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National Health Service and Community Care Act 1990

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Changes to legislation:

National Health Service and Community Care Act 1990, Part I is up to date with all changes known to be in force on or before 13 November 2024. There are changes that may be brought into force at a future date. Changes that have been made appear in the content and are referenced with annotations. Help about Changes to Legislation

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Revised legislation carried on this site may not be fully up to date. Changes and effects are recorded by our editorial team in lists which can be found in the ‘Changes to Legislation’ area. Where those effects have yet to be applied to the text of the legislation by the editorial team they are also listed alongside the legislation in the affected provisions. Use the ‘more’ link to open the changes and effects relevant to the provision you are viewing.

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Changes and effects yet to be applied to the whole Act associated Parts and Chapters:

Whole provisions yet to be inserted into this Act (including any effects on those provisions):

  • s. 4A(1)(c) and word added by S.I. 2006/1056 Sch. para. 5(a)(ii) (This amendment comes into force on the day on which 2005 asp 13, s. 20 comes into force, see art. 1(2)(b))

Part IE+W+S The National Health Service: England and Wales

Local managementE+W

1 Regional and District Health Authorities.E+W

F1(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F1(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3)F2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F1(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F1(5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F32. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W

Textual Amendments

F3S. 2 repealed (1.4.1996) by 1995 c. 17, s. 5(1)(2), Sch. 3

3 Primary and other functions of health authorities etc. and exercise of functions.E+W

F4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F4S. 3 omitted (the amendment coming into force immediately before the National Health Service Act 2006 (c. 41) which Act came into force on 1.3.2007 in accordance with s. 277(1) (subject to s. 277(2)-(5) of that Act)) by virtue of The National Health Service (Pre-consolidation Amendments) Order 2006, arts. 1(1), 2, Sch. 1 Pt. 2 {para. 2} (with art. 4)

4 NHS contracts.E+W

F5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

[F64A Provision of certain services under NHS contracts.E+W

[F7(1)This section applies to any arrangement under which [F8a Strategic Health Authority,][F9a Primary Care Trust,] a Health Authority or such other health service body as may be prescribed arrange for the provision to them—

(a)by a person on an ophthalmic list, F10. . .

[F11(aa)by a contractor under a general ophthalmic services contract, or]

(b)by a person on a pharmaceutical list,

of goods or services that they reasonably require for the purposes of functions which they are exercising under Part I of the principal Act [F12other than under section 16CD of that Act].

(2)Any such arrangement is to be treated as an NHS contract for the purposes of section 4 (other than subsections (4) and (6)).

(3)In this section—

  • [F13“general ophthalmic services contract” and “contractor” under such a contract have the meanings given by section 28WA of the principal Act;]

  • “health service body” means a body which is a health service body for the purposes of section 4;

  • “ophthalmic list” means a list published in accordance with regulations made under—

    (a)

    section [F1439(1)(a)] of the principal Act;

    (b)

    section 26(2)(a) of the M1National Health Service (Scotland) Act 1978; or

    (c)

    Article 62(2)(a) of the M2Health and Personal Social Services (Northern Ireland) Order 1972; and

  • “pharmaceutical list” means a list published in accordance with regulations made under—

    (a)

    section 42(2)(a) of the principal Act;

    (b)

    section 27(2) of the National Health Service (Scotland) Act 1978; or

    (c)

    Article 63(2A)(a) of the 1972 Order.

[F15(4)In subsection (3), in paragraph (b) of the definition of “ophthalmic list” the reference to a list published in accordance with regulations made under paragraph (a) of section 26(2) of the National Health Service (Scotland) Act 1978 is a reference to the first part of the list (referred to in sub-paragraph (i) of that paragraph) which is published in accordance with regulations under that paragraph.]]]

Textual Amendments

F6S. 4A inserted (1.9.1997) by 1997 c. 46, s. 31(1); S.I. 1997/1780,

F7S. 4A repealed (1.3.2007 for certain purposes, 1.8.2008 for certain purposes and otherwise prosp.) by National Health Service (Consequential Provisions) Act 2006 (c. 43), ss. 6, 8(2)(4)(g)(h)(l)(5)(6), Sch. 4 (with Sch. 2 Pt. 1, Sch. 3 Pt. 1); S.I. 2008/1972, art. 2(b)

F8Words in s. 4A(1) inserted (1.10.2002) by 2002 c. 17, s. 1(3), Sch. 1 Pt. 2 para. 41; S.I. 2002/2478, art. 3(1)(c) (with art. 3(3) and transitional provision in art. 4)

F9Words in s. 4A(1) inserted (1.10.2002) by 2002 c. 17, s. 2(5), Sch. 2 Pt. 2 para. 54; S.I. 2002/2478, art. 3(1)(d) (with art. 3(3) and transitional provision in art. 4)

F13S. 4A(3): definition of "general ophthalmic services contract" and "contractor" inserted (19.7.2006 for specified purposes, otherwise 1.8.2008) by Health Act 2006 (c. 28), ss. 80(1), 83(1)(e)(7), Sch. 8 {para. 29(3)}

F14Words in s. 4A(3) substituted (1.7.2002) by virtue of 2001 c. 15, s. 67, Sch. 5 Pt. 1 para. 8 (with ss. 64(9), 65(4)); S.I. 2002/1475, art. 2, Sch. Pt. 1

F15S. 4A(4) inserted (1.4.2006) by The Smoking, Health and Social Care (Scotland) Act 2005 (Consequential Modifications) (England, Wales and Northern Ireland) Order 2006 (S.I. 2006/1056, arts. 1(2)(c), 2, Sch. para. 5(c) (which came into force in accordance with art. 1(2) of that Order and The National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006 (S.S.I. 2006/135) which were made on 10.3.2006 under substituted s. 26 of the National Health Service (Scotland) Act 1978 (c. 29) and came into force on 1.4.2006)

Marginal Citations

National Health Service trustsE+W

5 NHS trusts.E+W

F16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

6 Transfer of staff to NHS trusts.E+W

F17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

7 Supplementary provisions as to transfer of staff.E+W

F18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

8 Transfer of property, rights and liabilities to NHS trust.E+W

F19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

9 Originating capital debt of, and other financial provisions relating to NHS trusts.E+W

F20. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

10 Financial obligations of NHS trusts.E+W

F21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

11 Trust funds and trustees for NHS trusts.E+W

F22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

Family Health Services AuthoritiesE+W

12 Functions of Family Health Services Authorities.E+W

F23. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F2413. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W

Textual Amendments

F24S. 13 repealed (1.4.1996) by 1995 c. 17, s. 5(1)(2), Sch. 3 (with Sch. 2 paras. 6, 16)

Fund-holding practicesE+W+S

F2514

  • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

[F2615 Payments to recognised fund-holding practices.E+W+S

F26(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F27(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F26(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F28(4)In any case where—

(a)a Health Authority make a payment of, or of any part of, an allotted sum to the members of a recognised fund-holding practice, and

(b)some of the individuals on the list of patients of any of the members of the practice reside in the area of another Health Authority, or in the area of a Health Board,

the Health Authority making the payment shall be entitled to recover from that other Health Authority, or from that Health Board, an amount equal to such portion of the payment as may be determined in accordance with directions given by the Secretary of State.]

(5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F26(6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F26(7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F27(8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F26(9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F26(10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .]

Extent Information

E1S. 15 other than s. 15(4) does not extend to Scotland

Textual Amendments

F26S. 15 repealed (1.10.1999 for E., 1.4.2000 for W. and otherwise prosp.) by 1999 c. 8, ss. 1, 65, Sch. 5; S.I. 1999/2540, art. 2(1)(a), Sch. 1; S.I. 2000/1026, art. 2(1), Sch.; S.I. 2000/1041, art. 2(d), Sch.

F27S. 15(2)(5) and (8) repealed (1.4.1996 subject to s. 8 of the amending Act) by 1995 c. 17, ss. 2(1)(3), 5(1)(2), Sch. 1 para. 74(b)(e) and (g), Sch. 3 (with Sch. 2 paras. 6, 16)

F28S. 15(4) substituted (1.4.1996 subject to s. 8 of the amending Act) by 1995 c. 17, s. 2(1)(3), Sch. 1 Pt. II para. 74(a) (with Sch. 2 paras. 6, 16)

Commencement Information

I1S. 15 wholly in force at 1.4.1991 see s. 67(1) and S.I. 1990/1329, art. 2(8), Sch. 3.

F2916

  • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F3017

  • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

Indicative amountsE+W

[F3118 Indicative amounts for doctors’ practices.E+W

(1)Subject to [F32subsections (2) and (8)] below, for each financial year, [F33every Primary Care Trust and] every [F34Local Health Board] shall, by notice in writing given to each practice in relation to the members of which it is the relevant [F35Primary Care Trust or][F34Local Health Board], specify an amount of money (in this Act referred to as an “indicative amount”) representing the basic price of the drugs, medicines and listed appliances which, in the opinion of the [F35Primary Care Trust or][F34Local Health Board], it is reasonable to expect will be supplied in that year pursuant to orders given by or on behalf of the members of that practice.

(2)Subsection (1) above does not apply with respect to a practice which is or forms part of a fund-holding practice recognised under section 14 above.

(3)For the purposes of this section, a “practice” means—

[F36(a)a person or body who has entered into a contract under section 28Q of the principal Act, otherwise than in partnership; or

(b)two or more individuals practising in partnership who together have entered into such a contract,]

and any reference to the members of a practice shall be construed accordingly.

(4)The members of a practice shall seek to secure that, except with the consent of the relevant [F37Primary Care Trust or][F38Local Health Board] or for good cause, the orders for drugs, medicines and listed appliances given by them or on their behalf are such that the basic price of the items supplied pursuant to those orders in any financial year does not exceed the indicative amount notified to the practice for that year under subsection (1) above.

(5)For the purpose of measuring the extent to which a practice is operating within the indicative amount notified to it under subsection (1) above for any financial year, a [F37Primary Care Trust or][F38Local Health Board] shall set against that indicative amount an amount equal to the basic price of the drugs, medicines and listed appliances supplied in that year pursuant to orders given by or on behalf of members of the practice.

(6)For the purposes of this section, regulations may make provision as to the specification of, or means of calculating, the basic price of any drugs, medicines or listed appliances.

(7)F39. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F40(8)This section does not apply in relation to the performance or provision of personal medical services in accordance with arrangements made under section 28C of the principal Act.]

[F41(9)In this section, references to the “relevant” Primary Care Trust or Local Health Board, in relation to a practice, are to the Primary Care Trust or Local Health Board with which it has entered into a contract under section 28Q of the principal Act.]]

Textual Amendments

F31S. 18 repealed by 1999 c. 8, ss. 65, 67(1), Sch. 4 para. 80, Sch. 5 (the repeal being brought into force: on 1.10.1999 to the extent that Sch. 5 repeals s. 18(2) for E. by S.I. 1999/2540, art. 2(1)(a), Sch. 1; on 1.4.2000 to the extent that Sch. 5 repeals s. 18(2) and is not already in force by S.I. 2000/1041, art. 2(1)(d), Sch.; the repeal being otherwise prosp.)

F32Words in s. 18(1) substituted (1.4.1998) by 1997 c. 46, s. 41(10), (11), Sch. 2 para. 65(8); S.I. 1998/631, art. 2(b), Sch. 2

F33Words in s. 18(1) inserted (1.10.2002 with effect as mentioned in Sch. 2 para. 55(2) of the amending act) by 2002 c. 17, s. 2(5), Sch. 2 Pt. 2 para. 55(1)(a)(i)(2); S.I. 2002/2478, art. 3(1)(d) (with art. 3(3) and transitional provision in art. 4)

F35Words in s. 18(1) inserted (1.10.2002 with effect as mentioned in Sch. 2 para. 55(2) of the amending act) by 2002 c. 17, s. 2(5), Sch. 2 Pt. 2 para. 55(1)(a)(ii)(2); S.I. 2002/2478, art. 3(1)(d) (with art. 3(3) and transitional provision in art. 4)

F37Words in s. 18 inserted (1.10.2002 with effect as mentioned in Sch. 2 para. 55(2) of the amending act) by 2002 c. 17, s. 2(5), Sch. 2 Pt. 2 para. 55(1)(b); S.I. 2002/2478, art. 3(1)(d) (with art. 3(3) and transitional provision in art. 4)

F40S. 18(8) inserted (1.4.1998) by 1997 c. 46, s. 41(10(11), Sch. 2 para. 65(10); S.I. 1998/631, art. 2(b), Sch. 2

Modifications etc. (not altering text)

C1S. 18 modified (1.4.1991) by S.I. 1991/556, reg. 3.

S. 18(2) applied (with modifications) (1.4.1997) by S.I. 1997/980, reg. 3

C2S. 18: functions of local authority may be responsibility of an executive of the authority (1.4.2000) by virtue of S.I. 2000/695, reg. 3(2)(b), Sch. 2

Commencement Information

I2S. 18 wholly in force at 1.4.1991 see s. 67(2) and S.I. 1990/1329, art. 2(8), Sch. 3.

Funding, audit and liabilitiesE+W

F4219. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W

Textual Amendments

F42S. 19 repealed (1.4.1996) by 1995 c. 17, s. 5(1)(2), Sch. 3 (with Sch. 2 paras. 6, 16)

20 Extension of functions etc. of Audit Commission to cover the health service.E+W

F43(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2)In section 98 of the principal Act (accounts and audit),—

(a)in subsection (1), in the words following paragraph (e) for the words from “appointed” to “Comptroller” there shall be substituted “appointed by the Audit Commission for Local Authorities and the National Health Service in England and Wales and the Comptroller”;

F44(b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F45(c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F45(d). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F43(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F43(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F43(5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F43(6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F43(7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F43(8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

21 Schemes for meeting losses and liabilities etc. of certain health service bodies.E+W

F46. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

Further amendments of the principal ActE+W

22 The Medical Practices Committee.E+W

23 Distribution of general medical services.E+W

F47. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F47S. 23 repealed (1.4.2004) by Health and Social Care (Community Health and Standards) Act 2003 c. 43, ss. 196, 199(1), Sch. 14 Pt. 4; S.I. 2004/288, arts. 1(5), 6(2)(i) (as amended (23.3.2004) by S.I. 2004/866, art. 2(1)); S.I. 2004/480, art. 5(2)(i) (as amended by S.I. 2004/1019, art. 2(5)(a))

24 Limitations on right to be included on list of dental practitioners.E+W

F48. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F48S. 24 repealed (1.4.2006) by Health and Social Care (Community Health and Standards) Act 2003 c. 43, ss. 196, 199(1), Sch. 14 Pt. 4; S.I. 2005/2925, arts. 1(3), 11(2)(l); S.I. 2006/345, art. 7(2)(g)

25 Transfer to DHA of certain functions relating to private patients.E+W

F49. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

InterpretationE+W

26 Interpretation of Part I.E+W

F50. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

Yn ôl i’r brig

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