and safety of patients, (c) the quality of the provision by the trust of goods and services, (d) the financial position of the trust, and (e) the way that the trust is being run. (4) Before making an order under subsection (1) the Secretary of State must consult— (a) the trust, (b) any integrated care board in whose area the trust has hospitals, establishments or facilities, and (c) any other person to whom the trust provides goods or services under this Act and whom the Secretary of State considers it appropriate to consult. (5) Where an order is made under subsection (1) the Secretary of State may, for the purpose of ensuring compliance with provision made by the order or by regulations under paragraph 4 of Schedule 4— (a) terminate the appointment of the chair or any executive or non-executive director of the trust; (b) appoint a person to be the chair or an executive or non-executive director of the trust. (6) The powers conferred by subsection (5) lapse at the end of the period of one year beginning with the day on which the order is made. (7) When an order under subsection (1) takes effect the body— (a) ceases to be an NHS foundation trust (and, accordingly, the constitution required by Schedule 7 ceases to have effect), and (b) is established as an NHS trust, in accordance with provision made by the order, to provide goods and services for the purposes of the health service. (8) Schedule 9A makes transitional provision in connection with the conversion of an NHS foundation trust into an NHS trust in pursuance of an order under subsection (1). 57C Guidance about conversion
(1) The Secretary of State must publish guidance about the matters that the Secretary of State proposes to consider in deciding whether to make an order under section 57B(1) (including about the matters mentioned in subsection 57B(3)). (2) Before publishing guidance or revised guidance under subsection (1) the Secretary of State must consult such persons as the Secretary of State considers appropriate.
;(1) An order under section 25 or 57B establishing an NHS trust must specify— (a) the name of the NHS trust, (b) the functions of the NHS trust, (c) the number of executive directors and non-executive directors, and (d) where the NHS trust has a significant teaching commitment, a provision to secure the inclusion in the non-executive directors referred to in paragraph (c) of a person appointed from a university with a medical or dental school specified in the order. (1A) The first order under section 25 in relation to an NHS trust must also specify— (a) the operational date of the NHS trust, and (b) if a scheme is to be made under paragraph 8, the Special Health Authority or Local Health Board which is to make the scheme. (2) The functions which may be specified in an order under section 25 or 57B include a duty to provide goods or services so specified at or from a hospital or other establishment or facility so specified.
36 Licence conditions for failing NHS foundation trusts¶
111 Imposition of licence conditions on NHS foundation trusts
(1) Where the Secretary of State is satisfied that the governance of an NHS foundation trust is such that the trust will fail to comply with the conditions of its licence, the Secretary of State may include in the licence such conditions relating to governance as the Secretary of State considers appropriate for the purpose of reducing that risk. (2) The reference to the governance of an NHS foundation trust being such that the trust will fail to comply with the conditions of its licence includes circumstances in which the board of directors is failing— (a) to secure compliance with conditions in the trust’s licence, or (b) to take steps to reduce the risk of a breach of a condition in the trust’s licence. (3) Where a warning notice under section 29A of the Health and Social Care Act 2008 is given to an NHS foundation trust, the Secretary of State may include in the trust’s licence such conditions as the Secretary of State considers appropriate in connection with the matters to which the notice relates. (4) The Secretary of State may modify a condition included under subsection (1) or (3). (5) Where the Secretary of State is satisfied that the trust has breached or is breaching a condition included under subsection (1) or (3), the Secretary of State may by notice require the trust— (a) to remove one or more of the executive directors and appoint interim executive directors; (b) to suspend one or more of the executive directors from office for a specified period; (c) not to reappoint, within a specified period, an executive director who is removed or suspended by virtue of paragraph (a) or (b). (6) Where the Secretary of State is satisfied that a person has failed or is failing to comply with a notice under subsection (5), the Secretary of State may do anything that the trust may be required to do under that subsection. (7) Subsection (5) does not prevent the Secretary of State from exercising in relation to a condition included in a licence under subsection (1) or (3) the powers conferred by sections 105 and 106 (discretionary requirements and enforcement undertakings). (8) Where the Secretary of State includes a condition under subsection (1) or (3), the Secretary of State may also make such incidental or consequential modifications as the Secretary of State considers necessary or expedient of any other condition of the licence concerned which is affected. (9) Where the Secretary of State includes a condition under subsection (1) or (3) by modifying a standard condition of the licence concerned, the modification does not prevent any other part of the condition from continuing to be regarded as a standard condition for the purposes of this Chapter. (10) In this section, a reference to failing to discharge functions includes a reference to failing to discharge those functions properly.
37 Financial assistance in special administration cases¶
.(a) “special administrator” means a person appointed as a health special administrator under Chapter 5,
NHS trusts and NHS foundation trusts¶
38 Trust special administration¶
Schedule 6 contains amendments to do with special administration for NHS trusts and NHS foundation trusts, including—Joint working and delegation arrangements¶
39 Joint working and delegation arrangements¶
;(1A) The Secretary of State may arrange for any functions of the Secretary of State which relate to the health service in England to be exercised by or jointly with any one or more of the following— (a) a relevant body; (b) a local authority (within the meaning of section 2B); (c) a combined authority; (d) a combined county authority; (e) such other person as may be prescribed.
65Z6 Joint committees and pooled funds
(1) This section applies where— (a) a function is exercisable jointly by one or more persons by virtue of an arrangement under section 65Z5, or (b) a function is otherwise exercisable jointly by a relevant body and one or more of the following— (i) a relevant body; (ii) a local authority (within the meaning of section 2B); (iii) a combined authority; (iv) a combined county authority. (2) The persons by whom the function is exercisable jointly may— (a) arrange for the function to be exercised by a committee of persons appointed by them; (b) arrange for one or more of the persons, or a committee appointed as mentioned in paragraph (a), to establish and maintain a pooled fund. (3) A pooled fund is a fund— (a) which is made up of payments received in accordance with the arrangement from any of the following who is a party to the arrangement— (i) relevant bodies; (ii) the Secretary of State; and (b) out of which payments may be made in accordance with the arrangement towards expenditure incurred in the exercise of functions in relation to which the arrangements are made. (4) Arrangements under this section may be made on such terms as may be agreed between the parties, including terms as to payment. (5) In this section “relevant body” has the meaning given by section 65Z5(2).
.(ii) subsection (1)(ca),
Finance¶
40 Consolidated accounts¶
For section 65Z4 of the National Health Service Act 2006 substitute—65Z4 Consolidated accounts for certain NHS bodies
(1) The Secretary of State must, in respect of each financial year, prepare a set of accounts that consolidates the annual accounts of— (a) all integrated care boards, (b) all NHS trusts established under this Act, and (c) all NHS foundation trusts. (2) The Secretary of State must send a copy of the consolidated accounts to the Comptroller and Auditor General. (3) The Comptroller and Auditor General must— (a) examine, certify and report on the consolidated accounts, and (b) send a copy of the report to the Secretary of State. (4) The Secretary of State must lay before Parliament a copy of— (a) the consolidated accounts, and (b) the Comptroller and Auditor General’s report on them.
41 Schemes for meeting liabilities¶
In section 71 of the National Health Service Act 2006 (schemes for meeting liabilities etc of certain health service bodies), in subsection (2), for paragraph (ha) substitute—.(ha) a company formed under section 223 other than by an integrated care board by virtue of section 223A,
42 NHS England’s funding and financial responsibilities¶
43 Integrated care boards’ funding and financial responsibilities¶
223G Allotment of sums to integrated care boards
(1) The Secretary of State must, in respect of each financial year, allot an amount to each integrated care board towards meeting the expenditure of the board attributable to the performance of its functions in that year. (2) An amount is allotted to an integrated care board by the Secretary of State notifying the board in writing of the allotted amount. (3) The Secretary of State must pay the allotted amount to an integrated care board in such instalments and at such times as the Secretary of State considers appropriate. (4) In determining the amount to be allotted to an integrated care board in respect of a financial year, the Secretary of State may take into account the expenditure of the board during any previous financial year. (5) The Secretary of State may make a new allotment under this section increasing or reducing a previous allotment. (6) A sum falling to be paid to an integrated care board under this section is payable subject to such conditions as to records, certificates or otherwise as the Secretary of State may determine. 223GA Directions about use and management of resources
(1) The Secretary of State may give integrated care boards directions about their use or management of financial or other resources. (2) The directions that may be given under subsection (1) to an integrated care board include— (a) a direction imposing limits on expenditure or resource use by the board; (b) a direction to pay sums to the Secretary of State in respect of charges or other sums referable to the valuation or disposal of assets. (3) A direction under subsection (1) may include conditions relating to the approval of the Secretary of State. (4) If an integrated care board fails to comply with a direction under subsection (1) relating to the use or management of sums paid to the board under section 223G, the Secretary of State may direct the board to repay some or all of those sums. (5) The Secretary of State must publish any directions under this section. 223GB Expenditure on service integration
(1) A direction under section 223GA that requires an integrated care board to use an amount (a “designated amount”) of the sums paid to the board under section 223G in respect of a financial year for purposes relating to service integration may— (a) require the integrated care board to transfer some or all of the designated amount into one or more funds (“pooled funds”) established under arrangements under section 75(2)(a) (“pooling arrangements”); (b) impose requirements relating to the preparation and agreement by the integrated care board and one or more relevant local authorities of a plan for how to use the designated amount (a “spending plan”); (c) impose requirements relating to the approval of a spending plan by the Secretary of State; (d) impose requirements relating to the inclusion of performance objectives in a spending plan; (e) impose requirements relating to the meeting of any performance objectives included in a spending plan or specified by the Secretary of State. (2) Nothing in subsection (1) limits the power to give directions under section 223GA. (3) The payments that may be made out of a pooled fund into which a designated amount is transferred include payments to a local authority which is not party to the pooling arrangements in question in connection with the exercise of its functions under Part 1 of the Housing Grants, Construction and Regeneration Act 1996 (disabilities facilities grants). (4) A reference in this section to service integration is a reference to the integration of the provision of health services with the provision of health-related services or social care services, as referred to in section 14Z42. (5) In this section— health services means services provided as part of the health service in England; relevant local authority, in relation to an integrated care board, means a local authority whose area coincides with, or includes the whole or any part of, the area of the board.
44 Joint duties of integrated care boards and providers¶
;223L Joint financial objectives for integrated care boards etc
(1) The Secretary of State may set joint financial objectives for an integrated care board and one or more of its partner NHS trusts and NHS foundation trusts. (2) An integrated care board, NHS trust or NHS foundation trust must seek to achieve any financial objectives under this section that applies to it. (3) For the purposes of this section an NHS trust or NHS foundation trust is a “partner” of an integrated care board if the trust provides services for the purposes of the health service to people for whom the integrated care board is responsible.
Regulation of health and adult social care services¶
45 Licence conditions¶
In section 96 of the Health and Social Care Act 2012 (limits on power to set or modify licence conditions), in subsection (2), after paragraph (h) insert—.(ha) for the purpose of promoting or securing compliance by licence holders with obligations arising under or by virtue of any enactment;
46 Service of documents¶
;(A1) A notice required by section 100, 114C, 114D or 114E to be given or sent to a person may be given or sent to them— (a) by being delivered to them personally, (b) by being sent to them by post, or (c) by being sent to them by an electronic communication.
;(A1) This section applies in relation to any notice required to be given or sent to or served on a person under any provision of this Part other than— (a) section 100 (modification of standard licence conditions); (b) section 114C (the NHS payment scheme: impact assessment and consultation); (c) section 114D (objections to proposed NHS payment scheme); (d) section 114E (amendments of the NHS payment scheme). (1) If the notice is sent by an electronic communication it is to be treated as given, sent or served only if the requirements of subsection (2) or (3) are met.
Information¶
47 Single patient record¶
250E Single patient record
(1) The Secretary of State may by regulations make provision for the purpose of establishing a system for making patient information readily available to— (a) patients who have received health care as part of the health service in England or have received social care in England, and (b) people involved in the provision to patients of health care or social care in England. (2) The regulations may, in particular, make provision— (a) conferring functions on public authorities in connection with the establishment or operation of the system; (b) requiring or authorising the disclosure or other processing of patient information, or information held in connection with it, for the purpose of making it available through the system; (c) requiring or authorising the making available of patient information, or information held in connection with it, through the system, including— (i) making it available to people other than a patient on the patient’s behalf; (ii) making it available to people involved in the provision to patients of health care or social care anywhere in the British Islands; (d) conferring on the Secretary of State, the Care Quality Commission or a Special Health Authority the power to impose financial penalties in circumstances specified in the regulations (see further section 250F). (3) The regulations may provide that the processing of information in accordance with the regulations does not breach any obligation of confidence owed by the person processing the information. (4) In making the regulations the Secretary of State must have regard to the need to ensure that adequate safeguards are in place to prevent the improper use of information made available under the regulations. (5) Nothing in subsection (1) or (2) limits the processing of information available by means of the system for any purpose for which it could otherwise lawfully be processed. (6) Before making regulations under this section the Secretary of State must consult such persons as the Secretary of State considers appropriate. (7) In this section— health care includes all forms of health care whether relating to physical or mental health and also includes procedures that are similar to forms of medical or surgical care but are not provided in connection with a medical condition; patient includes an individual who needs or receives social care or whose need for such care is being assessed; patient information means information (however recorded) which relates to the physical or mental health or condition of a person, to the diagnosis of their condition or to their care or treatment, whether or not the person’s identity is ascertainable from the information; processing has the same meaning as in Parts 5 to 7 of the Data Protection Act 2018 (see section 3(4) of that Act); social care includes all forms of personal care and other practical assistance provided for individuals who are in need of such care or other assistance by reason of age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or any other similar circumstances. 250F Enforcement of regulations under section 250E
(1) This section makes further provision about regulations which include provision made by virtue of section 250E(2)(d) conferring power on the Secretary of State, the Care Quality Commission or a Special Health Authority (“the enforcement authority”) to impose a financial penalty. (2) The amount of the financial penalty is to be specified in, or determined in accordance with, the regulations. (3) The regulations must include provision— (a) requiring the enforcement authority, before imposing a financial penalty on a person, to give the person written notice (a “notice of intent”) of the proposed financial penalty; (b) ensuring that the person is given an opportunity to make representations about the proposed financial penalty; (c) requiring the enforcement authority, after the period for making representations, to decide whether to impose the financial penalty; (d) requiring the enforcement authority, if it decides to impose the financial penalty, to give the person notice in writing (a “final notice”) imposing the penalty; (e) enabling a person on whom a financial penalty is imposed to appeal to the First-tier Tribunal in accordance with the regulations; (f) as to the powers of the Tribunal on such an appeal. (4) The regulations may include provision— (a) enabling a notice of intent or final notice to be withdrawn or amended; (b) requiring a final notice to be withdrawn in circumstances specified in the regulations; (c) for a financial penalty to be increased by an amount specified in or determined in accordance with the regulations in the event of late payment; (d) for the recovery of financial penalties in the county court.
.(db) sections 250E and 250F (single patient record),
.(ze) regulations under section 250E,
48 Information about health service products¶
;(ba) a person with whom the Secretary of State or an integrated care board has made arrangements under this Act to provide health services as part of the health service in England;
(6) Where— (a) a service provider provides services to a person falling within subsection (1)(b) to (i), and (b) in consequence, confidential or commercially sensitive information is disclosed to the service provider under subsection (1)(j), the service provider may disclose the confidential or commercially sensitive information to that person.(7) A person to whom confidential or commercially sensitive information is disclosed under subsection (6) may not— (a) use the information for any purpose other than the purpose for which they could have used it if it had it been disclosed to them under subsection (1) by the Secretary of State; (b) disclose the information to another person.
49 Health and social care information: delegation of functions¶
Exercise of functions under Chapter 1
251ZF Exercise of functions of Secretary of State by others
(1) The Secretary of State may make arrangements for a person prescribed by regulations under this subsection to exercise some or all of the functions of the Secretary of State under this Chapter other than— (a) a function under section 251ZC (public censure of relevant IT providers); (b) a function of making regulations. (2) Arrangements under subsection (1) may— (a) provide for the Secretary of State to make payments to the person, and (b) make provision as to the circumstances in which such payments are to be repaid to the Secretary of State. (3) Section 304(9) applies in relation to the power to make arrangements under subsection (1) as it applies to a power of the Secretary of State to give directions under this Act.
Chapter 5 — Exercise of functions under Part 9
277G Power to direct public bodies to exercise Secretary of State’s functions
(1) The Secretary of State may— (a) direct a public body that exercises functions in, or in relation to, England to exercise some or all of the Secretary of State’s relevant information functions; (b) give the public body directions about the exercise of those functions, including directions about the processing of information that the body obtains in exercising those functions. (2) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a body of any function by virtue of a direction under this section are enforceable by or against that body (and no other person) unless or to the extent that the direction provides otherwise. (3) The Secretary of State must publish any directions under this section. (4) In this section— adult social care— (a) includes all forms of personal care and other practical assistance provided for individuals who, by reason of age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or any other similar circumstances, are in need of such care or other assistance, but (b) does not include anything provided by an establishment or agency for which Her Majesty's Chief Inspector of Education, Children's Services and Skills is the registration authority under section 5 of the Care Standards Act 2000; health care includes all forms of health care whether relating to physical or mental health and also includes procedures that are similar to forms of medical or surgical care but are not provided in connection with a medical condition; health services means services which must or may be provided as part of the health service in England; processing has the same meaning as in Parts 5 to 7 of the Data Protection Act 2018 (see section 3(4) of that Act); public body means a body or other person whose functions— (a) are of a public nature, or (b) include functions of that nature; relevant information function means any of the following functions other than a function of making regulations— (a) a function of the Secretary of State conferred by or under— (i) any provision of Chapter 1 (information standards), other than section 251ZC (public censure of relevant IT providers); (ii) any provision of Chapter 2 (health and social care information etc), other than section 267 (power to establish accreditation scheme); (iii) any provision of Chapter 3 (information about adult social care); (iv) paragraph 7B(1)(d) of Schedule 1 to the National Health Service Act 2006 (processing of information resulting from weighing or measuring of children etc); (v) section 2 of the Access to Medical Treatments (Innovation) Act 2016 (database of innovative treatments); (vi) sections 7A and 19 of the Medicines and Medical Devices Act 2021 (information systems about medicines and medical devices); (b) a function of the Secretary of State that is exercisable in relation to the development or operation of information or communications systems in connection with the provision of health services or of adult social care in England; (c) any other functions of the Secretary of State that— (i) relate to the processing of information in connection with the provision of health care or adult social care in England, and (ii) are specified in regulations made by the Secretary of State for the purposes of this paragraph.
50 Health and social care information systems etc¶
Schedule 7 amends Chapter 2 of Part 9 of the Health and Social Care Act 2012 to—51 Sharing information about births and deaths¶
In section 42 of the Statistics and Registration Service Act 2007 (sharing of information about births and deaths etc), in subsection (4A), after paragraph (d) insert—.(da) an NHS trust established under the National Health Service Act 2006, (db) an NHS foundation trust,
Arrangements with devolved authorities and Crown dependencies¶
52 Arrangements with devolved authorities etc about information services¶
Before section 295 of the Health and Social Care Act 2012 (but after the italic heading “Arrangements with devolved authorities etc”) insert—294A Arrangements with devolved authorities etc about information services
(1) The Secretary of State may— (a) make arrangements with the Scottish Ministers or a Scottish health body for the provision by the Secretary of State of services or facilities in connection with the processing of information for the purposes of— (i) the Scottish health service, or (ii) the provision of social care in, or in relation to, Scotland; (b) make arrangements with the Welsh Ministers or a Welsh health body for the provision by the Secretary of State of services or facilities in connection with the processing of information for the purposes of— (i) the Welsh health service, or (ii) the provision of social care in, or in relation to, Wales; (c) make arrangements with a Northern Ireland department or a Northern Ireland health body for the provision by the Secretary of State of services or facilities in connection with the processing of information for the purposes of the Northern Ireland health service; (d) make arrangements with a public body in the Isle of Man or Channel Islands for the provision by the Secretary of State of services or facilities in connection with the processing of information for purposes connected with the provision in, or in relation to, the Isle of Man or Channel Islands of— (i) health care, or (ii) social care. (2) Arrangements under this section may be on such terms as may be agreed between the parties, including terms as to payment. 294B Delegation of functions under section 294A
(1) The Secretary of State may— (a) direct a public body that exercises functions in, or in relation to, England to exercise some or all of the Secretary of State’s functions under section 294A or under arrangements under that section; (b) give the public body directions about the exercise of those functions including directions about the processing of information that the body obtains in exercising those functions. (2) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a body of any function by virtue of a direction under this section are enforceable by or against that body (and no other person) unless or to the extent that the direction provides otherwise. (3) The Secretary of State must publish any directions under this section.
53 Arrangements with devolved authorities about commissioning¶
295 Arrangements to commission services for devolved authorities
(1) The Secretary of State may— (a) make arrangements with the Scottish Ministers or a Scottish health body for the Secretary of State to commission services or facilities for the purposes of the Scottish health service; (b) make arrangements with the Welsh Ministers or a Welsh health body for the Secretary of State to commission services or facilities for the purposes of the Welsh health service; (c) make arrangements with a Northern Ireland department for the Secretary of State to commission services or facilities for the purposes of the Northern Ireland health service. (2) Arrangements under this section may be made on such terms as may be agreed between the parties, including terms as to payment.
54 Arrangements with devolved authorities about education etc¶
For section 296A of the Health and Social Care Act 2012 substitute—296A Arrangements with devolved authorities in respect of education and training
(1) The Secretary of State may make arrangements with the Scottish Ministers, the Welsh Ministers or a Northern Ireland department (“a devolved authority”) for the Secretary of State— (a) to exercise on behalf of the devolved authority any function of that authority that corresponds to a function of the Secretary of State that relates to the education and training of people to meet the workforce needs of the health service continued under section 1 of the National Health Service Act 2006; (b) to provide services or facilities in so far as the devolved authority requires them in connection with the exercise of such a function. (2) Arrangements under this section may be on such terms as may be agreed between the parties.
55 Delegation of functions under certain arrangements with devolved authorities¶
After section 296A of the Health and Social Care Act 2012 insert—296B Delegation of functions under section 295 and 296A arrangements
(1) The Secretary of State may— (a) direct a public body that exercises functions in, or in relation to, England to exercise some or all of the Secretary of State’s functions under arrangements under section 295 or 296A; (b) give the public body directions about the exercise of those functions, including directions about the processing of information that the body obtains in exercising those functions. (2) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a body of any function by virtue of a direction under this section are enforceable by or against that body (and no other person) unless or to the extent that the direction provides otherwise. (3) The Secretary of State must publish any directions under this section.
56 Advice and assistance to Crown dependencies¶
For section 298 of the Health and Social Care Act 2012 substitute—298 Advice or assistance to public authorities in the Isle of Man or Channel Islands
(1) The Secretary of State or an integrated care board may provide advice or assistance to any public body in the Isle of Man or Channel Islands for purposes connected with the provision of health care. (2) Advice or assistance under this section may be provided on such terms, including terms as to payment, as the person providing the advice or assistance considers appropriate.
57 Sections 52 to 56: interpretation¶
After section 298 of the Health and Social Care Act 2012 insert—298A Sections 294A to 298: interpretation
In sections 294A to 298—commission, in relation to a service, means arrange for the provision of; facilities has the meaning given by section 275 of the National Health Service Act 2006; health care includes all forms of health care whether relating to physical or mental health and also includes procedures that are similar to forms of medical or surgical care but are not provided in connection with a medical condition; Northern Ireland health body means— (a) a special health and social care agency established under Article 3 of the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990 (S.I. 1990/247 (N.I. 3)), (b) a Health and Social Care trust established under Article 10 of the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I. 1)), (c) the Health and Social Care Regulation and Quality Improvement Authority (so named by section 1 of the Health and Social Care (Reform) Act (Northern Ireland) 2009), (d) the Regional Agency for Public Health and Social Well-being established under section 12 of the Health and Social Care (Reform) Act (Northern Ireland) 2009, or (e) the Regional Business Services Organisation established under section 14 of the Health and Social Care (Reform) Act (Northern Ireland) 2009; Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009; processing has the same meaning as in Parts 5 to 7 of the Data Protection Act 2018 (see section 3(4) of that Act); public body means a body or other person whose functions— (a) are of a public nature, or (b) include functions of that nature; Scottish health body means— (a) a Health Board or Special Health Board constituted under section 2 of the National Health Service (Scotland) Act 1978, or (b) the Common Services Agency for the Scottish Health Service constituted by section 10 of that Act; Scottish health service means the health service continued under section 1 of the National Health Service (Scotland) Act 1978; social care includes all forms of personal care and other practical assistance provided for individuals who, by reason of age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or any other similar circumstances, are in need of such care or other assistance; Welsh health body means— (a) an NHS trust established under the National Health Service (Wales) Act 2006, (b) a Special Health Authority established under that Act, or (c) a Local Health Board; Welsh health service means the health service continued under section 1 of the National Health Service (Wales) Act 2006.
NICE¶
58 NICE recommendations: decisions about time for compliance¶
In section 237 of the Health and Social Care Act 2012 (NICE recommendations etc), after subsection (8) insert—(8A) Provision made under subsection (8)(b) may include provision about the period within which a recommendation is to be complied with (including provision for the period to be determined by NICE or the Secretary of State).
Care Quality Commission¶
59 Transfer of HSSIB’s functions to CQC¶
60 Transfer schemes in connection with abolition of HSSIB¶
61 Transfer schemes under section 60: taxation¶
62 Reviews and investigations of commissioning¶
.(ba) the exercise of the functions of an integrated care board in arranging for the provision of NHS care under— (i) the National Health Service Act 2006, or (ii) section 117 of the Mental Health Act 1983 (after-care), (baa) the exercise of any prescribed functions of the Secretary of State in arranging for the provision of NHS care under the enactments mentioned in paragraph (ba)(i) or (ii),
63 Time limit for bringing proceedings¶
Healthwatch England and Local Healthwatch organisations¶
64 Abolition of Healthwatch England¶
65 Abolition of arrangements with Local Healthwatch organisations¶
Schedule 10 contains amendments which—Civil contingencies¶
66 Civil contingencies: category 1 responders¶
5 A National Health Service trust established under the National Health Service Act 2006 if, and in so far as, it has the function of providing— (a) ambulance services, or (b) hospital accommodation and services in relation to accidents and emergencies.
Minor and consequential amendments¶
67 Minor and consequential amendments¶
Schedule 11 contains minor and consequential amendments, including amendments—General¶
68 Power to make consequential provision¶
69 Financial provision¶
There is to be paid out of money provided by Parliament—70 Extent¶
71 Commencement¶
72 Short title¶
This Act may be cited as the Health Act 2026.Schedules¶
Schedule 11 — Conferral of primary care functions on integrated care boards etc¶
Part 1 — Conferral of functions etc¶
Preliminary¶
Medical services¶
Meaning of primary medical services
82A Primary medical services for purposes of this Act
(1) Regulations may provide that services of a prescribed description must, or must not, be regarded as primary medical services for the purposes of this Act. (2) Regulations under this section may, in particular, describe services by reference to the manner or circumstances in which they are provided. Duty of integrated care boards to arrange primary medical services
82B Duty of integrated care boards to arrange primary medical services
(1) Each integrated care board must exercise its powers so as to secure the provision of primary medical services to such extent as it considers necessary to meet the reasonable requirements of the people for whom it has responsibility. (2) For the purposes of this section an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service). General functions
83 General power to make arrangements
(1) An integrated care board may make such arrangements for the provision of primary medical services as it considers appropriate for the purpose of discharging its functions under section 82B (and may, in particular, make contractual arrangements with any person). (2) The arrangements that may be made by an integrated care board under this section include arrangements for the performance of a service outside its area (whether or not in England). (3) The powers under this section are in addition to the powers conferred by sections 84 and 92. 83A Publication of information
Each integrated care board must publish information about such matters as may be prescribed in relation to the primary medical services provided under this Act.
(4) The services to be provided under a general medical services contract may include services which are not primary medical services. (4A) The services to be provided under a general medical services contract entered into by an integrated care board may include services to be performed outside its area (whether or not in England).
(b) an integrated care board is responsible for a primary medical service if it secures its provision under or by virtue of any enactment.
.(za) ensuring that only suitable persons are included in a list, (zb) addressing inappropriate conduct,
(1) An integrated care board may make agreements, other than arrangements pursuant to section 83 or general medical services contracts, under which primary medical services are provided.
.the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009,
.(ca) provide that section 92 arrangements made by an integrated care board may be made in relation to services to be performed outside its area (whether or not in England),
Dental services¶
Meaning of primary dental services
98C Primary dental services for purposes of this Act
(1) Regulations may provide that services of a prescribed description must, or must not, be regarded as primary dental services for the purposes of this Act. (2) Regulations under this section may, in particular, describe services by reference to the manner or circumstances in which they are provided. Duty of integrated care boards to arrange primary dental services
99 Duty of integrated care boards to arrange primary dental services
Each integrated care board must exercise its powers so as to secure the provision of primary dental services within its area to such extent as it considers necessary to meet the reasonable requirements of people seeking to obtain those services there.General functions
99A General power to make arrangements
(1) An integrated care board may make such arrangements for the provision of primary dental services as it considers appropriate for the purpose of discharging its functions under section 99 (and may, in particular, make contractual arrangements with any person). (2) The powers in this section are in addition to the powers conferred by sections 100 and 107. 99B Publication of information
Each integrated care board must publish information about such matters as may be prescribed in relation to the primary dental services provided under this Act.
(3A) The services to be provided under a general dental services contract may include services which are not primary dental services.
(b) an integrated care board is responsible for a primary dental service if it secures its provision under or by virtue of any enactment.
.(za) ensuring that only suitable persons are included in a list, (zb) addressing inappropriate conduct,
(1) An integrated care board may make agreements, other than arrangements pursuant to section 99A or general dental services contracts, under which primary dental services are provided.
.the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009,
Ophthalmic services¶
Meaning of primary ophthalmic services
114B Primary ophthalmic services for purposes of this Act
(1) Regulations may provide that services of a prescribed description must, or must not, be regarded as primary ophthalmic services for the purposes of this Act (but these regulations may not affect the duty in section 115(1)(a)). (2) Regulations under this section may, in particular, describe services by reference to the manner or circumstances in which they are provided.
(1) Each integrated care board must exercise its powers so as to secure the provision, within its area, of the following primary ophthalmic services— (a) the sight-testing service mentioned in subsection (2), (b) such other primary ophthalmic services as may be prescribed, and (c) to the extent that it considers necessary to meet all reasonable requirements, any further primary ophthalmic services.
General functions
116A General powers to make arrangements
(1) An integrated care board may make such arrangements for the provision of primary ophthalmic services as it considers appropriate for the purpose of discharging its functions under section 115 (and may, in particular, make contractual arrangements with any person). (2) The powers in this section are in addition to the power conferred by section 117. 116B Publication of information
Each integrated care board must publish information about such matters as may be prescribed in relation to the primary ophthalmic services provided under this Act.
(4) The services to be provided under a general ophthalmic services contract may include services which are not primary ophthalmic services.
(b) an integrated care board is responsible for a primary ophthalmic service if it secures its provision under or by virtue of any enactment.
.(za) ensuring that only suitable persons are included in a list, (zb) addressing inappropriate conduct,
Pharmaceutical services¶
(8A) For the purposes of this section an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service).
the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009.
(3A) For the purposes of this section an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service).
(2A) For the purposes of this section an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service).
(4A) Regulations may make provision about the remuneration to be paid to persons who provide services under a pilot scheme, including provision about determination of the remuneration and who is liable to pay it (and the provision that may be made by virtue of this paragraph includes provision corresponding to any provision that may be made by regulations under section 164).
(d) requiring a designation to be cancelled in prescribed circumstances.
.(a) the integrated care board that established the pilot scheme,
(1) Regulations may make provision for the preparation, maintenance and publication by the Secretary of State or an NHS body of one or more lists of— (a) persons approved by the Secretary of State or the NHS body for the purpose of assisting in the provision of pharmaceutical services which an integrated care board arranges; (b) persons approved by the Secretary of State or the NHS body for the purpose of performing local pharmaceutical services.
.(za) ensuring that only suitable persons are included in a list, (zb) addressing inappropriate conduct,
;(a) that a person included in a pharmaceutical list is subject to conditions determined by the integrated care board in whose list the person is included,
.(i) the practitioner,
(5) If an integrated care board suspends a practitioner under this section it may revoke the suspension.
(1) The First-tier Tribunal may impose a national disqualification on a person if— (a) it removes the person from a pharmaceutical list, (b) it dismisses an appeal by the person against a refusal to include the practitioner in a pharmaceutical list, or (c) the person responsible for preparing a relevant list makes an application for such an order under subsection (4). (2) A national disqualification is an order disqualifying a person from inclusion in a relevant list or a description of relevant lists specified in the order. (3) In this section “relevant list” means— (a) a pharmaceutical list, (b) a list under section 147A, (c) a list under section 91, 106, or 123, (d) a list corresponding to a list under section 91 prepared by virtue of regulations made under section 145, or (e) a list corresponding to the a list mentioned in paragraphs (a) to (d) prepared by each Local Health Board under or by virtue of the National Health Service (Wales) Act 2006. (4) The person responsible for preparing a relevant list of any of the kinds mentioned in subsection (3)(a) to (d) may apply to the First-tier Tribunal for a national disqualification to be imposed if they— (a) remove a person from the list, or (b) refuse to include a person in the list. (5) Any such application must be made before the end of the period of three months beginning with the date of the removal or refusal. (6) A person responsible for preparing a relevant list— (a) must not include a person in the list if that person is disqualified from inclusion in that list by a national disqualification, and (b) must remove from the list any person who is disqualified from inclusion in that list by a national disqualification.
(1) Regulations must make provision about the remuneration to be paid to persons who provide pharmaceutical services under Chapter 1 of this Part, including provision about— (a) determination of the remuneration; (b) who is liable to pay the remuneration. (2) The regulations may include provision about the remuneration to be paid to those persons in respect of the instruction of any person in matters relating to those services. (3) Regulations made by virtue of subsection (1)(a) must include provision about— (a) who is to determine the remuneration (the “determining authority”), and (b) the things in respect of which remuneration is payable (and the regulations may provide for things in respect of which remuneration is payable to be determined by the determining authority). (3A) See also section 165 (which makes further provision about determinations under the regulations). (3B) Regulations made by virtue of subsection (1)(b) must make the Secretary of State liable to pay any remuneration determined under the regulations, subject to subsection (3C). (3C) The regulations may— (a) specify services in respect of which the integrated care board is liable to make payments; (b) specify elements of remuneration in respect of which the integrated care board is liable to make payments.
(A1) This section applies in relation to determinations under regulations under section 164(1).
165A Pharmaceutical remuneration: further provision
Schedule 12A makes further provision in connection with remuneration paid by the Secretary of State to persons providing pharmaceutical services or local pharmaceutical services.
(3A) An integrated care board may recognise a committee under this section only if the committee’s area coincides with or falls wholly within the board’s area.
(10) The amount of any sums allotted under subsection (9) must be deducted by the relevant person from pharmaceutical remuneration payable by them to persons of whom the committee is representative under subsection (1)(a) in such proportions as the Secretary of State may determine. (11) In subsection (10)— pharmaceutical remuneration means remuneration payable by the Secretary of State or an integrated care board to persons providing pharmaceutical services; relevant person means— (a) the Secretary of State, or (b) if the Secretary of State so directs, the integrated care board that allotted the sums under subsection (9).
;(1) If the Secretary of State notifies an integrated care board in accordance with paragraph 3(3)(a) that proposals for a pilot scheme have been approved, the board must implement those proposals.
8 As soon as is reasonably practicable after implementing proposals for a pilot scheme, the integrated care board concerned must publish details of the scheme.
;(1) Integrated care boards may establish LPS schemes.
;(a) made by an integrated care board in accordance with this Schedule;
;(2ZA) For the purposes of this paragraph an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service).
(d) requiring a designation to be cancelled in prescribed circumstances.
;(da) make provision about the remuneration to be paid to persons who provide services under an LPS scheme, including provision about determination of the remuneration and who is liable to pay it (and the provision that may be made by virtue of this paragraph includes provision corresponding to any provision that may be made by regulations under section 164),
;(4) The Secretary of State must apportion the sums paid by the Secretary of State in respect of each designated element during the financial year among all integrated care boards, in such manner as the Secretary of State thinks appropriate.
;(8) In determining the amount to be allotted to an integrated care board under section 223G, the Secretary of State must take into account the effect of this Schedule.
Charging¶
Part 2 — Consequential amendments etc¶
Dentists Act 1984¶
Access to Health Records Act 1990¶
.(a) in the case of a record made by a health professional performing primary medical services under a general medical services contract made with an integrated care board or a Local Health Board, the person or body who entered into the contract with the integrated care board or Local Health Board (or, in a case where more than one person so entered into the contract, any such person); (aza) in the case of a record made by a health professional performing such services under a contract made with an integrated care board under section 100 of the National Health Service Act 2006 (general dental services contracts), the person or body who entered into the contract with the integrated care board (or, in a case where more than one person so entered into the contract, any such person); (aa) in the case of a record made by a health professional performing such services in accordance with arrangements under section 83, 92, 99A or 107 of the National Health Service Act 2006, or section 50 or 64 of the National Health Service (Wales) Act 2006, with an integrated care board or a Local Health Board, the person or body which made the arrangements with the integrated care board or Local Health Board (or, in a case where more than one person so made the arrangements, any such person);
Trade Union and Labour Relations (Consolidation) Act 1992¶
(2) In this Act “worker” also includes an individual regarded in their capacity as one who works or normally works or seeks to work as a person performing primary medical services, primary dental services or primary ophthalmic services— (a) in accordance with arrangements made by an integrated care board under section 83, 92, 99A, 107 or 116A of the National Health Service Act 2006; (b) in accordance with arrangements made by a Local Health Board under section 50 or 64 of the National Health Service (Wales) Act 2006; (c) under a contract under section 84, 100 or 117 of the National Health Service Act 2006 entered into by the individual with an integrated care board; (d) under a contract under section 42 or 57 of the National Health Service (Wales) Act 2006 entered into by the individual with a Local Health Board, and “employer” in relation to such an individual, regarded in that capacity, means that body.
Health Service Commissioners Act 1993¶
Employment Rights Act 1996¶
;(bza) works or worked as a person providing services under arrangements made by the person with an integrated care board under section 83, 84, 92, 99A, 100, 107, 116A, 117 or 134 of, or Schedule 12 to, the National Health Service Act 2006,
;(aza) in relation to a worker falling within paragraph (bza) of that subsection, the integrated care board referred to in that paragraph,
Freedom of Information Act 2000¶
Health and Social Care (Community Health and Standards) Act 2003¶
Health Act 2006¶
National Health Service Act 2006¶
Provision of primary care services
24 An NHS trust may— (a) enter into arrangements under Part 4 or 5 for the provision of services, or (b) be a member of a body that does so.
National Health Service (Wales) Act 2006¶
;the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009,
;section 83 arrangements means arrangements for the provision of services made under section 83 of the National Health Service Act 2006,
.section 83 employee means an individual who, in connection with the provision of services in accordance with section 83 arrangements, is employed by a person providing or performing those services,
;the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009,
;section 99A arrangements means arrangements for the provision of services made under section 99A of the National Health Service Act 2006,
.section 99A employee means an individual who, in connection with the provision of services in accordance with section 99A arrangements, is employed by a person providing or performing those services,
the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009.
Health Act 2009¶
;(a) section 83 (arrangements for provision of primary medical services);
;(ca) section 99A (arrangements for provision of primary dental services);
.(ea) section 116A (arrangements for provision of primary ophthalmic services);
Domestic Abuse Act 2021¶
.(ii) any arrangements made under section 83 of that Act;
Health and Care Act 2022¶
Schedule 22 — Patient choice: undertakings by integrated care boards¶
Schedule 1C3 — Patient choice: undertakings by integrated care boards
Introductory
1 This Schedule makes further provision about undertakings under section 14Z45C. Procedure
2 (1) The Secretary of State must publish a procedure for entering into undertakings. (2) The Secretary of State may revise the procedure and, if it is revised, must publish the procedure as revised. (3) The Secretary of State must consult such persons as the Secretary of State considers appropriate before publishing or revising the procedure. 3 (1) Where the Secretary of State accepts an undertaking, the Secretary of State must publish the undertaking. (2) But the Secretary of State must not under sub-paragraph (1) publish any part of an undertaking which contains information which the Secretary of State is satisfied is— (a) commercial information the disclosure of which would, or might, significantly harm the legitimate business interests of the person to whom it relates; (b) information relating to the private affairs of an individual the disclosure of which would, or might, significantly harm that person’s interests. Variation of terms
4 The terms of an undertaking (including, in particular, the action specified under it and the period so specified within which the action must be taken) may be varied if both the integrated care board giving the undertaking and the Secretary of State agree. Compliance certificates
5 (1) Where the Secretary of State is satisfied that an undertaking has been complied with, the Secretary of State must issue a certificate to that effect (referred to in this Schedule as a “compliance certificate”). (2) An integrated care board which has given an undertaking may at any time make an application to the Secretary of State for a compliance certificate. (3) The application must be made in such form, and accompanied by such information, as the Secretary of State requires. (4) The Secretary of State must decide whether or not to issue a compliance certificate, and give notice to the applicant of the decision, before the end of the period of 14 days beginning with the day after that on which the application is received. 6 (1) An appeal lies to the First-tier Tribunal against a decision of the Secretary of State to refuse an application for a compliance certificate. (2) The grounds for an appeal under this paragraph are that the decision was— (a) based on an error of fact, (b) wrong in law, or (c) unfair or unreasonable. (3) On an appeal under this paragraph, the Tribunal may confirm the Secretary of State’s decision or direct that it is not to have effect. Inaccurate, incomplete or misleading information
7 Where the Secretary of State is satisfied that an integrated care board which has given an undertaking has supplied the Secretary of State with inaccurate, misleading or incorrect information in relation to the undertaking— (a) the Secretary of State may treat the integrated care board as having failed to comply with the undertaking, and (b) if the Secretary of State decides so to treat the integrated care board, the Secretary of State must by notice revoke any certificate of compliance given to that integrated care board.
Schedule 34 — Constitution of NHS foundation trusts¶
Mental Health Act 1983¶
National Health Service Act 2006¶
30 NHS foundation trusts
(1) This Chapter makes provision about NHS foundation trusts. (2) An NHS foundation trust may be created by virtue of— (a) section 36 (conversion of NHS trusts), (b) section 56 (mergers), or (c) section 56B (separations). (3) See also section 56A (which provides for the reconstitution of an NHS foundation trust in the context of acquisitions). (4) An NHS foundation trust is a body corporate. (5) Schedule 7 makes further provision about the constitution of NHS foundation trusts.
(4) Once an NHS trust has made the application— (a) the provisions of the proposed constitution which give effect to paragraphs 4 to 10 of Schedule 7 have effect, but only for the purpose of establishing the initial directors, and enabling the board of directors to make preparations for the performance of their functions; (b) the NHS trust may do anything which appears to it to be necessary or expedient for the purpose of preparing it for NHS foundation trust status.
37 Amendments of constitution
An NHS foundation trust may make amendments of its constitution with the approval of the Secretary of State.
Schedule 75 — Constitution of NHS foundation trusts
Requirement for a constitution
1 (1) An NHS foundation trust must have a constitution. (2) As well as any provision authorised or required to be made by any other provision of this Schedule, the constitution may make further provision (other than provision as to the powers of the NHS foundation trust) consistent with this Schedule. Name
2 (1) The constitution must specify the name of the NHS foundation trust. (2) The name must include the words “NHS foundation trust”. Principal purpose
3 The constitution must specify the NHS foundation trust’s principal purpose (as to which, see section 43(1)). Composition of board of directors
4 An NHS foundation trust is to have a board of directors. 5 (1) The board of directors is to consist of— (a) executive directors, one of whom is the chief executive (and accounting officer) and another the finance director, and (b) non-executive directors, one of whom is the chair. (2) An executive director is a director who is an employee of the NHS foundation trust, and a non-executive director is a director who is not an employee of the NHS foundation trust, subject to any regulations under sub-paragraph (3). (3) The Secretary of State may by regulations make provision with respect to the circumstances in which a person who is not an employee of the NHS foundation trust is, on appointment as a director, to be regarded as an executive rather than a non-executive director. Eligibility for appointment as director
6 (1) A person may not be appointed as a director if disqualified by sub-paragraph (2). (2) The following are disqualified by this sub-paragraph— (a) a person who has been made bankrupt or whose estate has been sequestrated and (in either case) has not been discharged; (b) a person in relation to whom a moratorium period under a debt relief order applies (under Part 7A of the Insolvency Act 1986); (c) a person who has made a composition or arrangement with, or granted a trust deed for, the person’s creditors and has not been discharged in respect of it; (d) a person who within the preceding five years has been convicted in the British Islands of any offence if a sentence of imprisonment (whether suspended or not) for a period of at least three months (without the option of a fine) was imposed. 7 The Secretary of State may by regulations make further provision about eligibility for appointment as a director. Appointment etc, tenure and terms
8 (1) It is for the Secretary of State to appoint, suspend or remove the chair and the other non-executive directors. (2) It is for the non-executive directors to appoint, suspend or remove the chief executive. (3) It is for a committee consisting of the chief executive, the chair and the other non-executive directors to appoint, suspend or remove the executive directors. (4) The Secretary of State may by regulations make provision as to circumstances in which the power conferred by sub-paragraph (1), (2) or (3) must be exercised. 9 (1) The Secretary of State may by regulations make provision as to the tenure of office of non-executive directors. (2) It is for the Secretary of State to decide the remuneration and allowances, and the other terms and conditions of office, of the non-executive directors (subject to any regulations under sub-paragraph (1)). (3) The NHS foundation trust must establish a committee of non-executive directors to decide the remuneration and allowances, and the other terms and conditions of office, of the executive directors; but the constitution may make provision for those matters to be decided pending the establishment of such a committee. 10 (1) Where an application for authorisation is made by an NHS trust under section 33, this paragraph applies to the exercise of the powers mentioned in paragraphs 8 and 9 in relation to the appointment of the initial non-executive directors and initial chief executive. (2) The power to appoint the initial chair of the NHS foundation trust must be exercised by appointing the chair of the NHS trust, if the chair of the NHS trust wishes to be appointed. (3) The power to appoint the other initial non-executive directors of the NHS foundation trust must be exercised, so far as possible, by appointing any of the non-executive directors of the NHS trust (other than the chair) who wish to be appointed. (4) A person appointed in accordance with sub-paragraph (2) or (3) must be appointed for the unexpired period of the person’s term of office as chair or non-executive director of the NHS trust; but if, on any such appointment, that period is less than 12 months, the appointment must be for 12 months. (5) The power to appoint the initial chief executive of the NHS foundation trust must be exercised by appointing the chief officer of the NHS trust, if the chief officer of the NHS trust wishes to be appointed. Duties of directors and avoiding conflicts of interest
11 The general duty of the board of directors, and of each director individually, is to act with a view to promoting the success of the NHS foundation trust so as to maximise the benefits for the public. 12 (1) The duties that a director of an NHS foundation trust has by virtue of being a director include in particular— (a) a duty to avoid a situation in which the director has (or can have) a direct or indirect interest that conflicts (or possibly may conflict) with the interests of the NHS foundation trust; (b) a duty not to accept a benefit from a third party by reason of being a director or doing (or not doing) anything in that capacity. (2) The duty referred to in sub-paragraph (1)(a) is not infringed if— (a) the situation cannot reasonably be regarded as being likely to give rise to a conflict of interest, or (b) the matter has been authorised in accordance with the constitution. (3) The duty referred to in sub-paragraph (1)(b) is not infringed if acceptance of the benefit cannot reasonably be regarded as being likely to give rise to a conflict of interest. (4) In sub-paragraph (1)(b), “third party” means a person other than— (a) the NHS foundation trust, or (b) a person acting on its behalf. 13 (1) If a director of an NHS foundation trust has in any way a direct or indirect interest in a proposed transaction or arrangement with the NHS foundation trust, the director must declare the nature and extent of that interest to the other directors. (2) If a declaration under this paragraph proves to be, or becomes, inaccurate or incomplete, a further declaration must be made. (3) Any declaration required by this paragraph must be made before the NHS foundation trust enters into the transaction or arrangement. (4) This paragraph does not require a declaration of an interest of which the director is not aware or where the director is not aware of the transaction or arrangement in question. (5) A director need not declare an interest— (a) if it cannot reasonably be regarded as likely to give rise to a conflict of interest; (b) if, or to the extent that, the directors are already aware of it; (c) if, or to the extent that, it concerns terms of the director’s appointment that have been or are to be considered— (i) by a meeting of the board of directors, or (ii) by a committee of the directors appointed for the purpose under the constitution. Meetings of board of directors
14 (1) The constitution must provide for meetings of the board of directors to be open to members of the public. (2) But the constitution may provide for members of the public to be excluded from a meeting for special reasons. Registers of directors and their interests
15 (1) An NHS foundation trust must have— (a) a register of directors, and (b) a register of interests of the directors. (2) The constitution may make further provision about the registers including, in particular, provision about admission to, and removal from, the registers. 16 The constitution must make provision for dealing with conflicts of interest of the directors. Arrangements for discharge of functions
17 (1) The constitution must provide for all functions of the NHS foundation trust to be exercisable by the board of directors on its behalf. (2) But the constitution may provide for any of those powers to be exercisable by— (a) a committee of directors, or (b) an executive director. Accounts
18 (1) An NHS foundation trust must keep proper accounts and proper records in relation to the accounts. (2) An NHS foundation trust must prepare annual accounts in respect of each financial year. (3) The Secretary of State may direct an NHS foundation trust to prepare accounts in respect of such period or periods as may be specified in the direction. (4) The Secretary of State may give directions to an NHS foundation trust as to— (a) the methods and principles according to which any accounts under this paragraph must be prepared, and (b) the form and content of any accounts prepared under this paragraph. (5) For the audit of the annual accounts, see the Local Audit and Accountability Act 2014 (and, in particular, section 4 of that Act). (6) Accounts prepared under sub-paragraph (3) are also to be audited under that Act if the Secretary of State so directs. (7) The Comptroller and Auditor General may examine— (a) the annual accounts, or accounts prepared under sub-paragraph (3), and any records relating to them, and (b) any report on them by the auditor. (8) An NHS foundation trust must lay before Parliament a copy of— (a) its annual accounts, and (b) any report of the auditor on them. (9) An NHS foundation trust must send to the Secretary of State— (a) a copy of its annual accounts and of any accounts prepared under sub-paragraph (3), and (b) any report of the auditor on them. (10) An NHS foundation trust must comply with sub-paragraph (9) by such date as the Secretary of State may direct. (11) The constitution of an NHS foundation trust must provide for its functions under this paragraph to be delegated to the accounting officer for that trust. (12) In this paragraph “financial year” means— (a) the period— (i) beginning with the date on which the NHS foundation trust is created by virtue of section 36, 56 or 56B, and (ii) ending with the next 31 March, and (b) each successive period of twelve months beginning with 1 April. Annual reports and forward plans
19 (1) An NHS foundation trust must prepare annual reports and send them to the Secretary of State. (2) The reports must give— (a) information about the NHS foundation trust’s policy on pay and the work of the committee established under paragraph 9(3), (b) information about such other procedures as the NHS foundation trust has on pay, and (c) information about the remuneration of the directors and the allowances of the directors. (3) It is for the Secretary of State to decide— (a) the form of the reports, (b) when the reports must be sent to the Secretary of State, and (c) the periods to which the reports are to relate. 20 (1) An NHS foundation trust must give information to the Secretary of State as to its forward planning in respect of each financial year. (2) In this paragraph “financial year” means— (a) the period— (i) beginning with the date on which the NHS foundation trust is created by virtue of section 36, 56 or 56B, and (ii) ending with the next 31 March, and (b) each successive period of twelve months beginning with 1 April. Publication of constitution etc
21 (1) An NHS foundation trust must publish the following— (a) its current constitution, (b) its register of directors and register of interests of the directors, (c) its latest annual accounts and any report of the auditor on them, and (d) its latest annual report. (2) The Secretary of State may by regulations provide for exceptions to the duty to publish the registers under sub-paragraph (1)(b). Public meetings
22 (1) At such time or times as may be prescribed, an NHS foundation trust must hold a public meeting at which must be presented— (a) its latest audited annual accounts, and (b) its latest annual report. (2) In such circumstances and at such time or times as may be prescribed, an NHS foundation trust must hold a public meeting at which such documents as may be prescribed must be presented. Instruments etc
23 (1) The constitution must make provision for the authentication of the fixing of the NHS foundation trust’s seal. (2) A document purporting to be duly executed under the NHS foundation trust’s seal or to be signed on its behalf must be received in evidence and, unless the contrary is proved, taken to be so executed or signed.
Schedule 46 — NHS foundation trusts: audit of accounts¶
Public Finance and Accountability (Scotland) Act 2000 (asp 1)¶
Audit and Accountability (Northern Ireland) Order 2003 (S.I. 2003/418 (N.I. 5))¶
Public Audit (Wales) Act 2004¶
National Health Service Act 2006¶
Local Audit and Accountability Act 2014¶
(c) an NHS foundation trust.
(7) In relation to an NHS foundation trust, “accounts” means— (a) the annual accounts of the NHS foundation trust prepared under paragraph 18(2) of Schedule 7 to the National Health Service Act 2006 (accounts and audit of NHS foundation trusts); (b) any accounts of the NHS foundation trust prepared in accordance with a direction under paragraph 18(3) of that Schedule in respect of which a direction has been given under paragraph 18(6) of that Schedule.
(4) If it appears to the Secretary of State that a health service body has failed to appoint an auditor in accordance with this Part, the Secretary of State may— (a) direct the health service body to appoint an auditor named in the direction, or (b) appoint an auditor on behalf of the health service body.
23B An NHS foundation trust.
Schedule 57 — Conversion of failing NHS foundation trust into NHS trust¶
Schedule 9A8 — Conversion of failing NHS foundation trusts
Introduction
1 This Schedule applies to a body which is an NHS trust established as a result of an order under section 57B(1). 2 In this Schedule “the NHS foundation trust” means the body as it was constituted immediately before it became an NHS trust. Board of directors
3 (1) Pending the coming into force of the provision made by virtue of paragraph 5(1)(c) of Schedule 4 specifying the number of executive directors and non-executive directors for the NHS trust, the NHS trust is to have the same number of executive directors and non-executive directors as the NHS foundation trust had. (2) A reference in sub-paragraph (1) to the non-executive directors of a trust does not include the chair. 4 The people who were the chair and executive and non-executive directors of the NHS foundation trust become, for the unexpired terms of their appointments, the chair and executive and non-executive directors of the NHS trust (unless their appointment is terminated under section 57B(5)). Public dividend capital
5 (1) The amount which was the public dividend capital of the NHS foundation trust continues as public dividend capital of the NHS trust, held on the same conditions. (2) Sub-paragraph (1) is subject to any determination under paragraph 1(6) of Schedule 5. (3) Paragraph 1(1) of that Schedule does not apply to the NHS trust. Continuity: general
6 Nothing in this Act affects the continuity of the body that is established as an NHS trust or of its property or liabilities (including its criminal liabilities). Contracts
7 (1) Nothing in this Act— (a) prevents the NHS trust continuing to be a party to a contract to which the NHS foundation trust was a party, or (b) affects the rights or liabilities of any person under such a contract. (2) A contract to which the NHS foundation trust was a party does not, as a result of the body becoming an NHS trust, become an NHS contract by virtue of section 9(1). Other property
8 Nothing in this Act— (a) prevents the NHS trust continuing to hold property which the NHS foundation trust held, or (b) affects the rights or liabilities of any person in respect of that property. Membership of bodies corporate
9 Nothing in this Act— (a) prevents the NHS trust remaining a member of a body corporate of which the NHS foundation trust was a member, or (b) affects the rights or liabilities of any person in respect of that membership. Directions
10 Paragraphs 6 to 9 do not affect the Secretary of State’s powers to give directions under this Act.
Schedule 69 — Trust special administration¶
65B NHS trusts and NHS foundation trusts: appointment of trust special administrator
(1) The Secretary of State may make an order in accordance with this section authorising the appointment of a trust special administrator to exercise the functions of the chair and directors of— (a) an NHS trust to which this Chapter applies, or (b) an NHS foundation trust. (2) An order may be made under subsection (1)— (a) in relation to an NHS trust, only if the Secretary of State is satisfied that— (i) there is a serious failure by the trust to provide services that are of sufficient quality to be provided under this Act, or (ii) it is otherwise appropriate in the interests of the health service; (b) in relation to an NHS foundation trust, only if the Secretary of State is satisfied that— (i) there is a serious failure by the trust to provide services that are of sufficient quality to be provided under this Act, or (ii) the trust is, or is likely to become, unable to pay its debts. (3) An order under subsection (1) must specify the date when the appointment is to take effect, which must be within the period of five working days beginning with the day on which the order is made. (4) Before making an order under subsection (1) the Secretary of State must consult— (a) the trust, (b) any integrated care board in whose area the trust has hospitals, establishments or facilities, (c) any other person to whom the trust provides goods or services under this Act and whom the Secretary of State considers it appropriate to consult, and (d) the Care Quality Commission. (5) If an order is made under subsection (1), the Secretary of State must lay before Parliament a report stating the reasons for making the order (at the same time as laying before Parliament the statutory instrument containing the order). (6) If an order is made under subsection (1), the Secretary of State must— (a) appoint a person as the trust special administrator with effect from the day specified in the order, and (b) publish the name of the person appointed. (7) A person appointed as a trust special administrator holds and vacates office in accordance with the terms of the appointment. (8) The Secretary of State may pay remuneration and expenses to a trust special administrator appointed under this section. 65BA Recommendation by Care Quality Commission to appoint trust special administrator
(1) If the Care Quality Commission is satisfied that there is a serious failure by an NHS trust or NHS foundation trust to provide services that are of sufficient quality to be provided under this Act it may make a recommendation to the Secretary of State to make an order under section 65B(1). (2) If a recommendation is made under subsection (1) the Secretary of State must consider whether to make the requested order. 65BB Care Quality Commission report on safety and quality of services
The Care Quality Commission must, as soon as reasonably practicable after the making of an order under section 65B(1) in relation to an NHS trust or NHS foundation trust, provide the Secretary of State with a report on the safety and quality of the services that the trust provides under this Act.65BC Suspension of chair and directors
(1) When the appointment of a trust special administrator in relation to an NHS trust or NHS foundation trust takes effect, the trust’s chair and its executive and non-executive directors are suspended from office. (2) Subsection (1) does not affect the employment of the executive directors or their membership of any committee or sub-committee of the trust.
65F Draft report
(1) A trust special administrator appointed in relation to an NHS trust or NHS foundation trust must, within the period of 65 working days beginning with the day on which the administrator’s appointment takes effect— (a) provide the Secretary of State with a draft report recommending what action (if any) the Secretary of State should take in relation to the trust, and (b) publish a copy of that draft report. (2) When preparing a draft report under subsection (1), the administrator must consult— (a) any person to whom the trust provides goods or services under this Act and whom the Secretary of State directs the administrator to consult, and (b) the Care Quality Commission. (3) The Secretary of State must lay before Parliament any report received under subsection (1).
65I Final report
(1) A trust special administrator appointed in relation to an NHS trust or NHS foundation trust must, within the period of 15 working days beginning with the end of the consultation period, provide the Secretary of State with a final report stating any action that the administrator recommends that the Secretary of State should take in relation to the trust. (2) The administrator must attach to the final report a summary of the responses to the draft report which were received by the administrator in the period beginning with the publication of the draft report and ending with the last day of the consultation period. (3) The Secretary of State must publish and lay before Parliament any report received under subsection (1).
65K Decision of Secretary of State
(1) Within the period of 20 working days beginning with the day on which the Secretary of State receives a final report under section 65I relating to an NHS trust or NHS foundation trust, the Secretary of State must decide what (if any) action to take in relation to the trust. (2) The Secretary of State must as soon as reasonably practicable— (a) publish a notice of the decision and of the reasons for it; (b) lay a copy of the notice before Parliament. 65L Trusts coming out of administration
(1) This section applies if the Secretary of State’s decision under section 65K does not involve dissolving the NHS trust or NHS foundation trust. (2) The Secretary of State must make an order specifying a date when the following come to an end— (a) the appointment of the trust special administrator, and (b) the suspension of the chair and directors of the trust. (3) If it appears to the Secretary of State to be necessary in order to comply with Schedule 4 or 7, the Secretary of State may— (a) terminate the appointment of an executive director of the trust; (b) appoint a person to be an executive director of the trust. (4) For the Secretary of State’s powers to take the actions mentioned in subsection (3) in relation to other officers of an NHS trust or NHS foundation trust, see Schedules 4 and 7.
(6) For power to dissolve NHS trusts and transfer their property and liabilities, see paragraphs 28 and 29 of Schedule 4.
Schedule 710 — Health and social care information systems etc¶
Extension of extent¶
Other amendments¶
(2) When exercising relevant data functions other than those under the Medicines and Medical Devices Act 2021, the Secretary of State must seek to minimise the burdens imposed on others.
.(b) paragraph 7B(1)(d) of Schedule 1 to the National Health Service Act 2006;
254 Powers to establish information systems
(1) The Secretary of State must establish and operate such systems for the collection, analysis or other processing of information as the Secretary of State considers to be appropriate and in the interests of— (a) the health service in England, or (b) recipients or providers of adult social care in England. (2) The Secretary of State may establish and operate other systems for the collection, analysis or other processing of information for the purposes of, or in connection with, the provision in the British Islands of health care or adult social care. (3) In this Chapter— health care includes all forms of health care whether relating to physical or mental health and also includes procedures that are similar to forms of medical or surgical care but are not provided in connection with a medical condition; information system means a system established and operated under subsection (1) or (2).
(A1) Any person (anywhere) may request the Secretary of State to establish and operate an information system.
(3) The Secretary of State may charge a person a reasonable fee in respect of the cost of complying with a request to establish and operate an information system. (4) A person must consult the Secretary of State before making a request for the Secretary of State to establish and operate an information system. (5) If the Secretary of State complies with a request to establish and operate an information system, the Secretary of State must publish details of the request.
;(a) any person who made a request for the Secretary of State to establish the information system,
(2) If the Secretary of State reasonably believes that there is no longer any need to retain information obtained in the operation of an information system, the Secretary of State may destroy the information.
(1) The Secretary of State may— (a) require any person mentioned in subsection (2) to provide the Secretary of State with any information which the Secretary of State considers it necessary or expedient to have for the purposes of any function that the Secretary of State exercises by virtue of this Chapter, (b) require any health care provider, not within paragraph (a), to provide the Secretary of State with any information which the Secretary of State considers it necessary or expedient to have for the purposes of establishing and operating an information system, and (c) request any person to provide the Secretary of State with any information which the Secretary of State considers it necessary or expedient to have for the purposes of any function that the Secretary of State exercises by virtue of this Chapter.
(5) A requirement or request under this section may specify— (a) the form and manner in which the information is to be provided, and (b) the time within which it is to be provided. (5A) A person on whom a requirement is imposed under this section must comply with it. (6) If the Secretary of State considers it appropriate to do so, the Secretary of State may make a payment to any person who has provided information pursuant to a request made under subsection (1)(c) in respect of the costs to that person of doing so.
(10A) For enforcement of requirements under subsection (1)(a) or (b) against persons other than public bodies, see section 277E. (10B) In this section “health care provider” means a person who is required to be registered under Chapter 2 of Part 1 of the Health and Social Care Act 2008 in respect of the carrying on of a regulated activity (within the meaning of Part 1 of that Act) involving or connected with the provision of health care.
260 Publication of information
(1) The Secretary of State may publish information obtained in the operation of an information system. (2) But the Secretary of State may not publish personal information under subsection (1) unless— (a) the individual to whom it relates has consented to the publication, or (b) the Secretary of State considers that publishing the information is a proportionate means of achieving a legitimate aim. (3) In this section— legitimate aim means one, or a combination, of the following aims— (a) the protection of the life or health of humans; (b) the protection of public safety or security; personal information means information in a form which— (a) identifies an individual, other than a provider of health care or adult social care, to whom the information relates, or (b) enables the identity of such an individual to be ascertained. 261 Other disclosure of information
(1) The Secretary of State may disclose (otherwise than by publication) information obtained in the operation of an information system. (2) But the Secretary of State may not disclose personal information under subsection (1) unless— (a) the individual to whom it relates has consented to the disclosure, (b) the information has previously been lawfully disclosed to the public, (c) the disclosure is made to a person to whom the information could have been lawfully disclosed by the person from whom the Secretary of State collected it, (d) the disclosure is made for the purpose of facilitating the carrying out of clinical trials or otherwise for the purpose of facilitating research (including by enabling potential participants in research to be identified and contacted), (e) the disclosure is made in accordance with a court order, (f) the disclosure is necessary or expedient for the purposes of protecting the welfare of an individual, (g) the disclosure is to a person in circumstances where it is necessary or expedient for the person to have the information for the purpose of exercising functions conferred on them under or by virtue of any provision of this or any other Act, (h) the disclosure is made in connection with the investigation of a criminal offence (whether or not in the United Kingdom), (i) the disclosure is made for the purpose of criminal proceedings (whether or not in the United Kingdom), or (j) the Secretary of State considers that disclosing the information is a proportionate means of achieving a legitimate aim. (3) A disclosure of a description mentioned in paragraph (b), (e) or (i) (whether or not a disclosure of personal information) may be made under subsection (1) despite any rule of common law that would otherwise prohibit or restrict the disclosure. (4) Nothing in this section limits the Secretary of State from disclosing information under or by virtue of any other provision of this Act or any other Act. (5) In this section “legitimate aim” and “personal information” have the meaning given by section 260(3).
262A Publication and other disclosure: supplementary
In exercising any function of publishing or otherwise disclosing information obtained in connection with the exercise of the Secretary of State’s relevant data functions, the Secretary of State must have regard to any relevant advice given by the committee appointed by the Health Research Authority under paragraph 8(1) of Schedule 7 to the Care Act 2014 (committee to advise in connection with information disclosure etc).
265 Guidance
(1) The Secretary of State may give guidance to health or social care bodies on any matter relating to the processing of information so far as relevant to the exercise of their functions in connection with the provision of health services or of adult social care in England. (2) A health or social care body must have regard to guidance given under this section.
(2) The regulations must provide for the accreditation scheme to be established and operated by— (a) the Secretary of State, or (b) a public body that— (i) exercises functions in, or in relation to, England, and (ii) is designated by the Secretary of State in accordance with provision made by the regulations. (2A) The person for the time being responsible for establishing and operating the accreditation scheme in accordance with provision made by virtue of subsection (2) is referred to in this section as the “operator”.
;information system has the meaning given by section 254(3);
.processing has the same meaning as in Parts 5 to 7 of the Data Protection Act 2018 (see section 3(4) of that Act);
.section 234(1) (direction to NICE to prepare quality standards);
section 245(1) (direction to NICE to perform functions);
Schedule 811 — Transfer of HSSIB’s functions to CQC¶
Part 1 — Amendments to the Health and Social Care Act 2008¶
.(ba) investigation functions under Chapter 3A, and
an investigationinsert
(other than an investigation under Chapter 3A).
Chapter 3A — Health services safety investigations
Investigations
51A Investigation of incidents with safety implications
(1) The Commission may carry out such investigations as it considers appropriate into incidents that— (a) occur in England during the provision of health care services, and (b) have or may have implications for the safety of patients. (2) The purpose of the investigations is to— (a) identify risks to the safety of patients, and (b) address those risks by facilitating the improvement of systems and practices in the provision of NHS services or other health care services in England. (3) In particular, where an investigation relates to an incident that occurred during the provision of health care services that are not NHS services, the Commission must consider whether, in relation to any risks identified, the systems and practices in the provision of NHS services could be improved. (4) The purpose of the investigations does not include assessing or determining— (a) blame, (b) civil or criminal liability, or (c) whether action needs to be taken in respect of an individual by a regulatory body. (5) In this Chapter, an incident within subsection (1) is called a “qualifying incident”. 51B Deciding which incidents to investigate
(1) The Commission’s function under section 51A includes determining which qualifying incidents it will investigate, subject to subsection (2). (2) The Secretary of State may direct the Commission to carry out an investigation under section 51A of— (a) a particular qualifying incident that has occurred, or (b) qualifying incidents that have occurred and are of a particular description. (3) A direction under subsection (2) may specify the date by which the Commission must publish its final report (see section 51D). (4) Once the Commission has begun an investigation into a qualifying incident, it must, in such manner as it considers appropriate, publish a statement which— (a) reports that it has begun the investigation, (b) contains a brief description of the incident, and (c) sets out, in general terms, the issues that the Commission expects to consider in the investigation. (5) The Commission may give advance notice of a statement under subsection (4) to any person the Commission considers may be affected by the investigation. (6) Where the Commission discontinues an investigation under section 51A, it must, in such manner as it considers appropriate, publish a statement which— (a) reports that it has discontinued the investigation, and (b) gives its reasons for doing so. (7) Where the Commission determines not to investigate a qualifying incident, it may give notice of its determination to any person the Commission considers to have an interest in the determination. (8) Notice under subsection (7) may include— (a) a brief description of the incident, and (b) the Commission’s reasons for not investigating it. 51C Criteria, principles and processes
(1) The Commission must determine and publish— (a) the criteria it will use in determining which qualifying incidents it will investigate under section 51A, (b) the principles which are to govern such investigations, (c) the processes to be followed in carrying out such investigations, and (d) the processes for ensuring that, so far as reasonable and practicable, patients and their families are involved in such investigations. (2) The processes determined under subsection (1)(c) must include— (a) the procedures and methods to be used in investigations (including in the interviewing of persons), and (b) the time periods within which the Commission aims to complete investigations. (3) Different processes under subsection (1)(c) or (d) may be determined for different descriptions of investigation. (4) Anything published under subsection (1)(d) must be— (a) easily accessible to patients and their families, and (b) capable of being easily understood by them. (5) The Commission must review the criteria, principles and processes— (a) within the period of five years beginning with their publication under subsection (1), and (b) subsequently within each period of five years beginning with the completion of the previous review. (6) If the Commission revises the criteria, principles and processes it must publish them as revised. (7) In determining or revising the criteria, principles and processes the Commission must consult— (a) the Secretary of State, and (b) any other persons the Commission considers appropriate. Reports
51D Final reports
(1) When the Commission completes an investigation under section 51A, it must publish a report on the outcome of the investigation (the “final report”). (2) The final report must— (a) contain a statement of findings of fact made as a result of the investigation and an analysis of those findings, (b) make such recommendations as to the action to be taken by any person as the Commission considers appropriate (including recommendations as to any action to be taken by the Commission itself), and (c) set out the Commission’s conclusions on the matters it considered in accordance with section 51A(3) (but only if that provision is applicable to the investigation). (3) The final report must focus on ascertaining risks to the safety of patients and any recommendations as to the action to be taken by any person must focus on addressing those risks (rather than on the activities of individuals involved in the incident). (4) In particular, the final report may not include an assessment or determination of— (a) blame, (b) civil or criminal liability, or (c) whether action needs to be taken in respect of an individual by a regulatory body. (5) Information which is protected material (see section 51M) may be disclosed in a final report if the Commission determines that the benefits to the safety of patients served by the disclosure outweigh— (a) any adverse impact on current or future investigations under section 51A by deterring persons from providing information for the purposes of such investigations, and (b) any adverse impact on securing the improvement of the safety of health care services provided to patients in England. (6) The final report may not, without their consent, include the name of any individual— (a) who has provided information to the Commission for the purposes of the investigation, or (b) who was involved in the incident being investigated. (7) Where an investigation is carried out pursuant to a direction under section 51B(2), the Commission must send a copy of the final report to the Secretary of State. 51E Interim reports
(1) While the Commission is carrying out an investigation under section 51A, it may publish a report on any matter relating to the investigation (an “interim report”). (2) An interim report may— (a) contain a statement of findings of fact made as a result of the investigation to date and an analysis of those findings, (b) make such recommendations as to the action to be taken by any person as the Commission considers appropriate (including recommendations as to any action to be taken by the Commission itself), and (c) set out the Commission’s conclusions to date on the matters it has considered in accordance with section 51A(3) (but only if that provision is applicable to the investigation). (3) Subsections (3) to (7) of section 51D apply in relation to an interim report as they apply in relation to a final report. 51F Final and interim reports: drafts
(1) Before it publishes a final or interim report, the Commission— (a) must send a draft of the report to any person who the Commission reasonably believes could be adversely affected by the report, and (b) may send a draft of the report to any other person who the Commission believes should be sent a draft. (2) If a person who the Commission reasonably believes could have been adversely affected by the report has died, the draft report must be sent to the person (if any) who appears to the Commission to best represent the interests of the person who has died. (3) The Commission must notify every person to whom a draft report is sent— (a) that the person has an opportunity to comment on the draft report before the deadline specified by the Commission, and (b) how any such comments should be made. (4) If a person’s comments on a draft report are not taken into account in the final or interim report as published, the Commission must explain to the person why that is. (5) Where this section would otherwise require the report to be sent to the Commission, the report is to be sent to the chief executive of the Commission or a person nominated by the chief executive. 51G Response to reports
(1) This section applies where a final or interim report includes recommendations as to the action to be taken by any person. (2) The Commission must, in such manner as it considers appropriate, send the report to that person or make it available to them. (3) The report must specify— (a) the deadline for that person to provide a written response, and (b) how the written response should be provided. (4) Before that deadline, the person must respond to the Commission in writing setting out the actions they propose to take in pursuance of the recommendations. (5) The Commission may publish the response. (6) Subsection (4) does not require a person to respond to the extent that the person could be required to respond to the Commission by an Act of Senedd Cymru (ignoring any requirement for the consent of a Minister of the Crown imposed under Schedule 7B to the Government of Wales Act 2006). (7) Where this section would otherwise require the report to be sent or made available to the Commission, the report is to be sent or made available to the chief executive of the Commission or a person nominated by the chief executive. 51H Admissibility of reports
(1) A final report, an interim report and the draft of a final or interim report sent to a person under section 51F are not admissible in any proceedings within subsection (2). (2) Those proceedings are— (a) proceedings to determine civil or criminal liability in respect of any matter; (b) proceedings before any employment tribunal; (c) proceedings before a regulatory body (including proceedings for the purposes of investigating an allegation); (d) proceedings to determine an appeal against a decision made in proceedings falling within paragraphs (a) to (c). (3) But the High Court may order that a final or interim report is admissible in proceedings within subsection (2) on an application by a person who is a party to the proceedings or otherwise entitled to appear in them. (4) The Commission may make representations to the High Court about any application under subsection (3). (5) The High Court may make an order under subsection (3) only if it determines that the interests of justice served by admitting the report outweigh— (a) any adverse impact on current or future investigations under section 51A by deterring persons from providing information for the purposes of such investigations, and (b) any adverse impact on securing the improvement of the safety of health care services provided to patients in England. Investigatory powers etc
51I Powers of entry, inspection and seizure
(1) If an investigator considers it necessary for the purposes of an investigation under section 51A, the investigator may— (a) enter and inspect premises in England, other than premises used wholly or mainly as a private dwelling; (b) inspect and take copies of any document at, or capable of being viewed using equipment at, the premises; (c) inspect any item at the premises; (d) seize and remove from the premises any document or other item (unless that would risk the safety of any patient). (2) In subsection (1)(b) the reference to inspecting and taking copies of any document includes requiring any document which is kept in electronic form to be produced in a form in which it is legible and can be taken away. (3) Where any document or other item is seized by an investigator, or any copy of a document is taken, it may be retained by the Commission for so long as is necessary for the purposes of the investigation. (4) An investigator exercising any power conferred by this section must, if asked, produce evidence of the investigator’s authority from the Commission to act on its behalf. 51J Powers to require information etc
(1) An investigator may by notice require any person— (a) to attend at a specified time and place and to provide information by answering questions; (b) to provide specified information, or information of a specified description, by a specified date; (c) to provide specified documents or items, or documents or items of a specified description, by a specified date. (2) An investigator may give a person a notice under subsection (1) only if the investigator reasonably believes that— (a) in the case of a requirement under subsection (1)(a), the person is able to provide information which is necessary for the purposes of an investigation under section 51A; (b) in the case of a requirement under subsection (1)(b)— (i) it is necessary to obtain the information for the purposes of an investigation under section 51A, and (ii) the person is able to provide it; (c) in the case of a requirement under subsection (1)(c)— (i) it is necessary to obtain the document or other item for the purposes of an investigation under section 51A, and (ii) the person is able to provide it. (3) But a person is not required by virtue of subsection (1) to provide any information, document or other item where— (a) its provision would risk the safety of any patient, (b) its provision might incriminate the person, or (c) in the case of information or a document, the person would be entitled to refuse to provide it in any proceedings in any court on the grounds that it is the subject of legal professional privilege. (4) A notice must— (a) specify the grounds for the investigator believing the matters in subsection (2), (b) give an explanation of the consequences of failing to comply with the notice (see section 51L), and (c) attach evidence of the investigator’s authority from the Commission to exercise the powers conferred by this section. (5) If a notice requires a person to provide anything which is kept in electronic form, the notice may require it to be provided in a form in which it is legible. (6) An investigator may withdraw a notice under subsection (1) by giving notice of withdrawal to the person to whom the notice was given. (7) Where any document or other item is provided to an investigator pursuant to a notice, it may be retained by the Commission for so long as is necessary for the purposes of the Commission’s investigation function under section 51A, unless its retention would risk the safety of any patient. (8) Where a person attends to answer questions pursuant to a notice under subsection (1)(a), the Commission— (a) must reimburse the person the reasonable costs incurred in attending; (b) may record, by any means, the answers given. (9) In this section “specified” means specified in the notice. 51K Voluntary provision of information etc
A person may disclose any information, document or other item to the Commission if the person reasonably believes that the disclosure is necessary for the purpose of enabling the Commission to carry out its investigation function under section 51A.51L Offences relating to investigations
(1) A person commits an offence if the person— (a) intentionally obstructs an investigator in the performance of functions conferred by section 51I, or (b) fails without reasonable excuse to comply with a notice given under section 51J. (2) A person commits an offence if the person provides information to the Commission for the purposes of the Commission’s investigation function under section 51A which the person knows or suspects is false or misleading in a material respect. (3) It is a defence for a person charged with an offence under subsection (2) to show that— (a) the person reasonably believed that the information would assist the Commission in carrying out its investigation function under section 51A, and (b) at the time of providing the information the person informed the Commission that the person knew or suspected that it was false or misleading. (4) If a person charged with an offence under subsection (2) relies on the defence under subsection (3), and evidence is adduced which is sufficient to raise an issue with respect to that defence, the court must assume that the defence is satisfied unless the prosecution proves beyond reasonable doubt that it is not. (5) A person who commits an offence under this section is liable on summary conviction to a fine. Protection of material held by the Commission under Chapter 3A
51M Prohibition on disclosure of material
(1) The Commission, or a connected individual, must not disclose protected material to any person. (2) In this Chapter “protected material” means any information, document or other item which— (a) is held by the Commission, or a connected individual, for the purposes of the Commission’s investigation function under section 51A, (b) relates to a qualifying incident (whether or not investigated by the Commission), and (c) has not already been lawfully made available to the public. (3) In this Chapter “connected individual” means— (a) a member of the Commission, (b) a member of a committee or sub-committee of the Commission, (c) an investigator, or (d) an individual (other than an investigator) who works for the Commission. (4) For the purposes of subsection (3)(d) an individual “works for” the Commission if the individual works— (a) under a contract of employment with the Commission, (b) under a contract of apprenticeship with the Commission, (c) under a contract under which the individual undertakes to do or perform personally any work or services for the Commission, or (d) as an agency worker within the meaning of the Agency Workers Regulations 2010 (S.I. 2010/93) in circumstances where the Commission is the hirer within the meaning of those Regulations. (5) An individual who was, but has ceased to be, a connected individual must not disclose to any person, other than a connected individual who is involved in the exercise of the Commission’s investigation function under section 51A, any information, document or other item held by that individual— (a) which the individual obtained because they were a connected individual, (b) which, immediately before they ceased to be a connected individual, was protected material, and (c) which has not already been lawfully made available to the public. 51N Exceptions to prohibition on disclosure
(1) Section 51M(1) does not apply to a disclosure which is required or authorised by— (a) Schedule 2A, (b) any other provision of this Chapter, or (c) regulations under this subsection. (2) Regulations under subsection (1)(c) may, for example, require or authorise disclosures of protected material by reference to— (a) the kind of material that it is (for example, a particular kind of equipment), (b) the matters to which it relates, (c) the person from whom it was obtained, (d) the purpose for which it was produced or is held, or (e) the purpose for which it is disclosed. (3) But regulations under subsection (1)(c) may not require or authorise disclosures of protected material by reference to the qualifying incident to which the material relates. (4) Regulations under subsection (1)(c) may provide for a person to exercise a discretion in dealing with any matter. (5) Regulations under subsection (1)(c) may provide that disclosures which are required or authorised by the regulations do not breach— (a) obligations of confidence owed by the person making the disclosure, or (b) any other restrictions on disclosure. 51O Offences of unlawful disclosure
(1) A person commits an offence if the person— (a) breaches the prohibition in section 51M(1) by knowingly or recklessly disclosing protected material to another person, and (b) knows or suspects that the disclosure is prohibited. (2) An individual commits an offence if the individual— (a) breaches the prohibition in section 51M(5) by knowingly or recklessly disclosing any information, document or other item to another person, and (b) knows or suspects that the disclosure is prohibited. (3) Subsection (4) applies where protected material is disclosed to a person who is not a connected individual— (a) in a draft report sent to the person under section 51F(1), (b) under paragraph 4, 5 or 6 of Schedule 2A (disclosures for purposes of an investigation, offence or safety risk), or (c) under regulations under section 51N(1)(c). (4) The person to whom protected material is disclosed commits an offence if the person— (a) knowingly or recklessly discloses the protected material to another person without reasonable excuse, and (b) knows or suspects that it is protected material. (5) A person who commits an offence under this section is liable on summary conviction to a fine. 51P Restriction of statutory powers requiring disclosure
(1) A power under any enactment (whenever passed or made) other than this Chapter to require the disclosure of, or to seize, any information, document or other item may not be used— (a) to require the disclosure of protected material by the Commission, or (b) to seize protected material from the Commission. (2) Subsection (1) applies to a power to require disclosure, or to seize, however it is expressed (and, for example, it applies if the power is to require a person to give, supply, furnish or produce any information, document or other item). (3) Subsection (1) does not apply to a power to the extent that the provision conferring it is within the legislative competence of a devolved legislature. (4) A provision is within the legislative competence of a devolved legislature if— (a) it would be within the legislative competence of the Scottish Parliament if it were contained in an Act of that Parliament; (b) it would be within the legislative competence of Senedd Cymru if it were contained in an Act of the Senedd (ignoring any requirement for the consent of a Minister of the Crown imposed under Schedule 7B to the Government of Wales Act 2006); (c) the provision— (i) would be within the legislative competence of the Northern Ireland Assembly if it were contained in an Act of that Assembly, and (ii) would not, if it were contained in a Bill in the Northern Ireland Assembly, result in the Bill requiring the consent of the Secretary of State under section 8 of the Northern Ireland Act 1998. (5) References to the Commission in subsection (1) include— (a) a connected individual, and (b) an individual who was, but has ceased to be, a connected individual. Relationship with other bodies
51Q Co-operation with other bodies
(1) This section applies where— (a) the Commission is carrying out an investigation under section 51A into a qualifying incident, and (b) a listed person is also carrying out an investigation into the same or a related incident. (2) The Commission and the listed person must co-operate with each other regarding practical arrangements for co-ordinating those investigations. (3) The following are listed persons— (a) an English NHS body or any other person providing NHS services; (b) a cross-border Special Health Authority; (c) the Health Research Authority; (d) the Human Tissue Authority; (e) the Human Fertilisation and Embryology Authority; (f) the Health Service Commissioner for England; (g) the Parliamentary Commissioner for Administration; (h) any regulatory body; (i) the Health and Safety Executive; (j) the Commissioner for Patient Safety. (4) The Commission must publish guidance about when a qualifying incident is to be regarded as related to another incident for the purposes of this section. (5) If the Commission revises the guidance the Commission must publish it as revised. 51R Provision of assistance to Secretary of State, NHS bodies and other persons
(1) The Commission must comply with— (a) any request by a relevant NHS body to provide it with assistance in connection with the carrying out of investigations into incidents occurring during the provision of NHS services or occurring at premises at which NHS services are provided; (b) any request by the Secretary of State to provide a relevant NHS body with such assistance; (c) any request by the Secretary of State to provide the Secretary of State with such assistance. (2) In subsection (1) “relevant NHS body” means— (a) an NHS foundation trust; (b) an NHS trust; (c) an integrated care board. (3) For the purposes of this section, providing assistance includes— (a) disseminating information about best practice, (b) developing standards to be adopted, and (c) giving advice, guidance or training. (4) Subsection (1) does not apply if— (a) the assistance requested is giving advice, guidance or training, and (b) the Commission determines that it is impracticable for it to give the assistance. (5) The Commission may give assistance to a person other than a relevant NHS body or the Secretary of State in relation to any matter connected with the carrying out of investigations if the Commission has been requested to provide the assistance by the person to whom it is to be given. (6) But the Commission may give assistance under subsection (5) only to the extent that the assistance does not to any significant extent interfere with the exercise by the Commission of its investigation function under section 51A. (7) The activities which the Commission may carry out in, or in connection with, giving assistance under subsection (5) are not restricted to activities carried out in the United Kingdom. (8) The Commission may impose charges for or in connection with giving assistance under subsection (5). (9) Charges under subsection (8) must not exceed the costs incurred by the Commission in giving the assistance. 51S Investigations relating to Wales and Northern Ireland
(1) The Commission may enter into an agreement with any person for the Commission to carry out an investigation falling within subsection (2). (2) An investigation falls within this subsection if— (a) it is an investigation into one or more incidents that have occurred, or are occurring, in the United Kingdom— (i) during the provision of any of the services mentioned in subsection (3), or (ii) at premises at which any of those services are, or were, provided, (b) the incident or incidents have or may have implications for the safety of persons for whom those services are provided, (c) the investigation is carried out for the purpose of identifying risks to the safety of such persons and addressing those risks by facilitating the improvement of systems and practices in the provision of any of the services mentioned in subsection (3), and (d) the investigation does not involve the assessment or determination of blame or civil or criminal liability. (3) The services referred to in subsection (2) are— (a) services provided for the purposes of the health service continued under section 1 of the National Health Service (Wales) Act 2006, and (b) health care, within the meaning of the Health and Social Care (Reform) Act (Northern Ireland) 2009, provided for the purposes of the system promoted under section 2(1) of that Act. (4) The Commission may impose charges for providing services under an agreement under subsection (1). (5) Those charges must not exceed the costs incurred by the Commission in providing the services. (6) The Commission may enter into an agreement under subsection (1) only if it considers that the provision of the services under the agreement will not to any significant extent interfere with the exercise by the Commission of its investigation function under section 51A. Oversight of functions
51T Review
(1) Before the end of the period mentioned in subsection (2), the Secretary of State must— (a) review the effectiveness of the exercise by the Commission of its investigation function under section 51A, (b) prepare and publish a report of the review, and (c) lay the report before Parliament. (2) The period is four years beginning with the day on which section 51A comes into force. Supplementary
51U Obligations of confidence etc
A disclosure of any information, document or other item which is required or authorised by or under section 51J or 51K or Schedule 2A does not breach—(a) any obligation of confidence owed by the person making the disclosure, or (b) any other restriction on disclosure. 51V Interpretation of Chapter 3A
In this Chapter—connected individual has the meaning given by section 51M(3); “disclose”, in relation to information, documents and other items, includes to permit access to such things; “documents” includes records, including personal and medical records; “final report” means a report under section 51D; “interim report” means a report under section 51E; “investigator” means a person authorised by the Commission to carry out functions in relation to investigations under section 51A on its behalf; “NHS services” means health care services provided in England for the purposes of the health service continued under section 1(1) of the National Health Service Act 2006; “notice” means notice in writing; “patients” means individuals for whom health care services are provided; “premises” includes a vehicle; “protected material” has the meaning given by section 51M(2); “qualifying incident” has the meaning given by section 51A(5); “regulatory body” means— (a) the General Medical Council, (b) the General Dental Council, (c) the General Optical Council, (d) the General Osteopathic Council, (e) the General Chiropractic Council, (f) the General Pharmaceutical Council, (g) the Nursing and Midwifery Council, (h) the Health and Care Professions Council, or (i) any other regulatory body, within the meaning of Schedule 3 to the Health Act 1999, established at any time by an Order in Council under section 60 of that Act; responsible person means the person appointed in accordance with paragraph 1 of Schedule 2A.
(3A) A person is not required by subsection (1) to provide any information, document, record or other item where— (a) its provision would risk the safety of any patient, (b) its provision might incriminate the person, or (c) in the case of information, a document or a record, the person would be entitled to refuse to provide it in any proceedings in any court on the grounds that it is the subject of legal professional privilege.
(4) Subsection (3) is subject to section 51M (prohibition on disclosure of material).
the Commissioninsert
(other than its investigation function under section 51A).
, and
(c) is not protected material within the meaning of section 51M(2).
(2) Subsection (1) does not apply to protected material within the meaning of section 51M(2).
other than protected material within the meaning of section 51M(2).
(a) in relation to the performance of functions in a particular case, or (b) which directs the outcome of a particular investigation under section 51A.
Theat the beginning substitute
Subject to subsection (5A), the.
(5A) The Secretary of State may not require the Commission to provide any reports or information that relate to an investigation that the Commission is carrying out or has carried out under Chapter 3A.
(3) This section does not apply in relation to an offence under Chapter 3A.
Chapter 2insert
or 3A.
.(ca) regulations under section 46B(13) (amendment of definition of relevant health care), (cb) regulations under section 51N (exceptions to prohibition on disclosure),
andat the end of paragraph (d);
, and
(f) developing and exploiting ideas and exploiting intellectual property in relation to its functions under Chapter 3A.
Losses and liabilities etc
9A (1) Section 265 of the Public Health Act 1875 (which relates to the protection of members and officers of certain authorities from personal liability) has effect as if the Commission were an authority of the kind referred to in that section. (2) In its application to the Commission as a result of sub-paragraph (1), section 265 of that Act has effect as if the references in that section to that Act were references to this Part of this Act.
Schedule 2A12 — Prohibition on disclosure of protected material: exceptions
Appointment of responsible person
1 (1) The Commission must appoint a person to discharge the functions of the responsible person under this Schedule. (2) The responsible person is to be an employee of the Commission. (3) The responsible person may arrange for any of their functions under this Schedule to be exercised by a connected individual who is involved in the exercise of the Commission’s functions under Chapter 3A. (4) An arrangement under sub-paragraph (3) may relate to a particular case, a particular class of case or all cases. Disclosure to the responsible person
2 The Commission, or a connected individual, may disclose protected material to the responsible person if the person making the disclosure reasonably believes that the disclosure is necessary for the purposes of the responsible person exercising their functions under this Schedule. Disclosures for purposes of investigations
3 The Commission, or a connected individual, may disclose protected material to a connected individual who is involved in the exercise of the Commission’s functions under Chapter 3A if the person making the disclosure reasonably believes that the disclosure is necessary for the purposes of carrying out the Commission’s investigation function under section 51A. 4 The Commission, or a connected individual, may disclose protected material to a person if the responsible person reasonably believes that the disclosure is necessary for the purposes of carrying out the Commission’s investigation function under section 51A. Disclosures relating to prosecution or investigation of offences
5 The Commission, or a connected individual, may disclose protected material to a person if the responsible person reasonably believes that the disclosure is necessary for the purposes of the prosecution or investigation of an offence under section 51L (offences relating to investigations) or 51O (unlawful disclosure). Disclosures relating to safety risks
6 The Commission, or a connected individual, may disclose protected material to a person (“the recipient”) where— (a) the responsible person reasonably believes that the disclosure of the material is necessary to address a serious and continuing risk to the safety of any patient or to the public, (b) the responsible person reasonably believes that the recipient is in a position to address the risk, and (c) the disclosure is only to the extent necessary to enable the recipient to take steps to address the risk. Disclosure by order of the High Court
7 (1) A person may apply to the High Court for an order that any protected material be disclosed by the Commission to the person for the purposes specified in the application. (2) Those purposes may include onward disclosure by the person making the application to a person specified in the application. (3) The Commission may make representations to the High Court about any application under this paragraph. (4) The High Court may make an order on an application under this paragraph only if it determines that the interests of justice served by the disclosure outweigh— (a) any adverse impact on current and future investigations under section 51A by deterring persons from providing information for the purposes of such investigations, and (b) any adverse impact on securing the improvement of the safety of health care services provided to patients in England. Guidance
8 (1) The Commission must publish guidance as to— (a) when it might be appropriate for protected material to be disclosed under paragraph 4, 5, or 6, (b) the types of protected material which it might be appropriate to disclose under any such provision, and (c) the processes which should be used when disclosing protected material under any such provision. (2) If the Commission revises the guidance, the Commission must publish it as revised. Interpretation
9 In this Schedule, a reference to the Commission’s functions under Chapter 3A does not include the Commission’s function in responding to a report under section 51G(4).
(6) This paragraph does not apply in relation to the Commission’s functions under Chapter 3A.
Part 2 — Other consequential amendments¶
Public Records Act 1958¶
Public Bodies (Admission to Meetings) Act 1960¶
Parliamentary Commissioner Act 1967¶
House of Commons Disqualification Act 1975¶
Copyright, Designs and Patents Act 1988¶
Employment Rights Act 1996¶
Freedom of Information Act 2000¶
National Health Service Act 2006¶
Health Act 2009¶
Equality Act 2010¶
Health and Care Act 2022¶
Schedule 913 — Abolition of Healthwatch England¶
House of Commons Disqualification Act 1975¶
Northern Ireland Assembly Disqualification Act 1975¶
National Health Service Act 2006¶
Health and Social Care Act 2008¶
Health and Social Care Act 2012¶
Schedule 1014 — Abolition of arrangements with Local Healthwatch organisations¶
Public Bodies (Admission to Meetings) Act 1960¶
House of Commons Disqualification Act 1975¶
Northern Ireland Assembly Disqualification Act 1975¶
Freedom of Information Act 2000¶
Local Healthwatch organisationinsert
former.
Local Government and Public Involvement in Health Act 2007insert
(which was repealed by the Health Act 2026).
National Health Service Act 2006¶
14Z45 Consultation by integrated care boards
(1) This section applies in relation to any health services which are, or may be, provided pursuant to arrangements made by an integrated care board in the exercise of its functions. (2) An integrated care board must make such arrangements as it considers appropriate to obtain the views of users or potential users of those services about— (a) what health services are needed, (b) their experiences of health services, (c) the standard of provision of health services, (d) whether, and how, health services could be improved, and (e) whether, and how, health services ought to be improved. (3) An integrated care board must consider views obtained under subsection (2) when exercising its functions. (4) The reference in subsection (2) to users or potential users of a service includes any carers or representatives of users or potential users of the service. (5) This section does not require an integrated care board to make arrangements in relation to matters to which a trust special administrator’s draft or final report under section 65F or 65I relates before the Secretary of State has made a decision under section 65K.
111insert
, 242ZA.
(1FA) The reference in subsection (1B) to users of health services (as defined by subsection (1F)(b)) includes any carers or representatives of users of those services.
242ZA Consultation: public health services
(1) This section applies in relation to any services which are, or may be, provided by or pursuant to arrangements made by a local authority (within the meaning of section 2B) in the exercise of its public health functions. (2) The local authority must make such arrangements as it considers appropriate to obtain the views of users or potential users of those services about— (a) what services are needed, (b) their experiences of services, (c) the standard of provision of services, (d) whether, and how, services could be improved, and (e) whether, and how, services ought to be improved. (3) A local authority must consider views obtained under subsection (2) when exercising its public health functions. (4) The reference in subsection (2) to users or potential users of a service includes any carers or representatives of users or potential users of the service. (5) The Secretary of State may require a local authority to provide the Secretary of State with information relating to the exercise of its functions under this section. (6) The information must be provided in such form, and at such time or within such period, as the Secretary of State may require.
section 14Z45(2)insert
and (3).
Local Government and Public Involvement in Health Act 2007¶
(9A) Any power of the Secretary of State to make regulations under this section includes power to make incidental, supplementary, consequential, transitory or transitional provision or savings.
Meaning of local authority.
regulations under section 221, 224(2)(e) or 225,.
Health and Social Care Act 2008¶
Health and Social Care Act 2012¶
Care Act 2014¶
5A Consultation on the provision of services
(1) This section applies in relation to any services for meeting care and support needs (within the meaning of section 5(7)) which are, or may be, provided by or pursuant to arrangements made by a local authority. (2) The local authority must make such arrangements as it considers appropriate to obtain the views of users or potential users of those services about— (a) what services are needed, (b) their experiences of services, (c) the standard of provision of services, (d) whether, and how, services could be improved, and (e) whether, and how, services ought to be improved. (3) A local authority must consider views obtained under subsection (2) when exercising its functions under this Part. (4) The reference in subsection (2) to users or potential users of a service includes any carers or representatives of users or potential users of the service. (5) The Secretary of State may require a local authority to provide the Secretary of State with information relating to the exercise of its functions under this section. (6) The information must be provided in such form, and at such time or within such period, as the Secretary of State may require.
(2) In preparing its strategic plan, the SAB must involve the community in its area.
andat the end);
Schedule 1115 — Minor and consequential amendments¶
Reserve and Auxiliary Forces (Protection of Civil Interests) Act 1951¶
Public Bodies (Admission to Meetings) Act 1960¶
Leasehold Reform Act 1967¶
Parliamentary Commissioner Act 1967¶
Health Services and Public Health Act 1968¶
.(a) in relation to subsection (2)(a)— (i) any enactment functions under which are social services functions within the meaning of the Local Authority Social Services Act 1970 or the Social Services and Well-being (Wales) Act 2014, and (ii) the National Health Service Act 2006;
Employers’ Liability (Compulsory Insurance) Act 1969¶
Local Authority Social Services Act 1970¶
Local Government Act 1972¶
Superannuation Act 1972¶
Health and Safety at Work etc. Act 1974¶
House of Commons Disqualification Act 1975¶
Northern Ireland Assembly Disqualification Act 1975¶
National Health Service (Scotland) Act 1978¶
.the health service in England means the health service continued under section 1 of the National Health Service Act 2006; the health service in Wales means the health service continued under section 1 of the National Health Service (Wales) Act 2006; the Northern Ireland health service means the system of health and social care referred to in section 2 of the Health and Social Care (Reform) Act (Northern Ireland) 2009.
Acquisition of Land Act 1981¶
Mental Health Act 1983¶
(c) a Special Health Authority on which a requirement is imposed under section 12ZB.
;NHS commissioning authority means the Secretary of State or an integrated care board;
.(a) the Secretary of State is “responsible” for any people for whom the Secretary of State is made responsible by regulations made by virtue of section 3B(3) of the National Health Service Act 2006;
Disabled Persons (Services, Consultation and Representation) Act 1986¶
Copyright, Designs and Patents Act 1988¶
Road Traffic Act 1988¶
Children Act 1989¶
.(ca) by a person in pursuance of arrangements made by the Secretary of State in the exercise of functions in relation to the health service continued under section 1 of the National Health Service Act 2006;
Local Government and Housing Act 1989¶
Access to Health Records Act 1990¶
London Local Authorities Act 1991¶
Health and Personal Social Services (Northern Ireland) Order 1991 (SI 1991/194 (N.I. 1)¶
Health Service Commissioners Act 1993¶
Value Added Tax Act 1994¶
;(b) a National Health Service trust established under the National Health Service Act 2006 or the National Health Service (Wales) Act 2006;
Employment Rights Act 1996¶
Housing Grants, Construction and Regeneration Act 1996¶
Crime and Disorder Act 1998¶
Greater London Authority Act 1999¶
Health Act 1999¶
Immigration and Asylum Act 1999¶
Freedom of Information Act 2000¶
Local Government Act 2000¶
Adoption and Children Act 2002¶
Enterprise Act 2002¶
International Development Act 2002¶
Nationality, Immigration and Asylum Act 2002¶
Criminal Justice Act 2003¶
Finance Act 2003¶
Health and Social Care (Community Health and Standards) Act 2003¶
.(za) the exercise of any functions of the Secretary of State in arranging for the provision of services as part of the health service continued under section 1 of the National Health Service Act 2006;
;(ia) the Secretary of State in the exercise of functions in relation to the health service continued under section 1 of the National Health Service Act 2006,
Licensing Act 2003¶
Children Act 2004¶
.(ba) the Secretary of State so far as exercising any functions which relate to the health service in England other than functions conferred by regulations under section 250E of the National Health Service Act 2006 (single patient record);
Civil Contingencies Act 2004¶
Domestic Violence, Crime and Victims Act 2004¶
Finance Act 2004¶
Armed Forces Act 2006¶
Childcare Act 2006¶
Emergency Workers (Obstruction) Act 2006¶
.(a) in relation to England and Wales— (i) the Secretary of State in the exercise of any functions in relation to the health service continued under section 1 of the National Health Service Act 2006, (ii) a local authority in the exercise of public health functions, (iii) an integrated care board, (iv) an NHS foundation trust, (v) a National Health Service trust, (vi) a Special Health Authority, or (vii) a Local Health Board;
(6) In subsection (5)(a)(ii) “public health functions”, in relation to a local authority, has the meaning given by section 6C(7) of the National Health Service Act 2006.
National Health Service Act 2006¶
(7) In this Act— (a) a reference to the public health functions of the Secretary of State is a reference to the functions of the Secretary of State under sections 2A and 2B and paragraphs 7C, 8 and 12 of Schedule 1; (b) a reference to the public health functions of local authorities is a reference to the functions of local authorities under sections 2B and 111 and paragraphs 1 to 7B and 13 of Schedule 1.
(1) The Secretary of State may direct a public body to exercise any of the investigation functions specified in the direction.
(9) In this section “the investigation functions” means the functions which, immediately before 1 July 2022 (the day on which section 36 of the Health and Care Act 2022 came into force), were exercised by the Special Health Authority called the National Health Service Trust Development Authority pursuant to the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) (Additional Investigatory Functions in respect of Maternity Cases) Directions 2018 given under sections 7 and 8.
(g) the Secretary of State.
(2) Subsection (1) applies to— (a) anything which a local authority has a duty or power to provide or arrange under section 2B or Schedule 1; (b) anything which an integrated care board has a duty or power to arrange under this Act or any other enactment; (c) anything which the Secretary of State has a duty or power to provide or arrange in the exercise of a function that— (i) relates to the health service, and (ii) is conferred by this Act or any other enactment.
Information in relation to safety
12DB Information on safety of services provided by the health service
(1) The Secretary of State must establish and operate systems for collecting and analysing information relating to the safety of the services provided by the health service. (2) The Secretary of State must make information collected by virtue of subsection (1), and any other information obtained by analysing it, available to such persons as the Secretary of State considers appropriate. (3) The Secretary of State must give advice and guidance, to such persons as the Secretary of State considers appropriate, for the purpose of maintaining and improving the safety of the services provided by the health service. (4) The Secretary of State must monitor the effectiveness of advice and guidance given under subsection (3). (5) An integrated care board must have regard to any advice or guidance given to it under subsection (3).
(3) In this section “mental health services” means services that are provided as part of the health service in relation to mental health.
Interpretation
12G Interpretation
In this Part—the health service means the health service in England; health services means services provided as part of the health service.
(1) There are to continue to be integrated care boards established in accordance with this Chapter. (2) The Secretary of State may by order establish an integrated care board for an area within England.
Intervention powers in respect of reconfiguration of NHS services
14Z60A Power to call in proposal for reconfiguration
(1) The Secretary of State may give an integrated care board a direction calling in any proposal by the board for the reconfiguration of NHS services. (2) Where a direction is given under subsection (1), the Secretary of State— (a) may, within the period of six months beginning with the date of the direction, take any decision in relation to the proposal that could have been taken by the integrated care board, and (b) must notify the board once the Secretary of State has finished considering the proposal. (3) The power of the Secretary of State to take decisions under subsection (2)(a) includes— (a) power to decide whether a proposal should, or should not, proceed, or should proceed in a modified form; (b) power to decide particular results to be achieved by the integrated care board in taking decisions in relation to the proposal; (c) power to decide procedural or other steps that should, or should not, be taken in relation to the proposal; (d) power to retake any decision previously taken by the integrated care board. (4) The Secretary of State must, before acting under subsection (2)(a), give each of the following an opportunity to make representations to the Secretary of State in relation to the proposal— (a) the integrated care board, (b) each local authority (within the meaning of section 2B) to whose area the proposed reconfiguration of NHS services relates, and (c) any other person that the Secretary of State considers appropriate. (5) The Secretary of State must— (a) publish any decision under subsection (2)(a) together with an explanation of the reasons for taking it, and (b) notify the integrated care board of the decision and the reasons. (6) The Secretary of State must publish a summary of any representations made under subsection (4). (7) An integrated care board, NHS trust established under this Act or NHS foundation trust must give the Secretary of State any information or other assistance that the Secretary of State requires it to give for the purposes of carrying out any functions under this section. (8) The Secretary of State must publish guidance for integrated care boards, NHS trusts and NHS foundation trusts about— (a) the exercise of their functions under this section, and (b) how the Secretary of State proposes to exercise the Secretary of State’s functions under this section. (9) Integrated care boards, NHS trusts and NHS foundation trusts must have regard to guidance published under subsection (8). (10) In this section “reconfiguration of NHS services” means a change in the arrangements made by an integrated care board for the provision of NHS services where that change has an impact on— (a) the manner in which a service is delivered to individuals (at the point when the service is received by users), or (b) the range of health services available to individuals. 14Z60B Effect of direction under section 14Z60A on integrated care board
(1) This section applies where the Secretary of State gives a direction under section 14Z60A(1) calling in a proposal. (2) Until notified that the Secretary of State has finished considering the proposal, the integrated care board must not take further steps in relation to a proposal except to such extent (if any) as may be permitted by the direction. (3) Once notified that the Secretary of State has finished considering the proposal, the integrated care board must give effect to any decision of the Secretary of State under section 14Z60A(2)(a) in relation to the proposal.
14Z60C Power to require consideration of proposals for reconfiguration
(1) The Secretary of State may direct an integrated care board to consider a reconfiguration of NHS services. (2) The Secretary of State must publish any direction under this section, together with an explanation of the reasons for giving it. (3) In this section “reconfiguration of NHS services” has the meaning given by section 14Z60A(10).
(1) The Secretary of State may give an authorisation under this section to an NHS trust if— (a) the NHS trust has applied under section 33, and (b) the Secretary of State is satisfied as to the matters set out in subsection (2).
(4) The Secretary of State must grant the application if satisfied that such steps as are necessary to prepare for the dissolution of the trusts and the establishment of the new trust have been taken, and must otherwise refuse the application.
(4) The Secretary of State must grant the application if satisfied that such steps as are necessary to prepare for the acquisition have been taken, and must otherwise refuse the application.
(4) The Secretary of State must grant the application if satisfied that such steps as are necessary to prepare for the dissolution of the trust and the establishment of each of the proposed new trusts have been taken, and must otherwise refuse the application.
(1) This section applies to— (a) NHS trusts established under this Act, and (b) Special Health Authorities.
(1) This section applies to— (a) NHS trusts established under this Act, and (b) Special Health Authorities.
.(aa) any facilities the provision of which is arranged by the Secretary of State in pursuance of functions under this Act,
.(aa) any services (other than the services of any person) or other facilities the provision of which is arranged by the Secretary of State in pursuance of functions under this Act,
(6) This section does not require a body to make arrangements in relation to matters to which a trust special administrator’s draft or final report under section 65F or 65I relates before the Secretary of State has made a decision under section 65K.
252ZA Code of practice on confidential patient information
(1) The Secretary of State must issue a code of practice relating to the processing of confidential patient information in connection with the provision of health services or of adult social care in England. (2) The Secretary of State must keep the code under review and may from time to time— (a) revise the whole or any part of the code, and (b) issue a revised code. (3) Before issuing or revising a code the Secretary of State must consult such persons as the Secretary of State considers appropriate. (4) The Secretary of State must publish any code issued under this section. (5) A health or social care body must have regard to a code under this section in exercising functions in connection with the provision of health services or of adult social care in England. (6) A person, other than a public body, who provides health services, or adult social care in England, pursuant to arrangements made with a health or social care body must, in providing those services or that care, have regard to the code. (7) In this section— adult social care— (a) includes all forms of personal care and other practical assistance provided for individuals who are in need of such care or other assistance by reason of age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or any other similar circumstances, but (b) does not include anything provided by an establishment or agency for which His Majesty’s Chief Inspector of Education, Children’s Services and Skills is the registration authority under section 5 of the Care Standards Act 2000; confidential patient information has the same meaning as in section 251 (see subsections (10) and (11) of that section); health or social care body means a public body which exercises functions in connection with the provision of health services or of adult social care in England; health services means services which must or may be provided as part of the health service in England; public body means a body or other person whose functions— (a) are of a public nature, or (b) include functions of that nature, but in the latter case, the body or person is a public body to the extent only of those functions.
(A1) The Secretary of State must take appropriate steps for securing that the Secretary of State is properly prepared to exercise the functions of the Secretary of State in relation to the health service in England in the event of an emergency.
(4) In subsection (3)— local authority includes the Council of the Isles of Scilly but only in respect of its functions under Part 2 of the Housing Act 1985; NHS functions means the functions of an NHS body.
(8A) Payments under this section by the Secretary of State may be made subject to conditions, including, in particular, conditions of the kind described in subsection (7).
(3A) The Secretary of State may by directions prescribe conditions relating to— (a) payments by integrated care boards under subsection (2), or (b) payments by local authorities under subsection (3), including, in particular, conditions of the kind described in section 256(7).
(4) Where conditions have been prescribed as mentioned in subsection (3A), no payment may be made by an integrated care board under subsection (2) or by a local authority under subsection (3) except subject to conditions which conform with any prescribed conditions that are relevant to the payment. (5) Payments under subsection (2) by the Secretary of State may be made subject to conditions, including, in particular, conditions of the kind described in section 256(7). (6) In this section “local authority” includes the Council of the Isles of Scilly.
.(ga) sections 256 and 257 (payments towards expenditure on community services),
.(a) the functions of an integrated care board under section 3 or 3A or Schedule 1,
.(a) section 42B,
.(aza) section 56A(4A), (azb) section 57, (azc) section 57A,
.(zbb) an order or regulations under Chapter 5 of Part 2 that, by virtue of subsection (8)(a), amend an Act,
omit the definitions of the following—
“education and training functions”;
“regulatory functions”.
(d) section 253(1A)(d).
Application
A1 This Schedule applies in relation to NHS trusts established under this Act.
Application
A1 This Schedule applies in relation to NHS trusts established under this Act.
National Health Service (Wales) Act 2006¶
.(f) a list corresponding to a list mentioned in any of paragraphs (a), (c) or (d) prepared under or by virtue of the National Health Service Act 2006,
;(f) any list corresponding to a list mentioned in any of paragraphs (a), (c) or (d) prepared under or by virtue of the National Health Service Act 2006,
(6) A person responsible for preparing a list— (a) must not include a person in the list if that person is disqualified from inclusion in that list by a national disqualification, and (b) must remove from the list any person who is disqualified from inclusion in that list by a national disqualification.
NHS Redress Act 2006¶
Safeguarding Vulnerable Groups Act 2006¶
(8C) The Secretary of State or an integrated care board does not make arrangements for another to engage in a regulated activity by virtue of anything the Secretary of State or board does under section 12A or 12D, or regulations under section 12A or 12B, of the National Health Service Act 2006 (direct payments for health services).
Corporate Manslaughter and Corporate Homicide Act 2007¶
Local Government and Public Involvement in Health Act 2007¶
Statistics and Registration Service Act 2007¶
Criminal Justice and Immigration Act 2008¶
Health and Social Care Act 2008¶
(1) The Commission must monitor the practice followed by registered persons in relation to the processing of relevant information.
20B Secretary of State guidance in relation to processing of information
(1) The Secretary of State must issue guidance for registered persons on the practice to be followed by them in relation to the processing of— (a) patient information, and (b) any other information obtained or generated in the course of the provision of the health service. (2) Registered persons who carry on an activity which involves, or is connected with, the provision of health care must have regard to any guidance published under this section. (3) The Secretary of State may from time to time revise guidance issued under this section and issue the revised guidance. (4) In this section, “patient information”, “processing” and “registered person” have the same meaning as in section 20A.
(9) Before preparing or revising a statement under subsection (7) the Commission must consult any persons it considers appropriate.
.(b) a person providing health care commissioned by an integrated care board,
.(a) the Secretary of State,
Autism Act 2009¶
Coroners and Justice Act 2009¶
Health Act 2009¶
Corporation Tax Act 2010¶
Equality Act 2010¶
Charities Act 2011¶
Health and Social Care Act 2012¶
86 Licensing criteria
The Secretary of State must by regulations specify the criteria that must be met by a person in order to be granted a licence under this Chapter.
(2) If the Secretary of State is satisfied that the applicant meets the criteria for holding a licence for the time being prescribed by regulations under section 86, the Secretary of State must as soon as reasonably practicable grant the application, and must otherwise refuse the application.
88A Lapse of licences on conversion of NHS trust or NHS foundation trust
(1) This section applies where— (a) a body that is an NHS trust is converted into an NHS foundation trust under section 36 of the National Health Service Act 2006, or (b) a body that is an NHS foundation trust is converted into an NHS trust under section 57B of that Act. (2) Any licence under this Chapter that is held by the body lapses. (3) Any discretionary requirements imposed on the body under section 105 lapse (but liabilities incurred under Schedule 11 do not). (4) Any enforcement undertakings given by the body under section 106 lapse.
;(a) the Secretary of State,
(6) The Secretary of State may revise the guidance under subsection (4) and, if it is revised, must publish the guidance as revised.
(1) The Secretary of State may require a person mentioned in subsection (2) to provide any information, documents, records or other items that the Secretary of State considers it necessary or expedient to have for the purposes of any relevant regulatory functions.
(4) In this section “relevant regulatory functions” means— (a) the Secretary of State’s functions under the provisions listed in subsection (5), and (b) any other functions of the Secretary of State so far as exercisable in connection with those functions. (5) Those provisions are— (a) in Part 2 of the National Health Service Act 2006— (i) Chapter 5 (NHS foundation trusts); (ii) Chapter 5A (trust special administrators); (b) the following provisions of this Part— (i) this Chapter (licensing); (ii) Chapter 4 (NHS payment scheme); (iii) Chapter 5 (health special administration); (iv) Chapter 6 (financial assistance in special administration cases).
(1) The Secretary of State must publish guidance about how the Secretary of State intends to exercise functions under sections 105 and 106 and Schedule 11. (2) The Secretary of State may revise the guidance and, if it is revised, must publish the guidance as revised. (3) The Secretary of State must consult such persons as the Secretary of State considers appropriate before publishing the guidance or revised guidance.
;(aa) for the provision of services in pursuance of arrangements made by the Secretary of State in the exercise of the Secretary of State’s public health functions, within the meaning of the National Health Service Act 2006;
(ii) services in pursuance of arrangements of the kind mentioned in section 114A(1)(aa) or (b).
(3) The Secretary of State may secure that a mechanism established under this section operates so as to enable the recovery of the costs incurred by the Secretary of State in establishing and operating the mechanism.
(9) The Secretary of State must notify the applicant of the decision on the reconsideration of the application and— (a) if the decision is to grant the application, must notify the applicant of the matters specified in subsection (3), and (b) if the decision is to refuse the application, must notify the applicant of the reasons for the refusal.
(3) Subject to that, a grant or loan under section 136 may be given in such manner and on such terms as the Secretary of State may determine.
(1A) Levies under this section must be set at a level that the Secretary of State estimates will raise an amount not exceeding the cap. (1B) “The cap” is an amount specified by the Secretary of State in regulations.
(2) “Quality matter” means any matter in relation to which the Secretary of State has the power to direct NICE to prepare a quality standard.
(6B) Regulations may confer a power on the Secretary of State to waive a requirement for a person other than the Secretary of State to comply with an information standard (in whole or in part and generally or for a specific period).
;(2) The Secretary of State may revise the procedure and, if it is revised, must publish the procedure as revised.
Care Act 2014¶
.(ba) the Minister of the Crown exercising functions in relation to the provision of services as part of the health service;
(c) to the Secretary of State in connection with— (i) the exercise by the Secretary of State of functions conferred in regulations under section 251 of the National Health Service Act 2006 (processing of patient information for medical purposes); (ii) any publication or other disclosure by the Secretary of State of relevant information which is in a form which identifies an individual to whom the information relates or enables the identity of such an individual to be ascertained.
(1A) In sub-paragraph (1)(c) “relevant information” means information obtained by the Secretary of State in the exercise of a relevant data function within the meaning given by section 253(3) of the Health and Social Care Act 2012.
Children and Families Act 2014¶
(a) employed by a local authority in England or an integrated care board, or (b) employed in the civil service of the state.
(a) employed by a local authority in England or an integrated care board, or (b) employed in the civil service of the state.
(a) employed by a local authority in England or an integrated care board, or (b) employed in the civil service of the state.
.(j) the Secretary of State;
Immigration Act 2014¶
;(1A) An agreement— (a) under which accommodation is provided to a person in pursuance of arrangements made by the Secretary of State in the exercise of functions relating to the health service continued under section 1 of the National Health Service Act 2006, and (b) which is not excluded by another provision of this Schedule.
Housing (Wales) Act 2014 (anaw 7)¶
Social Services and Well-being (Wales) Act 2014 (anaw 4)¶
Counter-Terrorism and Security Act 2015¶
Modern Slavery Act 2015¶
Cities and Local Government Devolution Act 2016¶
.(d) Chapter A3 of Part 2 of the NHSA 2006 (integrated care boards),
.(c) regulations or directions under the NHSA 2006 so far as relating to service delivery;
Additional Learning Needs and Education Tribunal (Wales) Act 2018 (anaw 2)¶
Data Protection Act 2018¶
;(i) section 2A or 2B of, or paragraph 7C, 8 or 12 of Schedule 1 to, the National Health Service Act 2006, or (ii) Chapter 2 of Part 9 of the Health and Social Care Act 2012;
Mental Health Units (Use of Force) Act 2018¶
.(c) the Secretary of State;
Domestic Abuse Act 2021¶
Medicines and Medical Devices Act 2021¶
;(d) requiring the Secretary of State to have regard to specified matters in exercising functions under the regulations.
;(b) information that the Secretary of State considers it necessary or expedient to have for the purposes of the Secretary of State’s functions under the regulations,
;(c) about any procedural steps that the Secretary of State must follow in requiring a person to provide information;
.appropriate authority means— (a) in relation to England and Wales and Scotland, the Secretary of State, and (b) in relation to Northern Ireland, the Department of Health in Northern Ireland and the Secretary of State acting jointly;
.appropriate authority— (a) in section 7A, has the meaning given by subsection (13) of that section, and (b) otherwise has the meaning given by section 2(6);
;(d) requiring the Secretary of State to have regard to specified matters in exercising functions under the regulations.
;(c) enabling the Secretary of State to require specified persons or descriptions of person to whom subsection (4) applies to provide, in a manner, and at a time, determined by the Secretary of State— (i) information of a specified description; (ii) information for specified purposes; (iii) any other information that the Secretary of State considers it necessary or expedient to have for the purposes of the Secretary of State’s functions under the regulations; (d) about any procedural steps the Secretary of State must follow in requiring a person to provide information;