National Health Service Act 2006

Part 12 Public involvement and scrutiny

Chapter 1 Patients' Forums

237 Establishment of Patients' Forums

(1) The Patients' Forums established by the Secretary of State continue in existence, and he must establish a Patients' Forum—

(a) for each NHS trust all or most of whose hospitals, establishments and facilities are situated in England,

(b) for each Primary Care Trust, and

(c) for each NHS foundation trust.

(2) The members of each Patients' Forum must be appointed by the Commission for Patient and Public Involvement in Health.

(3) A Patients' Forum must—

(a) monitor and review the range and operation of services provided by, or under arrangements made by, the trust for which it is established,

(b) obtain the views of patients and their carers about those matters and report on those views to the trust,

(c) provide advice, and make reports and recommendations, about matters relating to the range and operation of those services to the trust,

(d) make available to patients and their carers advice and information about those services,

(e) in prescribed circumstances, perform any prescribed function of the trust with respect to the provision of a service affording assistance to patients and their families and carers,

(f) carry out such other functions as may be prescribed.

(4) In providing advice or making recommendations under subsection (3)(c), a Patients' Forum must have regard to the views of patients and their carers.

(5) If, in the course of exercising its functions, a Patients' Forum becomes aware of any matter which in its view—

(a) should be considered by a relevant overview and scrutiny committee, or

(b) should be brought to the attention of the Commission for Patient and Public Involvement in Health,

the Forum may refer that matter to the committee, or to the Commission.

(6) Subsection (5) does not affect the power of a Patients' Forum to make such other representations or referrals as it considers appropriate, to such persons or bodies as it considers appropriate, about matters arising in the course of it exercising its functions.

(7) Patients' Forums must in prescribed circumstances—

(a) co-operate with each other in the exercise of their functions,

(b) exercise functions jointly with one or more other Forums.

(8) References in subsection (3) to services are references to—

(a) services provided as part of the health service in England,

(b) services provided in England in pursuance of section 75 arrangements in relation to the exercise of health-related functions of a local authority, and

(c) services provided elsewhere (and not as part of the health service in England) in pursuance of section 75 arrangements with a local authority in England.

(9) In this section—

• “carer”, in relation to a patient, means a person who provides care for the patient, but who is not employed to do so by any body in the exercise of its functions under any enactment,

• “patient” includes a person who receives services provided in pursuance of section 75 arrangements in relation to the exercise of health-related functions of a local authority,

• “relevant overview and scrutiny committee”, in relation to a Patients' Forum, means any overview and scrutiny committee in relation to which the Primary Care Trust, NHS trust or NHS foundation trust for which the Forum is established is a local NHS body by virtue of regulations made under section 244(3) (including that provision as read with section 245(5) and as applied by section 247(2)),

• “section 75 arrangements” means arrangements under regulations under section 75.

238 Additional functions of PCT Patients' Forums

(1) A Patients' Forum established for a Primary Care Trust (a “PCT Patients' Forum”) has the following additional functions—

(a) providing independent advocacy services to persons in the Primary Care Trust’s area or persons to whom services have been provided by, or under arrangements with, the Primary Care Trust,

(b) making available to patients and their carers advice and information about the making of complaints in relation to services provided by or under arrangements with the Primary Care Trust, and

(c) representing to persons and bodies which exercise functions in relation to the area of the Primary Care Trust (including, in particular, any relevant overview and scrutiny committee) the views of members of the public in the Primary Care Trust’s area about matters affecting their health.

(2) In subsection (1), references to services have the meaning given by section 237(8).

(3) It is also the function of a PCT Patients' Forum—

(a) to promote the involvement of members of the public in the area of the Primary Care Trust in consultations or processes leading (or potentially leading) to decisions by those mentioned in subsection (4), or the formulation of policies by them, which would or might affect (whether directly or not) the health of those members of the public,

(b) to make available advice and information to such members of the public about such involvement,

(c) to advise those mentioned in subsection (4) about how to encourage such involvement (including, in the case of bodies mentioned in subsection (4) to which section 242 applies, advising them how to comply with the requirements of that section in relation to the area of the Primary Care Trust), and

(d) to monitor how successful those mentioned in subsection (4) are at achieving such involvement.

(4) Those referred to in subsection (3) are—

(a) Strategic Health Authorities whose areas include any part of the area of the Primary Care Trust,

(b) the Primary Care Trust itself,

(c) NHS trusts which provide services to patients in the area of the Primary Care Trust,

(d) other public bodies, and

(e) others providing services to the public or a section of the public.

(5) In this section—

• “carer” and “patient” have the meaning given by section 237,

• “independent advocacy services” means services provided under section 248,

• “relevant overview and scrutiny committee” has the meaning given by section 237.

239 Entry and inspection of premises

(1) The Secretary of State may make regulations requiring—

(a) Strategic Health Authorities,

(b) Primary Care Trusts,

(c) NHS trusts,

(d) NHS foundation trusts,

(e) Local Health Boards,

(f) local authorities,

(g) persons providing primary medical services, primary dental services, or pharmaceutical services under this Act or the National Health Service (Wales) Act 2006 (c. 42),

(h) persons providing primary ophthalmic services under this Act,

(i) persons providing general ophthalmic services under the National Health Service (Wales) Act 2006, or

(j) persons providing piloted services (within the meaning of section 134(7) of this Act or section 92(7) of the National Health Service (Wales) Act 2006) or LP services (within the meaning of paragraph 1(7) of Schedule 12 to this Act or paragraph 1(7) of Schedule 7 to that Act),

to allow members of a Patients' Forum authorised by or under the regulations to enter and inspect, for the purposes of any of the Forum’s functions, premises owned or controlled by those referred to in paragraphs (a) to (j).

(2) The Secretary of State may also make regulations requiring any other person who owns or controls premises where services are provided as mentioned in subsection (1)(g) to (j) to allow members of a Patients' Forum authorised by or under the regulations to enter and inspect the premises for the purposes of any of the Forum’s functions.

(3) The regulations may in particular make provision as to—

(a) cases and circumstances in which access must be permitted,

(b) limitations or conditions to which access must be subject.

240 Annual reports

(1) Each Patients' Forum must—

(a) prepare a report in relation to its activities in each financial year, and

(b) as soon as possible after the end of each financial year, send a copy of its report for that year to the trust for which it is established, and to the persons mentioned in subsection (2).

(2) Those persons are—

(a) the Secretary of State,

(b) the Commission for Patient and Public Involvement in Health,

(c) each Strategic Health Authority whose area includes—

(i) any part of the area of the Primary Care Trust for which the Forum is established, or

(ii) all or most of the hospitals, establishments and facilities of the NHS trust or NHS foundation trust for which the Forum is established,

(d) any relevant overview and scrutiny committee within the meaning given by section 237,

(e) where the report includes provision which relates to any NHS foundation trust, the regulator.

(3) A report under this section relating to any year must include details of the arrangements maintained by the Forum in that year for obtaining the views of patients.

(4) In this section, “financial year”, in relation to a Patients' Forum, means—

(a) the period beginning with the date on which the Forum is established and ending with the next 31st March, and

(b) each successive period of 12 months ending with 31st March.

241 Further provision about Patients' Forums

(1) The Secretary of State may by regulations make further provision in relation to Patients' Forums.

(2) The regulations may in particular make provision as to—

(a) the appointment of members,

(b) any qualification or disqualification for membership,

(c) terms of appointment,

(d) circumstances in which a person ceases to be a member or may be suspended,

(e) the proceedings of Patients' Forums,

(f) the discharge of any function of a Patients' Forum by a committee of the Forum or by a joint committee appointed with another Forum,

(g) the appointment, as members of a committee or joint committee, of persons who are not members of the Forum or Forums concerned,

(h) the funding of Patients' Forums and the provision of premises, other facilities and staff,

(i) the payment of travelling and other allowances to members of a Patients' Forum or of a committee of a Forum or a joint committee of two or more Forums (including attendance allowances or compensation for loss of remunerative time),

(j) the preparation by a Patients' Forum of annual accounts, and their inclusion in accounts of the Commission for Patient and Public Involvement in Health,

(k) the provision of information (including descriptions of information which must or must not be provided) to a Patients' Forum by a Strategic Health Authority, a Primary Care Trust, an NHS trust, an NHS foundation trust, the Commission for Patient and Public Involvement in Health or a person providing independent advocacy services (within the meaning given by section 248),

(l) the provision of information by a Patients' Forum to another person (including another Forum),

(m) the referral of matters by a Patients' Forum to a relevant overview and scrutiny committee (within the meaning given by section 237),

(n) the preparation and publication of reports by Patients' Forums including the publication of reports under section 240,

(o) matters to be included in any such report,

(p) the furnishing and publication by Strategic Health Authorities, Primary Care Trusts, NHS trusts and NHS foundation trusts of comments on reports or recommendations of Patients' Forums.

(3) The regulations must secure that the members of a Patients' Forum include—

(a) at least one person who is a member or representative of a voluntary organisation whose purpose, or one of whose purposes, is to represent the interests of—

(i) persons for whom services are being provided under this Act, or

(ii) persons who provide care for such persons, but who are not employed to do so by any body in the exercise of its functions under any enactment, and

(b) at least one person for whom services are being or have been provided by the trust for which the Patients' Forum is established.

(4) The regulations must also secure that the members of a Patients' Forum established for a Primary Care Trust also include—

(a) at least one member of the Patients' Forum established for each NHS trust or NHS foundation trust all or most of whose hospitals, establishments and facilities are situated in the area of the Primary Care Trust, and

(b) if it appears to the Commission for Patient and Public Involvement in Health that there is a body which represents members of the public in the Primary Care Trust’s area in matters relating to their health, at least one person who is a member or representative of that body (or, if there is more than one such body, of any of those bodies).

(5) The regulations may include provision applying, or corresponding to, any provision of Part 5A of the Local Government Act 1972 (c 70) (access to meetings and documents), with or without modifications.

Chapter 2 Public involvement and consultation

242 Public involvement and consultation

(1) This section applies to—

(a) Strategic Health Authorities,

(b) Primary Care Trusts,

(c) NHS trusts, and

(d) NHS foundation trusts.

(2) Each body to which this section applies must make arrangements with a view to securing, as respects health services for which it is responsible, that persons to whom those services are being or may be provided are, directly or through representatives, involved in and consulted on—

(a) the planning of the provision of those services,

(b) the development and consideration of proposals for changes in the way those services are provided, and

(c) decisions to be made by that body affecting the operation of those services.

(3) For the purposes of this section a body is responsible for health services—

(a) if the body provides or will provide those services to individuals, or

(b) if another person provides, or will provide, those services to individuals—

(i) at that body’s direction,

(ii) on its behalf, or

(iii) in accordance with an agreement or arrangements made by that body with that other person,

and references in this section to the provision of services include references to the provision of services jointly with another person.

(4) Subsection (5) applies to health services for which a Strategic Health Authority is not responsible by virtue of subsection (3), but which are or will be provided to individuals in the area of the Strategic Health Authority, and for which—

(a) a Primary Care Trust any part of whose area falls within the Strategic Health Authority’s area, or

(b) an NHS trust which provides services at or from a hospital or other establishment or facility which falls within the Strategic Health Authority’s area,

is responsible by virtue of subsection (3).

(5) A Strategic Health Authority may give directions to Primary Care Trusts falling within paragraph (a) of subsection (4), and NHS trusts falling within paragraph (b) of that subsection, as to the arrangements which they are to make under subsection (2) in relation to health services to which this subsection applies.

243 The Commission for Patient and Public Involvement in Health

(1) There continues to be a body corporate known as the Commission for Patient and Public Involvement in Health (“the Commission”) to exercise the functions set out in subsections (2) to (5) (in addition to its function of appointing members of Patients' Forums).

(2) The Commission has the following functions—

(a) advising the Secretary of State, and such bodies as may be prescribed, about arrangements for public involvement in, and consultation on, matters relating to the health service in England,

(b) advising the Secretary of State, and such bodies as may be prescribed, about arrangements for the provision in England of independent advocacy services,

(c) representing to the Secretary of State and such bodies as may be prescribed, and advising him and them on, the views, as respects the arrangements referred to in paragraphs (a) and (b), of Patients' Forums and those voluntary organisations and other bodies appearing to the Commission to represent the interests of patients of the health service in England and their carers,

(d) providing staff to Patients' Forums established for Primary Care Trusts, and advice and assistance to Patients' Forums and facilitating the co-ordination of their activities,

(e) advising and assisting providers of independent advocacy services in England,

(f) setting quality standards relating to any aspect of—

(i) the way Patients Forums exercise their functions, and

(ii) the services provided by independent advocacy services in England,

monitoring how successfully they meet those standards, and making recommendations to them about how to improve their performance against those standards,

(g) such other functions in relation to England as may be prescribed.

(3) It is also the function of the Commission to promote the involvement of members of the public in England in consultations or processes leading (or potentially leading) to decisions by those mentioned in subsection (4), or the formulation of policies by them, which would or might affect (whether directly or not) the health of those members of the public.

(4) The decisions in question are those made by—

(a) health service bodies,

(b) other public bodies, and

(c) others providing services to the public or a section of the public.

(5) It is also the function of the Commission—

(a) to review the annual reports of Patients' Forums made under section 240, and

(b) to make, to the Secretary of State or to such other persons or bodies as the Commission considers appropriate, such reports or recommendations as the Commission considers appropriate concerning any matters arising from those annual reports.

(6) If the Commission—

(a) becomes aware in the course of exercising its functions of any matter connected with the health service in England which in its opinion gives rise to concerns about the safety or welfare of patients, and

(b) is not satisfied that the matter is being dealt with, or about the way it is being dealt with,

the Commission must report the matter to whichever person or body it considers most appropriate (or, if it considers it appropriate to do so, to more than one person or body).

(7) Bodies to whom the Commission might report a matter include—

(a) the regulatory body for the profession of a person working in the health service,

(b) the Commission for Healthcare Audit and Inspection.

(8) The Commission may make such charges as it considers appropriate for the provision of advice and other services (but this is subject to any prescribed limitation).

(9) The Secretary of State may by regulations make further provision in relation to the Commission.

(10) The regulations may, in particular, make provision as to the provision of information (including descriptions of information which must or must not be provided) to the Commission by a Strategic Health Authority, a Primary Care Trust, an NHS trust, a Special Health Authority, an NHS foundation trust, a Patients' Forum or a provider of independent advocacy services.

(11) Schedule 16 makes further provision about the Commission.

(12) In this section—

• “carer” and “patient” have the same meaning as in section 237,

• “the health service” includes services provided in pursuance of section 75 arrangements in relation to the exercise of health-related functions of a local authority,

• “health service bodies” means Strategic Health Authorities, Primary Care Trusts, NHS trusts and NHS foundation trusts,

• “independent advocacy services” means services provided under section 248,

• “section 75 arrangements” means arrangements under regulations under section 75.

Chapter 3 Overview and Scrutiny Committees

244 Functions of overview and scrutiny committees

(1) This section applies to any local authority, except that it applies to the council of a district only where the district is comprised in an area for which there is no county council.

(2) Regulations may, in relation to an overview and scrutiny committee of an authority to which this section applies, make provision—

(a) as to matters relating to the health service in the authority’s area which the committee may review and scrutinise,

(b) as to matters relating to the health service in the authority’s area on which the committee may make reports and recommendations to local NHS bodies, the Secretary of State or the regulator,

(c) as to matters on which local NHS bodies must consult the committee in accordance with the regulations (including provision as to circumstances in which the Secretary of State or the regulator may require consultation on those matters in accordance with the regulations),

(d) as to information which local NHS bodies must provide to the committee,

(e) as to information which may not be disclosed by a local NHS body to the committee,

(f) requiring any officer of a local NHS body to attend before the committee to answer questions.

(3) For the purposes of subsection (2), “local NHS body”, in relation to an overview and scrutiny committee, means an NHS body other than a Special Health Authority which is prescribed for those purposes in relation to the committee.

(4) “The health service” includes services provided in pursuance of arrangements under regulations under section 75 in relation to the exercise of health-related functions of a local authority.

245 Joint overview and scrutiny committees etc

(1) In this section, “relevant functions”—

(a) in relation to a local authority operating executive arrangements under Part 2 of the Local Government Act 2000 (c. 22) (“the 2000 Act”), are functions which are, or, but for regulations under this section, would be, exercisable under section 21(2)(f) of that Act by an overview and scrutiny committee of that authority, and

(b) in relation to a local authority operating alternative arrangements under that Part, are any corresponding functions which are, or, but for regulations under this section, would be, exercisable by a committee of the authority falling within paragraph (b) of section 32(1) of that Act,

and references to an overview and scrutiny committee include references to a committee falling within that paragraph.

(2) Regulations may make provision under which—

(a) two or more local authorities may appoint a joint committee of those authorities (a “joint overview and scrutiny committee”) and arrange for relevant functions in relation to any (or all) of those authorities to be exercisable by the committee,

(b) a local authority may arrange for relevant functions in relation to that authority to be exercisable by an overview and scrutiny committee of another local authority,

(c) a county council for any area may arrange for one or more of the members of an overview and scrutiny committee of the council for a district comprised in that area to be appointed as—

(i) a member of an overview and scrutiny committee of the county council or another local authority, for the purposes of relevant functions of the committee in relation to the county council, or

(ii) a member of an overview and scrutiny committee of the county council, for the purposes of relevant functions of the committee in relation to another local authority.

(3) The regulations may in particular—

(a) provide for arrangements to be made only in specified circumstances, or subject to specified conditions or limitations,

(b) in relation to joint overview and scrutiny committees, make provision applying, or corresponding to, any provision of—

(i) section 21(4) and (6) to (15) of the 2000 Act, or

(ii) section 246 of, and Schedule 17 to, this Act, and Schedule 11 to the National Health Service (Wales) Act 2006 (c. 42),

with or without modifications.

(4) The regulations may require, or enable the Secretary of State to direct, a local authority—

(a) to make arrangements of any description within subsection (2), and

(b) to comply with such requirements in connection with the arrangements as may be specified in the regulations or as the Secretary of State may direct.

(5) In section 244(2) and (3), references to an overview and scrutiny committee include references to a joint overview and scrutiny committee.

(6) In subsection (2)(c), references to an overview and scrutiny committee of a county council include references to a joint overview and scrutiny committee of the council and another local authority.

(7) Section 21(4) of the 2000 Act does not apply to the discharge of functions by virtue of arrangements under regulations under subsection (2).

(8) Section 21(10) of the 2000 Act does not apply to persons who are members of an overview and scrutiny committee by virtue of arrangements under regulations under subsection (2)(c).

(9) “Local authority” does not include the Common Council of the City of London.

246 Overview and scrutiny committees: exempt information

(1) This section applies in relation to any item of business at a meeting of an overview and scrutiny committee which is an item relating to functions of the committee under section 21(2)(f) of the Local Government Act 2000 (c. 22).

(2) In relation to any such item, information is exempt information for the purposes of section 100A(4) of the Local Government Act 1972 (c. 70) (exclusion of public from meetings to prevent disclosure of exempt information) if it falls within any of the descriptions of information specified in Schedule 17, or in Schedule 11 to the National Health Service (Wales) Act 2006.

(3) The Secretary of State may by order vary Schedule 17—

(a) by adding any description or other provision in connection with a relevant body or services provided by, or under arrangements made by, a relevant body, or

(b) by deleting or varying any description or other provision specified or contained in that Schedule.

(4) The Secretary of State may exercise the power conferred by subsection (3) by amending any Part of Schedule 17, with or without amendment of any other Part.

(5) In this section and Schedule 17 “relevant body” means a body in respect of which overview and scrutiny committees exercise functions under regulations under section 244.

247 Application to the City of London

(1) The Common Council may establish a committee which has, in relation to the City of London, the powers which under section 21(2)(f) of the Local Government Act 2000 a local authority’s overview and scrutiny committee has in relation to the authority’s area.

(2) Sections 244(2) to (4), 245 and 246 (and Schedule 17 to this Act and Schedule 11 to the National Health Service (Wales) Act 2006 (c. 42)) apply as if such a committee were an overview and scrutiny committee and as if the Common Council were a London borough council.

(3) Section 21 of the Local Government Act 2000 applies as if such a committee were an overview and scrutiny committee and as if the Common Council were a local authority, but with the omission—

(a) of subsections (1) to (3), (5) and (9),

(b) in subsection (8), of “Executive”,

(c) in subsection (11), of paragraph (b), and

(d) in subsection (13)(a), of the reference to members of the executive.

(4) In the provisions applied by subsections (2) and (3), references to functions under any provision of section 21(2) of the 2000 Act are, in the case of the committee established under subsection (1), references to its functions under that subsection.

(5) “The Common Council” means the Common Council of the City of London.