Health and Social Care (Community Health and Standards) Act 2003

Healthcare provided by and for NHS bodies E+W

48 Introductory E+W

(1) The CHAI has the general function of encouraging improvement in the provision of health care by and for NHS bodies.

(2) In exercising its functions under subsection (1) and sections 49 to 56 in relation to such provision, the CHAI shall be concerned in particular with—

(a) the availability of, and access to, the health care;

(b) the quality and effectiveness of the health care;

(c) the economy and efficiency of the provision of the health care;

(d) the availability and quality of information provided to the public about the health care;

(e) the need to safeguard and promote the rights and welfare of children; and

(f) the effectiveness of measures taken for the purpose of paragraph (e) by the body in question and any person who provides, or is to provide, health care for that body.

Commencement Information

I1 S. 48 in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

49 National performance data E+W

The CHAI has the function of publishing data relating to the provision of health care by and for NHS bodies.

Commencement Information

I2 S. 49 in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

50 Annual reviews E+W

(1) In each financial year the CHAI must conduct a review of the provision of health care by and for—

(a) each English NHS body, and

(b) each cross-border SHA,

and must award a performance rating to each such body.

(2) The CHAI is to exercise its function under subsection (1) by reference to criteria from time to time devised by it and approved by the Secretary of State.

(3) The CHAI must publish the criteria devised and approved from time to time under subsection (2).

[F1 (4) In exercising its functions under this section in relation to any health care, the CHAI must take into account—

(a) the standards set out in statements published under section 46, and

(b) any code of practice issued under section 47A.

(4A) In conducting a review under subsection (1) in relation to a particular body to which provisions of such a code apply, the CHAI must accordingly consider (among other things) the extent, if any, to which those provisions are being observed by the body. ]

(5) For the purposes of this section the CHAI may, subject to this Part, conduct an inspection of—

(a) the body being reviewed; and

(b) any person who provides, or is to provide, health care for that body (wherever the health care is or is to be provided).

(6) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the award of a performance rating under this section.

Textual Amendments

F1 S. 50(4)(4A) substituted for s. 50(4) (1.10.2006) by Health Act 2006 (c. 28), ss. 15(2), 83(7); S.I. 2006/2603, art. 2

Commencement Information

I3 S. 50 partly in force; s. 50 in force at Royal Assent for certain purposes, see s. 199(1)(4)

I4 S. 50(1) in force for specified purposes at 1.4.2004, 1.4.2006, 1.4.2007 and 1.4.2008 by S.I. 2004/759, art. 3(1), art. 3(3)-(6) (as amended (20.3.2006) by S.I. 2006/836, art. 2 and (29.3.2007) by S.I. 2007/1102, art. 2)

I5 S. 50(2)(3) in force at 1.4.2005 by S.I. 2004/759, art. 3(2)

I6 S. 50(4) in force at 1.4.2006 by S.I. 2004/759, art. 3(3)(b) (as subsituted (20.3.2006) by S.I. 2006/836, art. 2)

I7 S. 50(5) in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

51 Reviews: England and Wales E+W

(1) The CHAI has the function of conducting reviews of—

(a) the overall provision of health care by and for NHS bodies;

(b) the overall provision of particular kinds of health care by and for NHS bodies;

(c) the provision of health care, or a particular kind of health care, by and for NHS bodies of a particular description.

(2) If the Secretary of State so requests, the CHAI must conduct—

(a) a review under subsection (1)(a);

(b) a review under subsection (1)(b) of the overall provision of a kind of health care specified in the request; or

(c) a review under subsection (1)(c) of the provision of health care, or health care of a kind specified in the request, by or for NHS bodies of a description so specified.

(3) The Secretary of State must consult the Assembly before making a request under subsection (2).

(4) In conducting a review under this section in relation to any health care the CHAI must take into account—

(a) the standards set out in statements published under section 46 [F2 and any code of practice issued under section 47A], where the health care is provided by or for an English NHS body or cross-border SHA;

(b) the standards set out in statements published under section 47, where the health care is provided by or for a Welsh NHS body.

(5) For the purposes of this section the CHAI may carry out an inspection of—

(a) any NHS body; and

(b) any person who provides, or is to provide, health care for an NHS body (wherever the health care is or is to be provided).

(6) Where the CHAI conducts a review under this section it must publish a report.

(7) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of a report under this section.

Textual Amendments

F2 Words in s. 51(4)(a) inserted (1.10.2006) by Health Act 2006 (c. 28), ss. 15(3), 83(7); S.I. 2006/2603, art. 2

Modifications etc. (not altering text)

C1 S. 51(4) applied (E.) (1.9.2005) by Children Act 2004 (Joint Area Reviews) Regulations 2005 (S.I. 2005/1973), reg. 1(1), Sch. para. 7(2)

Commencement Information

I8 S. 51 partly in force; s. 51 in force at Royal Assent for certain purposes, see s. 199(1)(4)

I9 S. 51(1)-(3)(5)(6) in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

I10 S. 51(4) in force at 1.4.2005 by S.I. 2004/759, art. 3(2)

52 Reviews and investigations: England E+W

(1) The CHAI has the function of conducting other reviews of, and investigations into, the provision of health care by and for English NHS bodies and cross-border SHAs.

(2) The CHAI may in particular under this section conduct—

(a) a review of the overall provision of health care by and for English NHS bodies and cross-border SHAs;

(b) a review of the overall provision of a particular kind of health care by and for English NHS bodies and cross-border SHAs;

(c) a review of, or investigation into, the provision of any health care by or for a particular English NHS body or cross-border SHA.

[F3 (3) The CHAI has the function of conducting reviews of—

(a) the arrangements made by English NHS bodies and cross-border SHAs for the purpose of discharging their duty under section 45;

(b) the arrangements made by particular bodies within paragraph (a) for the purpose of discharging that duty.]

(4) If the Secretary of State so requests, the CHAI must conduct—

(a) a review under subsection (2)(a);

(b) a review under subsection (2)(b) of the overall provision of a kind of health care specified in the request;

(c) a review or investigation under subsection (2)(c), or a review under subsection (3), in relation to the provision of such health care by or for such body as may be specified in the request.

[F4 (5) In exercising its functions under this section in relation to any health care, the CHAI must take into account—

(a) the standards set out in statements published under section 46, and

(b) any code of practice issued under section 47A.

(5A) In conducting a review under subsection (3) in relation to a particular body to which provisions of such a code apply, the CHAI must accordingly consider (among other things) the extent, if any, to which those provisions are being observed by the body.]

(6) For the purposes of this section the CHAI may carry out an inspection of—

(a) any English NHS body or cross-border SHA; and

(b) any person who provides, or is to provide, health care for such a body (wherever the health care is or is to be provided).

(7) Where the CHAI conducts a review or investigation under this section it must publish a report.

(8) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of a report under this section.

(9) The Secretary of State may by regulations require an NHS body to publish a statement as to the action it proposes to take as a result of any review or investigation conducted under this section in relation to it.

(10) Regulations under subsection (9) may make provision—

(a) as to the matters with which a statement under the regulations must deal;

(b) as to the time by which any such statement must be published;

(c) requiring an NHS body, before publishing any such statement, to obtain the consent of any person specified in the regulations;

(d) requiring the NHS body publishing any such statement to send a copy of it to any person so specified.

Textual Amendments

F3 S. 52(3) substituted (1.10.2006) by Health Act 2006 (c. 28), ss. 15(4), 83(7); S.I. 2006/2603, art. 2

F4 S. 52(5)(5A) substituted for s. 52(5) (1.10.2006) by Health Act 2006 (c. 28), ss. 15(5), 83(7); S.I. 2006/2603, art. 2

Commencement Information

I11 S. 52 partly in force; s. 52 in force at Royal Assent for certain purposes, see s. 199(1)(4)

I12 S. 52(1)-(4)(6)(7) in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

53 Failings E+W

(1) This section applies where the CHAI conducts—

(a) a review under section 50 or 51; or

(b) a review or investigation under section 52.

(2) The CHAI must make a report to the Secretary of State if it is of the view that—

(a) there are significant failings in relation to the provision of health care by or for an English NHS body or cross-border SHA;

(b) there are significant failings in the running of an English NHS body or cross-border SHA; or

(c) there are significant failings in the running of any body, or the practice of any individual, providing health care for an English NHS body or cross-border SHA.

(3) A report made to the Secretary of State under subsection (2) may include a recommendation that, with a view to remedying the failings in question, the Secretary of State take special measures in relation to—

(a) in a case falling within paragraph (a) or (b) of subsection (2), the English NHS body or cross-border SHA in question;

(b) in a case falling within paragraph (c) of that subsection, any person, other than a Welsh NHS body, referred to in that paragraph.

(4) The CHAI must also report to the Assembly where it is of the view that—

(a) there are significant failings in relation to the provision of health care by or for a Welsh NHS body;

(b) there are significant failings in the running of a Welsh NHS body; or

(c) there are significant failings in the running of any body, or the practice of any individual, providing health care for a Welsh NHS body.

(5) A report made to the Assembly under subsection (4) may include a recommendation that, with a view to remedying the failings in question, the Assembly take special measures in relation to—

(a) in a case falling within paragraph (a) or (b) of subsection (4), the Welsh NHS body in question; and

(b) in a case falling within paragraph (c) of that subsection, any person, other than an English NHS body or cross-border SHA, referred to in that paragraph.

(6) The CHAI must also make a report to the regulator where it is of the view that—

(a) there are significant failings in relation to the provision of health care by or for an NHS foundation trust;

(b) there are significant failings in the running of an NHS foundation trust; or

(c) there are significant failings in the running of any body, or the practice of any individual, providing health care for an NHS foundation trust.

(7) A report made to the regulator under subsection (6) may include a recommendation that, with a view to remedying the failings in question, the regulator take special measures in relation to the NHS foundation trust in question.

(8) A report under this section must give the CHAI’s reasons for its view and for any recommendation made.

(9) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of a report under this section.

Modifications etc. (not altering text)

C2 S. 53 explained (1.4.2005) by Health Protection Agency Act 2004 (c. 17), ss. 10(4), 12(1); S.I. 2005/121, art. 2(2)

Commencement Information

I13 S. 53 partly in force; s. 53 in force at Royal Assent for certain purposes, see s. 199(1)(4)

I14 S. 53 in force at 1.4.2004 in so far as not already in force by S.I. 2004/759, art. 3(1)

[F5 53A Failings in connection with code under section 47A: improvement notices E+W

(1) This section applies where, following such a review or investigation as is mentioned in section 53(1), the CHAI—

(a) is of the view that any provisions of a code of practice issued under section 47A and applying to an English NHS body or a cross-border SHA are not being observed in any material respect in relation to the provision of health care by or for the body, but

(b) having regard to all the circumstances, is not of the view that it is required to make a report under section 53(2) (or, if relevant, section 53(6)).

(2) The CHAI may serve a notice under this section (an “improvement notice”) on the body in respect of the failure to observe the code, if it considers that serving the notice is the most appropriate course of action for it to take with a view to securing that the failure is remedied.

(3) An improvement notice must—

(a) state that the CHAI has formed the view mentioned in subsection (1)(a) in relation to the provision of health care by or for the body, giving particulars of the material respect in which the CHAI considers that the provisions of the code are not being observed as mentioned in that subsection,

(b) state the CHAI's reasons for its view, and

(c) require the body to remedy the failure to observe the code, and to do so within such period as is specified in the notice.

(4) An improvement notice may (but need not) include a recommendation by the CHAI as to the way in which the failure should be remedied.

(5) An improvement notice may relate to more than one failure within subsection (1)(a), and in such a case—

(a) subsections (2) to (4) and section 53B apply separately in relation to each such failure, but

(b) any report required by that section may relate to more than one such failure.

(6) Where the CHAI serves an improvement notice on a body under this section, the CHAI must notify the Secretary of State and—

(a) the regulator, if the body is an NHS foundation trust, and

(b) any relevant Strategic Health Authority, if the body is a Primary Care Trust or an NHS trust.

(7) In this section and section 53B “relevant Strategic Health Authority” means—

(a) in relation to a Primary Care Trust, any Strategic Health Authority whose area includes any part of the Trust's area;

(b) in relation to an NHS Trust (other than one responsible for providing ambulance services), the Strategic Health Authority in whose area all or most of the Trust's hospitals, establishments or facilities are situated;

(c) in relation to an NHS Trust responsible for providing ambulance services, the Strategic Health Authority in whose area the headquarters establishment responsible for the control of those services is situated.

(8) Subsection (9) applies where—

(a) an improvement notice is served on a body in respect of a particular failure to observe a code of practice issued under section 47A, and

(b) a review under section 52(3)(b) is conducted by the CHAI in pursuance of section 53B(4)(a) with a view to assessing the body's compliance with the notice.

(9) In such a case subsection (1)—

(a) does not apply in relation to that review so as to enable the CHAI to serve a further improvement notice on that body in respect of that failure; but

(b) does apply in relation to that review so as to enable the CHAI (if the conditions in subsections (1) and (2) are satisfied) to serve an improvement notice on that body in respect of a different failure to observe the code.

Textual Amendments

F5 Ss. 53A, 53B inserted (1.10.2006) by Health Act 2006 (c. 28), ss. 16, 83(7); S.I. 2006/2603, art. 2

53B Code of practice: action by CHAI following service of improvement notice E+W

(1) This section applies where the CHAI has served an improvement notice on a body under section 53A.

(2) If, before the end of the specified period—

(a) the body requests the CHAI to extend that period, and

(b) the CHAI considers that there are exceptional circumstances which justify its extending that period by a further period of time,

the CHAI may, by a notice served on the body, extend the specified period by that further period.

(3) In this section “the specified period” means—

(a) the period specified under section 53A(3)(c), or

(b) if that period has been extended under subsection (2) above, that period as so extended.

(4) Where the specified period has ended or the body notifies the CHAI before the end of that period that it has complied with the improvement notice, the CHAI must—

(a) conduct a review under section 52(3)(b) with a view to assessing the body's compliance with the notice, and

(b) then comply with subsection (5) or (6);

and the making of any report in accordance with subsection (5) or (6) is to be taken as satisfying the requirement to publish a report under section 52(7) in respect of the review.

(5) If the CHAI—

(a) remains of the view that the relevant provisions of the code are not being observed in any material respect in relation to the provision of health care by or for the body, and

(b) having regard to all the circumstances, is of the view that it is required to make a report under section 53(2) (and, if relevant, section 53(6)),

the CHAI must accordingly make a report under that provision (or, as the case may be, under each of those provisions).

(6) If the CHAI does not make any such report or reports, it must instead make a report—

(a) to the Secretary of State, and

(b) (if the body is an NHS foundation trust) to the regulator,

setting out the matters mentioned in subsection (7) or (8).

(7) If the CHAI is of the view that the relevant provisions of the code are being observed in relation to the provision of health care by or for the body, the matters are—

(a) that the CHAI is of that view, and

(b) its reasons for that view.

(8) If the CHAI is of the view that the relevant provisions of the code are not being so observed in any respect (material or otherwise), the matters are—

(a) that the CHAI is of that view,

(b) its reasons for that view,

(c) if its view is that those provisions are not being observed in any material respect, its reasons for not forming the view mentioned in subsection (5)(b), and

(d) (whether or not paragraph (c) applies) any action which it proposes to take in relation to the body in connection with the failure to observe the code.

(9) The CHAI must send a copy of any report made by it in accordance with subsection (5) or (6) in relation to a Primary Care Trust or an NHS trust to the relevant Strategic Health Authority.

(10) In this section “the relevant provisions of the code” means the provisions of the code in relation to which the CHAI formed the view mentioned in section 53A(1)(a).]

Textual Amendments

F5 Ss. 53A, 53B inserted (1.10.2006) by Health Act 2006 (c. 28), ss. 16, 83(7); S.I. 2006/2603, art. 2

54 Functions relating to Secretary of State and Assembly E+W

(1) The CHAI is to keep the appropriate authority informed about the provision of health care by and for any NHS body.

(2) The CHAI may at any time give advice to the appropriate authority on any matter connected with the provision of such health care (including, in particular, advice on any changes which it thinks should be made to the standards under section 46 or 47[F6 , or any code of practice issued under section 47A,] for the purpose of securing improvement in the quality of the health care).

(3) When requested to do so by the appropriate authority, the CHAI must give the authority advice or information on such matters connected with the provision of health care by or for any NHS body as may be specified in the request.

(4) The CHAI may give advice to the appropriate authority or any NHS body about the establishment or conduct of any inquiry held, or to be held, by the authority or the body in relation to the provision of health care by or for that body.

(5) In this section, the “appropriate authority” means—

(a) the Secretary of State, in relation to the provision of health care by or for an English NHS body or cross-border SHA; or

(b) the Assembly, in relation to the provision of health care by or for a Welsh NHS body.

Textual Amendments

F6 Words in s. 54(2) inserted (1.10.2006) by Health Act 2006 (c. 28), ss. 15(6), 83(7); S.I. 2006/2603, art. 2

Commencement Information

I15 S. 54 in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

55 Reviews of data E+W

(1) The CHAI may review—

(a) the quality of data obtained by others in relation to the provision of health care by and for NHS bodies;

(b) the methods used in the collection and analysis of such data; and

(c) the validity of conclusions drawn from such data.

(2) Where the CHAI conducts a review under this section it must publish a report.

Commencement Information

I16 S. 55 in force at 1.4.2004 by S.I. 2004/759, art. 3(1)

56 Co-ordination of reviews E+W

The CHAI has the function of promoting the effective co-ordination of reviews or assessments carried out by public bodies or other persons in relation to the provision of health care by or for English NHS bodies and cross-border SHAs.

Commencement Information

I17 S. 56 in force at 1.4.2004 by S.I. 2004/759, art. 3(1)