2

A service or facility may be prescribed under subsection (1)(d) only if the Secretary of State considers that it would be appropriate for NHS England to arrange for the provision of that service or facility (whether by NHS England making arrangements itself or by giving directions under section 13YB or making arrangements under section 65Z5).

4A

If the Secretary of State refuses a request by NHS England to revoke provision made by regulations under subsection (1)(d) prescribing a service or facility, the Secretary of State must explain why to NHS England.

12FExpected mental health spending

1

The Secretary of State must, in respect of each financial year, publish and lay before Parliament a document—

a

stating, by comparison with the previous financial year—

i

whether the Secretary of State expects there to be an increase in the amount of expenditure incurred by NHS England and integrated care boards (taken together) in relation to mental health, and

ii

whether the Secretary of State expects there to be an increase in the proportion of the expenditure incurred by NHS England and integrated care boards (taken together) that relates to mental health, and

b

explaining why.

2

The Secretary of State must publish and lay the document before the financial year to which it relates.

2B

The annual report must include—

a

a statement of the amount of expenditure incurred by NHS England and integrated care boards during the year (taken together) in relation to mental health,

b

a calculation of the proportion of the expenditure incurred by NHS England and integrated care boards during the year (taken together) that relates to mental health, and

c

an explanation of the statement and calculation.

a

the extent to which, in that year, it met any objectives or requirements specified in the mandate,

2A

The objectives specified by the Secretary of State under subsection (2)(a) for NHS England must include objectives relating to outcomes for cancer patients, and those objectives are to be treated by NHS England as having priority over any other objectives relating specifically to cancer.

• section 13L;

13SAInformation about inequalities

1

NHS England must publish a statement setting out—

a

a description of the powers available to relevant NHS bodies to collect, analyse and publish information relating to—

i

inequalities between persons with respect to their ability to access health services;

ii

inequalities between persons with respect to the outcomes achieved for them by the provision of health services (including the outcomes described in section 13E(3)); and

b

the views of NHS England about how those powers should be exercised in connection with such information.

2

NHS England may from time to time publish a revised statement under subsection (1).

3

In this section “relevant NHS bodies” means—

a

integrated care boards,

b

NHS trusts established under section 25, and

c

NHS foundation trusts.

1B

The annual report must, in particular, review the extent to which the NHS trust has exercised its functions consistently with NHS England’s views set out in the latest statement published under section 13SA(1) (views about how functions relating to inequalities information should be exercised).

1B

The reports must, in particular, review the extent to which the public benefit corporation has exercised its functions consistently with NHS England’s views set out in the latest statement published under section 13SA(1) (views about how functions relating to inequalities information should be exercised).

Discharge of functions

13YBDirections in respect of functions relating to provision of services

1

NHS England may by direction provide for any of its relevant functions to be exercised by one or more integrated care boards.

2

In this section “relevant function” means—

a

any function of NHS England under section 3B(1) (commissioning functions);

b

any function of NHS England, not within paragraph (a), that relates to the provision of—

i

primary medical services,

ii

primary dental services,

iii

primary ophthalmic services, or

iv

services that may be provided as pharmaceutical services, or as local pharmaceutical services, under Part 7;

c

any function of NHS England by virtue of section 7A or 7B (exercise of Secretary of State’s public health functions);

d

any other functions of NHS England so far as exercisable in connection with any functions within paragraphs (a) to (c).

3

Regulations may—

a

provide that the power in subsection (1) does not apply, or applies only to a prescribed extent, in relation to a prescribed function;

b

impose conditions on the exercise of the power.

4

A direction under subsection (1) may include provision prohibiting or restricting the integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction.

5

In subsection (4) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else.

6

NHS England 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).

7

NHS England may give directions to an integrated care board as to the exercise by it of any functions in pursuance of a direction under subsection (1).

8

As soon as reasonably practicable after giving a direction under subsection (1), NHS England must publish it.

9

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).

ba

section 13YB,

9A

1

NHS England may make arrangements for a person to be seconded to NHS England to serve as a member of NHS England’s staff.

2

A period of secondment to NHS England does not affect the continuity of a person’s employment with the employer from whose service the person is seconded.

3

In paragraphs 9, 10, and 13 a reference to an employee of NHS England includes a person seconded to NHS England.

4

In paragraph 3(3) the reference to an employee of NHS England includes any of the following seconded to NHS England—

a

a person employed in the civil service of the State, or

b

a person employed by—

i

an integrated care board,

ii

an NHS trust established under section 25,

iii

an NHS foundation trust,

iv

a Special Health Authority performing functions only or mainly in respect of England,

v

the Care Quality Commission,

vi

the Health and Social Care Information Centre,

vii

the Health Services Safety Investigations Body,

viii

the Human Tissue Authority,

ix

the Human Fertilisation and Embryology Authority, or

x

NICE.

5

The Secretary of State may by regulations amend this paragraph so as to provide that other references in this Act to an employee of NHS England include persons, or persons of a prescribed description, seconded to NHS England.

CHAPTER A3Integrated care boards

“Establishment of integrated care boards (including by re-purposing clinical commissioning groups)

14Z25Duty to establish integrated care boards

1

NHS England must establish bodies called integrated care boards in accordance with this Chapter.

2

Each integrated care board is to be established by order made by NHS England for an area within England.

3

The area for which an integrated care board is established must not coincide or overlap with the area of any other integrated care board.

4

NHS England must ensure that, at all times on and after the appointed day, the areas of integrated care boards together cover the whole of England.

5

An order establishing an integrated care board must provide for the constitution of the board, either by setting out the constitution or by making provision by reference to a published document where it is set out.

6

In Schedule 1B—

a

Part 1 is about the constitution of an integrated care board (including its area);

b

Part 2 is about the status and powers of an integrated care board and its accounts.

7

Before varying or revoking an order under this section NHS England must consult any integrated care board that it considers likely to be affected.

8

NHS England must publish orders under this section.

9

In this section “the appointed day” means a day appointed under this subsection by regulations made by the Secretary of State.

14Z26Process for establishing initial integrated care boards

1

NHS England must publish a list of the initial areas for which integrated care boards are to be established (each of which is referred to in this section as an “initial area”).

2

The relevant clinical commissioning group or groups for an initial area must propose the constitution of the first integrated care board to be established for that area.

3

Before making a proposal under subsection (2), the relevant clinical commissioning group or groups must consult any persons they consider it appropriate to consult (and it is immaterial for this purpose whether the consultation is carried out before or after this section comes into force).

4

When establishing the first integrated care board under section 14Z25 for an initial area, NHS England must give effect to any proposal under subsection (2) unless it considers that—

a

the proposal is inappropriate, or

b

the relevant clinical commissioning group or groups have not carried out an appropriate consultation under subsection (3),

and in that case NHS England must determine the terms of the constitution itself.

5

Nothing in this section—

a

prevents NHS England from establishing the first integrated care board for an initial area in a case where the relevant clinical commissioning group or groups have failed within a reasonable period to make a proposal under subsection (2), or

b

limits the re-exercise of the power in section 14Z25.

6

NHS England may publish guidance for clinical commissioning groups about the exercise of their functions under this section.

7

A clinical commissioning group must have regard to guidance published under this section.

8

In this section “the relevant clinical commissioning group or groups” means—

a

in relation to an area that coincides with the area of a clinical commissioning group, that group;

b

in relation to an area that includes the whole or part of the area of more than one clinical commissioning group, those groups acting jointly.

14Z27Abolition of clinical commissioning groups

1

Any clinical commissioning group in existence immediately before the appointed day is abolished at the beginning of that day.

2

In this section “the appointed day” has the same meaning as in section 14Z25.

14Z28Transfer schemes in connection with integrated care boards

1

NHS England may, in connection with the abolition of a clinical commissioning group under section 14Z27, make a scheme for the transfer of the group’s property, rights or liabilities to NHS England or an integrated care board.

2

NHS England 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

NHS England,

b

an NHS trust established under section 25,

c

an NHS foundation trust, or

d

a Special Health Authority established under section 28.

3

NHS England 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 NHS England or 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 14 of Schedule 1B.

5

NHS England must exercise its powers under subsection (1) or (3) so as to ensure that—

a

on the abolition of a clinical commissioning group whose area coincides with that of an integrated care board, all of the group’s property, rights and liabilities (other than criminal liabilities) are transferred to that board;

b

on the abolition of a clinical commissioning group whose area does not coincide with that of an integrated care board, all of the group’s property, rights and liabilities (other than criminal liabilities) are transferred to one or more integrated care boards;

c

on the abolition of an integrated care board, all of the board’s liabilities (other than criminal liabilities) are transferred.

6

The things that may be transferred under a transfer scheme include—

a

property, rights and liabilities that could not otherwise be transferred;

b

property acquired, and rights and liabilities arising, after the making of the scheme;

c

criminal liabilities.

7

A transfer scheme may—

a

create rights, or impose liabilities, in relation to property or rights transferred;

b

make provision about the continuing effect of things done by, on behalf of or in relation to the transferor in respect of anything transferred;

c

make provision about the continuation of things (including legal proceedings) in the process of being done by, on behalf of or in relation to the transferor in respect of anything transferred;

d

make provision for references to the transferor in an instrument or other document in respect of anything transferred to be treated as references to the transferee;

e

make provision for the shared ownership or use of property;

f

make provision which is the same as or similar to the TUPE regulations;

g

make other consequential, supplementary, incidental or transitional provision.

8

A transfer scheme may provide—

a

for modifications by agreement;

b

for modifications to have effect from the date when the original scheme came into effect.

9

In subsection (7)(f), “the TUPE regulations” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).

10

In this section—

a

references to rights and liabilities include rights and liabilities relating to a contract of employment;

b

references to the transfer of property include the grant of a lease.

Constitution: publication

14Z29Duty for integrated care board to publish constitution

Each integrated care board must publish its constitution (as varied from time to time by order under section 14Z25 or under provision included in its constitution by virtue of paragraph 15 of Schedule 1B).

Conflicts of interest

14Z30Register of interests and management of conflicts of interests

1

Each integrated care board must maintain one or more registers of the interests of—

a

members of the board,

b

members of its committees or sub-committees, and

c

its employees.

2

Each integrated care board must publish the registers maintained under subsection (1) or make arrangements to ensure that members of the public have access to the registers on request.

3

Each integrated care board must make arrangements to ensure—

a

that a person mentioned in subsection (1) declares any conflict or potential conflict of interest that the person has in relation to a decision to be made in the exercise of the commissioning functions of the integrated care board,

b

that any such declaration is made as soon as practicable after the person becomes aware of the conflict or potential conflict and, in any event, within 28 days of the person becoming aware, and

c

that any such declaration is included in the registers maintained under subsection (1).

4

Each integrated care board must make arrangements for managing conflicts and potential conflicts of interest in such a way as to ensure that they do not, and do not appear to, affect the integrity of the board’s decision-making processes.

5

For the purposes of this section, the commissioning functions of an integrated care board are the functions of the board in arranging for the provision of services as part of the health service.

za

section 14Z25(2),

People for whom integrated care board has responsibility

14Z31People for whom integrated care board has responsibility

1

NHS England must from time to time publish rules for determining the group of people for whom each integrated care board has core responsibility.

2

The rules must ensure that the following are allocated to at least one group—

a

everyone who is provided with NHS primary medical services, and

b

everyone who is usually resident in England and is not provided with NHS primary medical services.

3

Regulations may create exceptions to subsection (2) in relation to people of a prescribed description (which may include a description framed by reference to the primary medical services with which the people are provided).

4

References in this Act to the group of people for whom an integrated care board has core responsibility are to be read in accordance with this section.

5

In this section, “NHS primary medical services” means services provided by a person, other than NHS England or an integrated care board, in pursuance of—

a

a general medical services contract to provide primary medical services of a prescribed description,

b

arrangements under section 83(2) for the provision of primary medical services of a prescribed description, or

c

section 92 arrangements for the provision of primary medical services of a prescribed description.

General duties of integrated care boards

14Z32Duty to promote NHS Constitution

1

Each integrated care board must, in the exercise of its functions—

a

act with a view to securing that health services are provided in a way which promotes the NHS Constitution, and

b

promote awareness of the NHS Constitution among patients, staff and members of the public.

2

In this section, “patients” and “staff” have the same meaning as in Chapter 1 of Part 1 of the Health Act 2009 (see section 3(7) of that Act).

14Z33Duty as to effectiveness, efficiency etc

Each integrated care board must exercise its functions effectively, efficiently and economically.

14Z34Duty as to improvement in quality of services

1

Each integrated care board must exercise its functions with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness.

2

In discharging its duty under subsection (1), an integrated care board must, in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services.

3

The outcomes relevant for the purposes of subsection (2) include, in particular, outcomes which show—

a

the effectiveness of the services,

b

the safety of the services, and

c

the quality of the experience undergone by patients.

14Z35Duties as to reducing inequalities

Each integrated care board must, in the exercise of its functions, have regard to the need to—

a

reduce inequalities between persons with respect to their ability to access health services, and

b

reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services (including the outcomes described in section 14Z34(3)).

14Z36Duty to promote involvement of each patient

Each integrated care board must, in the exercise of its functions, 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.

14Z37Duty as to patient choice

Each integrated care board must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.

14Z38Duty to obtain appropriate advice

Each integrated care board must obtain advice appropriate for enabling it effectively to discharge its functions from persons who (taken together) have a broad range of professional expertise in—

a

the prevention, diagnosis or treatment of illness, and

b

the protection or improvement of public health.

14Z39Duty to promote innovation

Each integrated care board must, in the exercise of its functions, promote innovation in the provision of health services (including innovation in the arrangements made for their provision).

14Z40Duty in respect of research

Each integrated care board must, in the exercise of its functions, facilitate or otherwise promote—

a

research on matters relevant to the health service, and

b

the use in the health service of evidence obtained from research.

14Z41Duty to promote education and training

Each integrated care board must, in exercising its functions, have regard to the need to promote education and training for the persons mentioned in section 1F(1) so as to assist the Secretary of State and Health Education England in the discharge of the duty under that section.

14Z42Duty to promote integration

1

Each integrated care board must exercise its functions with a view to securing that health services are provided in an integrated way where it considers that this would—

a

improve the quality of those services (including the outcomes that are achieved from their provision),

b

reduce inequalities between persons with respect to their ability to access those services, or

c

reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services.

2

Each integrated care board must exercise its functions with a view to securing that the provision of health services is integrated with the provision of health-related services or social care services where it considers that this would—

a

improve the quality of the health services (including the outcomes that are achieved from the provision of those services),

b

reduce inequalities between persons with respect to their ability to access those services, or

c

reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services.

3

In this section—

• “health-related services” means services that may have an effect on the health of individuals but are not health services or social care services;

• “social care services” means services that are provided in pursuance of the social services functions of local authorities (within the meaning of the Local Authority Social Services Act 1970 or for the purposes of the Social Services and Well-being (Wales) Act 2014).

4

For the purposes of this section, the provision of housing accommodation is a health-related service.

14Z43Duty to have regard to wider effect of decisions

1

In making a decision about the exercise of its functions, an integrated care board must have regard to all likely effects of the decision in relation to—

a

the health and well-being of the people of England;

b

the quality of services provided to individuals—

i

by relevant bodies, or

ii

in pursuance of arrangements made by relevant bodies,

for or in connection with the prevention, diagnosis or treatment of illness, as part of the health service in England;

c

efficiency and sustainability in relation to the use of resources by relevant bodies for the purposes of the health service in England.

2

In subsection (1)—

a

the reference to a decision does not include a reference 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;

b

the reference to effects of a decision in relation to the health and well-being of the people of England includes a reference to its effects in relation to inequalities between the people of England with respect to their health and well-being;

c

the reference to effects of a decision in relation to the quality of services provided to individuals includes a reference to its effects in relation to inequalities between individuals with respect to the benefits that they can obtain from those services.

3

In discharging the duty under this section, integrated care boards must have regard to guidance published by NHS England under section 13NB.

4

In this section “relevant bodies” means—

a

NHS England,

b

integrated care boards,

c

NHS trusts established under section 25, and

d

NHS foundation trusts.

14Z44Duties as to climate change etc

1

Each integrated care board must, in the exercise of its functions, have regard to the need to—

a

contribute towards compliance with—

i

section 1 of the Climate Change Act 2008 (UK net zero emissions target), and

ii

section 5 of the Environment Act 2021 (environmental targets), and

b

adapt to any current or predicted impacts of climate change identified in the most recent report under section 56 of the Climate Change Act 2008.

2

In discharging the duty under this section, integrated care boards must have regard to guidance published by NHS England under section 13ND.

Involvement of the public

14Z45Public involvement and consultation by integrated care boards

1

This section applies in relation to any health services which are, or are to be, provided pursuant to arrangements made by an integrated care board in the exercise of its functions (“commissioning arrangements”).

2

The integrated care board must make arrangements to secure that individuals to whom the services are being or may be provided, and their carers and representatives (if any), are involved (whether by being consulted or provided with information or in other ways)—

a

in the planning of the commissioning arrangements by the integrated care board,

b

in the development and consideration of proposals by the integrated care board 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 (at the point when the service is received by them), or

ii

the range of health services available to them, and

c

in decisions of the integrated care board affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.

3

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—

a

in a case where the administrator’s report relates to an NHS trust, NHS England and the Secretary of State have made their decisions under section 65K(1) and (2), or

b

in a case where the administrator’s report relates to an NHS foundation trust, the Secretary of State is satisfied as mentioned in section 65KB(1) or 65KD(1) or makes a decision under section 65KD(9).

Joint exercise of functions with Local Health Boards

14Z46Joint exercise of functions with Local Health Boards

1

Regulations may provide for any prescribed functions of an integrated care board to be exercised jointly with a Local Health Board.

2

The regulations may permit or require any functions that are exercisable jointly by an integrated care board and a Local Health Board by virtue of the regulations to be exercised by a joint committee of those bodies.

3

Arrangements made by virtue of this section do not affect the liability of an integrated care board for the exercise of any of its functions.

Additional powers of integrated care boards

14Z47Raising additional income

1

An integrated care board has power to do anything specified in section 7(2)(a), (b) and (e) to (h) of the Health and Medicines Act 1988 (provision of goods etc) for the purpose of making additional income available for improving the health service.

2

An integrated care board may exercise a power conferred by subsection (1) only to the extent that its exercise does not to any significant extent interfere with the exercise by the board of its other functions.

14Z48Power to make grants

1

An integrated care board may make payments—

a

by way of grant to any of its partner NHS trusts or NHS foundation trusts;

b

by way of grant or loan to a voluntary organisation which provides or arranges for the provision of services which are similar to the services in respect of which the integrated care board has functions.

2

The payments may be made subject to such terms as the integrated care board considers appropriate.

3

For the purposes of this Act an NHS trust or NHS foundation trust is a “partner” of an integrated care board if the trust—

a

provides services for the purposes of the health service within the integrated care board’s area, and

b

has the function, under the integrated care board’s constitution, of participating in the nomination of members as a result of falling within a description prescribed for the purposes paragraph 8(2)(a) of Schedule 1B.

Experience of members

14Z49Duty to keep experience of members under review etc

An integrated care board must—

a

keep under review the skills, knowledge and experience that it considers necessary for members of the board to possess (when taken together) in order for the board effectively to carry out its functions, and

b

if it considers that the board as constituted lacks the necessary skills, knowledge and experience, take such steps as it considers necessary to address or mitigate that shortcoming.

NHS England’s functions in relation to integrated care boards

14Z50Responsibility for payments to providers

1

NHS England may publish a document specifying—

a

circumstances in which an integrated care board is liable to make a payment to a person in respect of services provided by that person in pursuance of arrangements made by another integrated care board in the discharge of commissioning functions, and

b

how the amount of any such payment is to be determined.

2

An integrated care board is required to make payments in accordance with any document published under subsection (1).

3

Where an integrated care board is required to make a payment by virtue of subsection (2), no other integrated care board is liable to make it.

4

Accordingly, any obligation of another integrated care board to make the payment ceases to have effect.

5

Any sums payable by virtue of subsection (2) may be recovered summarily as a civil debt (but this does not affect any other method of recovery).

6

NHS England may publish guidance for integrated care boards for the purpose of assisting them in understanding and applying any document published under subsection (1).

7

In this section “commissioning functions” means the functions of integrated care boards in arranging for the provision of services as part of the health service.

14Z51Guidance by NHS England

1

NHS England must publish guidance for integrated care boards on the discharge of their functions.

2

Each integrated care board must have regard to guidance under this section.

Forward planning and reports

14Z52Joint forward plans for integrated care board and its partners

1

Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out how they propose to exercise their functions in the next five years.

2

The plan must, in particular—

a

describe the health services for which the integrated care board proposes to make arrangements in the exercise of its functions by virtue of this Act;

b

explain how the integrated care board proposes to discharge its duties under—

i

sections 14Z34 to 14Z45 (general duties of integrated care boards), and

ii

sections 223GB to 223N (financial duties);

c

set out any steps that the integrated care board proposes to take to implement any joint local health and wellbeing strategy to which it is required to have regard under section 116B(1) of the Local Government and Public Involvement in Health Act 2007;

d

set out any steps that the integrated care board proposes to take to address the particular needs of children and young persons under the age of 25;

e

set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).

3

The integrated care board and its partner NHS trusts and NHS foundation trusts must publish the plan.

4

The integrated care board and its partner NHS trusts and NHS foundation trusts must give a copy of the plan to—

a

the integrated care partnership for the board’s area,

b

each relevant Health and Wellbeing Board, and

c

NHS England.

5

NHS England may give a direction as to the date by which subsection (4) must be complied with.

6

An integrated care board and its partner NHS trusts and NHS foundation trusts must have regard to the plan under subsection (1).

7

In this Chapter “relevant Health and Wellbeing Board”, in relation to an integrated care board (or an integrated care board and its partner NHS trusts and NHS foundation trusts), 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.

8

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.

14Z53Revision of forward plans

1

An integrated care board and its partner NHS trusts and NHS foundation trusts may revise a plan published under section 14Z52.

2

If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in a way that they consider to be significant, section 14Z52(3) and (4) apply in relation to the revised plan as they applied in relation to the original plan.

3

If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in any other way they must—

a

publish a document setting out the changes, and

b

give a copy of the document to—

i

the integrated care partnership for the board’s area,

ii

each relevant Health and Wellbeing Board, and

iii

NHS England.

14Z54Consultation about forward plans

1

This section applies where an integrated care board and its partner NHS trusts and NHS foundation trusts are—

a

preparing a plan under section 14Z52, or

b

revising a plan under section 14Z53 in a way that they consider to be significant.

2

The integrated care board and its partner NHS trusts and NHS foundation trusts must consult—

a

the group of people for whom the integrated care board has core responsibility, and

b

any other persons they consider it appropriate to consult.

3

The integrated care board and its partner NHS trusts and NHS foundation trusts must involve each relevant Health and Wellbeing Board in preparing or revising the plan.

4

The integrated care board and its partner NHS trusts and NHS foundation trusts must, in particular—

a

give each relevant Health and Wellbeing Board a draft of the plan or (as the case may be) the plan as revised, and

b

consult each relevant Health and Wellbeing Board on whether the draft takes proper account of each joint local health and wellbeing strategy published by it which relates to the period (or any part of the period) to which the plan relates.

5

Where a Health and Wellbeing Board is consulted under subsection (4)(b)—

a

it must respond with its opinion on the matter mentioned there;

b

it may also give that opinion to NHS England.

6

Where a Health and Wellbeing Board gives its opinion to NHS England under subsection (5)(b) it must inform the integrated care board and its partner NHS trusts and NHS foundation trusts that it has done so (unless it informed them, in advance, that it was planning to do so).

7

If an integrated care board and its partner NHS trusts and NHS foundation trusts revise or further revise a draft after it has been given to each relevant Health and Wellbeing Board under subsection (4), subsections (4) and (5) apply in relation to the revised draft as they applied in relation to the original draft.

8

An integrated care board and its partner NHS trusts and NHS foundation trusts must include in a plan published under section 14Z52(3)—

a

a summary of the views expressed by anyone consulted under subsection (2),

b

an explanation of how they took account of those views, and

c

a statement of the final opinion of each relevant Health and Wellbeing Board consulted in relation to the plan under subsection (4).

9

In this section, “joint local health and wellbeing strategy” means a strategy under section 116A of the Local Government and Public Involvement in Health Act 2007.

14Z55Opinion of Health and Wellbeing Boards on forward plan

1

A relevant Health and Wellbeing Board—

a

may give NHS England its opinion on whether a plan published by an integrated care board and its partner NHS trusts and NHS foundation trusts under section 14Z52(3) takes proper account of each joint local health and wellbeing strategy published by the Health and Wellbeing Board which relates to the period (or any part of the period) to which the plan relates, and

b

if it does so, must give the integrated care board and its partner NHS trusts and NHS foundation trusts a copy of its opinion.

2

In this section, “joint local health and wellbeing strategy” has the same meaning as in section 14Z54(9).

14Z56Joint capital resource use plan for integrated care board and its partners

1

Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out their planned capital resource use.

2

The plan must relate to such period as may be specified in a direction by the Secretary of State.

3

The Secretary of State must publish any direction under subsection (2).

4

The integrated care board and its partner NHS trusts and NHS foundation trusts must publish the plan.

5

The integrated care board and its partner NHS trusts and NHS foundation trusts must give a copy of the plan to—

a

the integrated care partnership for the board’s area,

b

each relevant Health and Wellbeing Board, and

c

NHS England.

6

NHS England may give a direction as to the date by which subsection (5) must be complied with.

7

NHS England may publish guidance about the discharge by an integrated care board and its partner NHS trusts and NHS foundation trusts of their functions under this section.

8

An integrated care board and its partner NHS trusts and NHS foundation trusts must have regard to any guidance published under subsection (7).

9

NHS England may give directions, in relation to a financial year—

a

specifying descriptions of resources which must, or must not, be treated as capital resources for the purposes of this section;

b

specifying uses of capital resources which must, or must not, be taken into account for the purposes of this section.

10

The reference in subsection (1) to the use of capital resources is a reference to its expenditure, consumption or reduction in value.

14Z57Revision of joint capital resource use plans

1

An integrated care board and its partner NHS trusts and NHS foundation trusts may revise a plan published under section 14Z56.

2

If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in a way that they consider to be significant, section 14Z56(4) and (5) apply in relation to the revised plan as they applied in relation to the original plan.

3

If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in any other way, they must—

a

publish a document setting out the changes, and

b

give a copy of the document to—

i

the integrated care partnership for the board’s area,

ii

each relevant Health and Wellbeing Board, and

iii

NHS England.

14Z58Annual report

1

An integrated care board must, in each financial year, prepare a report (an “annual report”) on how it has discharged its functions in the previous financial year.

2

An annual report must, in particular—

a

explain how the integrated care board has discharged its duties under sections 14Z34 to 14Z45 and 14Z49 (general duties of integrated care boards),

b

review the extent to which the board has exercised its functions in accordance with the plans published under—

• section 14Z52 (forward plan), and

• section 14Z56 (capital resource use plan),

c

review the extent to which the board has exercised its functions consistently with NHS England’s views set out in the latest statement published under section 13SA(1) (views about how functions relating to inequalities information should be exercised), and

d

review any steps that the board has taken to implement any joint local health and wellbeing strategy to which it was required to have regard under section 116B(1) of the Local Government and Public Involvement in Health Act 2007.

3

In undertaking the review required by subsection (2)(d), an integrated care board must consult each relevant Health and Wellbeing Board.

4

An annual report must include—

a

a statement of the amount of expenditure incurred by the integrated care board during the financial year in relation to mental health,

b

a calculation of the proportion of the expenditure incurred by the integrated care board during the financial year that relates to mental health, and

c

an explanation of the statement and calculation.

5

NHS England may give directions to integrated care boards as to the form and content of an annual report.

6

An integrated care board must—

a

give a copy of its annual report to NHS England before the date specified by NHS England in a direction, and

b

publish a copy of the annual report.

Performance assessment of integrated care boards

14Z59Performance assessment of integrated care boards

1

NHS England 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 assessment must, in particular, include an assessment of how well the integrated care board has discharged its duties under—

a

section 14Z34 (improvement in quality of services),

b

section 14Z35 (reducing inequalities),

c

section 14Z38 (obtaining appropriate advice),

d

section 14Z40 (duty in respect of research),

e

section 14Z43 (duty to have regard to effect of decisions),

f

section 14Z45 (public involvement and consultation),

g

sections 223GB to 223N (financial duties), and

h

section 116B(1) of the Local Government and Public Involvement in Health Act 2007 (duty to have regard to assessments and strategies).

4

In conducting a performance assessment, NHS England must consult each relevant Health and Wellbeing Board as to its views on any steps that the board has taken to implement any joint local health and wellbeing strategy to which the board was required to have regard under section 116B(1) of that Act of 2007.

5

In conducting a performance assessment, NHS England must, in particular, have regard to—

a

any guidance published by the Secretary of State for the purposes of this section, and

b

any guidance published under section 14Z51.

6

NHS England must publish a report in respect of each financial year containing a summary of the results of each performance assessment conducted by NHS England in respect of that year.

Power of NHS England to obtain information

14Z60Power of NHS England to obtain information

1

NHS England may require an integrated care board to provide NHS England with information.

2

The information must be provided in such form, and at such time or within such period, as NHS England may require.

Intervention powers

14Z61Power to give directions to integrated care boards

1

This section applies if NHS England is satisfied that—

a

an integrated care board is failing or has failed to discharge any of its functions, or

b

there is a significant risk that an integrated care board will fail to do so.

2

NHS England may direct the integrated care board to discharge such of those functions in such manner and within such period or periods as may be specified in the direction.

3

NHS England may direct—

a

the integrated care board, or

b

the chief executive of the integrated care board,

to cease to perform any functions for such period or periods as may be specified in the direction.

4

NHS England 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 a direction is given under subsection (3)(a) NHS England may—

a

exercise, on behalf of the integrated care board, any of the functions that are the subject of the direction;

b

direct another integrated care board to perform any of those functions on behalf of the integrated care board, in such manner and within such period or periods as may be specified in the direction.

6

A direction under subsection (5)(b) may include provision prohibiting or restricting the integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction.

7

In subsection (6) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else.

8

Where a direction is given under subsection (3)(b) NHS England may—

a

exercise, on behalf of the chief executive, any of the functions that are the subject of the direction;

b

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.

9

For the purposes 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 NHS England considers to be the interests of the health service.

14Z62Section 14Z61 directions: consultation and cooperation

1

Before exercising the power conferred by section 14Z61(5)(b) or (8)(b) NHS England 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.

2

Where a direction is given under section 14Z61(3)(b) 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 (8)(b).

Disclosure of information

14Z63Permitted disclosures of information

1

An integrated care board may disclose information obtained by it in the exercise of its functions if—

a

the information has previously been lawfully disclosed to the public,

b

the disclosure is made under or pursuant to regulations under section 113 or 114 of the Health and Social Care (Community Health and Standards) Act 2003 (complaints about health care or social services),

c

the disclosure is made in accordance with any enactment or court order,

d

the disclosure is necessary or expedient for the purposes of protecting the welfare of any individual,

e

the disclosure is made to any person in circumstances where it is necessary or expedient for the person to have the information for the purpose of exercising functions of that person under any enactment,

f

the disclosure is made for the purpose of facilitating the exercise of any of the integrated care board’s functions,

g

the disclosure is made in connection with the investigation of a criminal offence (whether or not in the United Kingdom), or

h

the disclosure is made for the purpose of criminal proceedings (whether or not in the United Kingdom).

2

Subsection (1)(a) to (c) and (h) have effect notwithstanding any rule of common law which would otherwise prohibit or restrict the disclosure.

Interpretation

14Z64Interpretation

In this Chapter—

• “the health service” means the health service in England;

• “health services” means services provided as part of the health service;

• “integrated care partnership” has the meaning given by section 116ZA(1) of the Local Government and Public Involvement in Health Act 2007;

• “relevant Health and Wellbeing Board”, in relation to an integrated care board, has the meaning given by section 14Z52(7).

ja

an integrated care board;

116ZAIntegrated care partnerships

1

An integrated care board and each responsible local authority whose area coincides with or falls wholly or partly within the board’s area must establish a joint committee for the board’s area (an “integrated care partnership”).

2

The integrated care partnership for an area is to consist of—

a

one member appointed by the integrated care board,

b

one member appointed by each of the responsible local authorities, and

c

any members appointed by the integrated care partnership.

3

An integrated care partnership may determine its own procedure (including quorum).

116ZBIntegrated care strategies

1

An integrated care partnership must prepare a strategy (an “integrated care strategy”) setting out how the assessed needs in relation to its area are to be met by the exercise of functions of—

a

the integrated care board for its area,

b

NHS England, or

c

the responsible local authorities whose areas coincide with or fall wholly or partly within its area.

2

In preparing a strategy under this section, an integrated care partnership must, in particular, consider the extent to which the needs could be met more effectively by the making of arrangements under section 75 of the National Health Service Act 2006 (rather than in any other way).

3

In preparing a strategy under this section, an integrated care partnership must have regard to—

a

the mandate published by the Secretary of State under section 13A of the National Health Service Act 2006, and

b

any guidance issued by the Secretary of State.

4

In preparing a strategy under this section, an integrated care partnership must—

a

involve the Local Healthwatch organisations whose areas coincide with or fall wholly or partly within its area, and

b

involve the people who live or work in that area.

5

An integrated care partnership may include in a strategy under this section a statement of its views on how arrangements for the provision of health-related services in its area could be more closely integrated with arrangements for the provision of health services and social care services in that area.

6

Each time that an integrated care partnership receives an assessment of relevant needs under section 116(5A) it must—

a

consider whether the current integrated care strategy should be revised, and

b

if so, prepare a revised integrated care strategy under subsection (1).

7

An integrated care partnership must—

a

publish each integrated care strategy, and

b

give a copy of each integrated care strategy to—

i

each responsible local authority whose area coincides with or falls wholly or partly within its area, and

ii

each partner integrated care board of those responsible local authorities.

8

In this section—

a

“assessed needs”, in relation to the area of an integrated care partnership, means the needs assessed under section 116 in relation to the areas of the responsible local authorities so far as those needs relate to the integrated care partnership’s area;

b

“partner integrated care board”, in relation to a responsible local authority, has the same meaning as in section 116;

c

“health services”, “health-related services” and “social care services” have the same meaning as in section 195 of the Health and Social Care Act 2012.

116BDuty to have regard to assessments and strategies

1

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,

b

any integrated care strategy prepared under section 116ZB in relation to an area that coincides with or includes the whole or part of the responsible local authority’s area, and

c

any joint local health and wellbeing strategy prepared under section 116A by the responsible local authority and its partner integrated care boards.

2

NHS England must, in exercising any functions in arranging for the provision of health services in relation to the area of a responsible local authority, have regard to the following so far as relevant—

a

any assessment of relevant needs prepared under section 116 in relation to that area,

b

any integrated care strategy prepared under section 116ZB in relation to an area that coincides with or includes the whole or part of that area, and

c

any joint local health and wellbeing strategy prepared under section 116A by the responsible local authority and its partner integrated care boards.

Integrated care boards

223GBPower to impose financial requirements on integrated care boards

1

NHS England may give integrated care boards directions about their management or use of financial or other resources.

2

The directions that may be given include a direction imposing limits on expenditure or resource use by integrated care boards.

3

NHS England must publish any directions under this section.

223GCFinancial duties of integrated care boards: expenditure limits

1

An integrated care board must exercise its functions with a view to ensuring that expenditure incurred by the board in a financial year does not exceed the sums received by it in that year.

2

NHS England may by direction—

a

specify descriptions of expenditure that are, or are not, to be treated for the purposes of this section as expenditure incurred by an integrated care board, or expenditure incurred by it in a particular financial year;

b

specify descriptions of sums that are, or are not, to be treated for the purposes of this section as having been received by an integrated care board, or as having been received by it in a particular financial year;

c

provide for sums received by an integrated care board under section 223G in a year but not spent to be treated for the purposes of this section as expenditure incurred by it in a particular financial year.

3

For the purposes of this section any sum allotted to an integrated care board for a year under section 223G is to be treated as received by it in that year (subject to any direction under subsection (2)(b)).

223GDIntegrated care boards: banking facilities

The Secretary of State may give integrated care boards directions requiring them to use specified banking facilities for any specified purposes.

Joint duties of an integrated care board and its partner NHS trusts and NHS foundation trusts

223LJoint financial objectives for integrated care boards etc

1

NHS England may set joint financial objectives for integrated care boards and their partner NHS trusts and NHS foundation trusts.

2

An integrated care board and its partner NHS trusts and NHS foundation trusts must seek to achieve any financial objectives set under this section.

3

Financial objectives under this section may apply to—

a

integrated care boards and their partner NHS trusts and NHS foundation trusts generally,

b

a particular integrated care board and its partner NHS trusts and NHS foundation trusts, or

c

an integrated care board of a particular description and its partner NHS trusts and NHS foundation trusts.

223MFinancial duties of integrated care boards etc: use of resources

1

Each integrated care board and its partner NHS trusts and NHS foundation trusts must exercise their functions with a view to ensuring that, in respect of each financial year—

a

local capital resource use does not exceed the limit specified in a direction by NHS England;

b

local revenue resource use does not exceed the limit specified in a direction by NHS England.

2

In this section “local capital resource use” and “local revenue resource use” means the use of capital resources or (as the case may be) revenue resources by the integrated care board and its partner NHS trusts and NHS foundation trusts, other than use that consists of the transfer of resources between those bodies.

3

Where an NHS trust or NHS foundation trust is the partner of more than one integrated care board, its use of capital resources or revenue resources is to be apportioned for the purposes of this section to one or more of the integrated care boards in such manner as may be provided for in a direction by NHS England.

4

NHS England may by direction make provision for determining to which integrated care board, NHS trust or NHS foundation trust a use of capital resources or revenue resources is to be attributed for the purposes of this section.

223NFinancial duties of integrated care boards etc: additional controls on resource use

1

NHS England may direct an integrated care board and its partner NHS trusts and NHS foundation trusts to exercise their functions with a view to—

a

ensuring that local capital resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified;

b

ensuring that local revenue resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified.

2

A direction under subsection (1) may—

a

specify descriptions of resources which must, or must not, be treated as local capital resources or local revenue resources for the purposes of the direction;

b

specify uses of local capital resources or local revenue resources which must, or must not, be taken into account for the purposes of the direction.

3

Any directions given under section 223M(3) or (4) apply for the purposes of this section as they apply for the purposes of section 223M.

4

In this section “local capital resource use” and “local revenue resource use” have the meaning given by section 223M(2).

Directions about resources etc to be taken into account

223OResources etc relevant to section 223D, 223E or 223M

The Secretary of State may give directions, in relation to a financial year—

a

specifying descriptions of resources which must, or must not, be treated as capital resources or revenue resources for the purposes of section 223D, 223E or 223M;

b

specifying uses of capital resources or revenue resources which must, or must not, be taken into account for the purposes of section 223D, 223E or 223M.

223LAFinancial duties of integrated care boards etc: expenditure limits

1

An integrated care board and its partner NHS trusts and NHS foundation trusts must exercise their functions with a view to ensuring that their expenditure in a financial year (taken together) does not exceed the aggregate of any sums received by them in the year.

2

Where an NHS trust or NHS foundation trust is the partner of more than one integrated care board its receipts and expenditure are to be apportioned for the purposes of this section to one or more of the integrated care boards in such manner as may be provided for in a direction by NHS England.

3

NHS England may by direction—

a

specify descriptions of expenditure that are, or are not, to be treated for the purposes of this section as expenditure incurred by a body, or expenditure incurred by it in a particular financial year;

b

specify descriptions of sums that are, or are not, to be treated for the purposes of this section as having been received by a body, or as having been received by it in a particular financial year;

c

provide for sums received by an integrated care board under section 223G in a year but not spent to be treated for the purposes of this section as expenditure by it in a particular financial year.

4

For the purposes of this section any sum allotted to an integrated care board for a year under section 223G is to be treated as received by it in that year (subject to any direction under subsection (3)(b)).

46BReviews and performance assessments: integrated care system

1

The Commission must, in accordance with this section—

a

conduct reviews of—

i

the provision of relevant health care, and adult social care, within the area of each integrated care board, and

ii

the exercise of the functions of the following in relation to the provision of that care within the area of each integrated care board: the board; its partner local authorities; and registered service providers,

b

assess the functioning of the system for the provision of relevant health care, and adult social care, within the area of each integrated care board (taking into account, in particular, how those mentioned in paragraph (a)(ii) work together), and

c

publish a report of its assessment.

2

The Secretary of State—

a

must set, and may from time to time revise, objectives and priorities for the Commission in relation to assessments under this section, and

b

must inform the Commission of the objectives and priorities.

3

The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services.

4

The Commission—

a

must determine, and may from time to time revise, indicators of quality for the purposes of assessments under this section, and

b

must obtain the approval of the Secretary of State in relation to the indicators.

5

The Secretary of State may direct the Commission to revise the indicators under subsection (4).

6

Different objectives and priorities may be set, and different indicators of quality may be determined, for different cases.

7

The Commission—

a

must prepare, and may from time to time revise, a statement—

i

setting out the frequency with which reviews under this section are to be conducted and the period to which they are to relate, and

ii

describing the method that it proposes to use in assessing and evaluating the functioning of the system for the provision of relevant health care, and adult social care, within the area of an integrated care board, and

b

must obtain the approval of the Secretary of State in relation to the statement.

8

The statement may—

a

make different provision about frequency and period of reviews for different cases, and

b

describe different methods for different cases.

9

Before preparing or revising a statement under subsection (7) the Commission must consult—

a

NHS England, and

b

any other persons it considers appropriate.

10

The Secretary of State may direct the Commission to revise the statement under subsection (7).

11

The Commission must publish—

a

the objectives and priorities under subsection (2),

b

the indicators of quality under subsection (4), and

c

the statement under subsection (7).

12

For the purposes of this section—

• “adult social care” means social care for individuals aged 18 or over;

• “partner local authority”, in relation to an integrated care board, means any English local authority whose area coincides with, or includes the whole or any part of, the area of the integrated care board;

• “registered service provider” means a person registered under Chapter 2 as a service provider;

• “relevant health care” means—

  1. a

     NHS care, or

  2. b

     the promotion and protection of public health.

13

Regulations may amend the definition of “relevant health care” to include health care which is provided or commissioned by a public authority (but which does not amount to NHS care).

c

regulations under section 46B(13) (amendment of definition of relevant health care),

Regulatory functions

13SBMinimising conflicts between regulatory and other functions

1

NHS England must make arrangements for—

a

minimising the risk of conflicts between the exercise of its regulatory functions and its other functions;

b

managing any conflicts that arise.

2

In this Act “regulatory functions”, in relation to NHS England, means—

a

its functions under the provisions listed in subsection (3),

b

its functions under Chapter 5A of Part 2 (trust special administrators) in relation to NHS foundation trusts, except for any functions that are conferred on it under section 65DA, 65F or 65G as a commissioner, and

c

any other functions of NHS England so far as exercisable in connection with functions within paragraph (a) or (b).

3

Those provisions are—

a

in Part 2 of this Act, Chapter 5 (NHS foundation trusts);

b

in Part 3 of the Health and Social Care Act 2012—

i

Chapter 3 (licensing);

ii

Chapter 4 (NHS payment scheme);

iii

Chapter 5 (health special administration);

iv

Chapter 6 (financial assistance in special administration cases).

2A

The annual report must include a statement explaining what NHS England has done, during the financial year, to comply with its duties under section 13SB.

• “regulatory functions”, in relation to NHS England, has the meaning given by section 13SB,

1A

Before making modifications under subsection (1) that NHS England consider to be a major change, NHS England must—

a

carry out an assessment of the likely impact of the modifications, or

b

publish a statement setting out its reasons for concluding that such assessment is not needed.

ba

set out any impact assessment carried out by NHS England under subsection (1A)(a),

7BDirections requiring NHS bodies to exercise public health functions

1

The Secretary of State may by direction provide for any of the public health functions of the Secretary of State to be exercised by one or more relevant bodies.

2

In this section “relevant body” means—

a

NHS England, or

b

an integrated care board.

3

A direction under subsection (1) may include provision prohibiting or restricting the relevant body from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction.

4

In subsection (3) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else.

5

The Secretary of State may make payments to a relevant body in respect of the exercise by it of a function by virtue of a direction under subsection (1).

6

The Secretary of State may give directions to an integrated care board as to the exercise by it of any functions by virtue of this section.

7

For power to give directions to NHS England as to the exercise of functions, see section 13ZC.

8

As soon as reasonably practicable after giving a direction under subsection (1) or (6), the Secretary of State must publish it.

9

Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a relevant body of any function by virtue of this section are enforceable by or against it (and no other person).

10

The reference in subsection (1) to the public health functions of the Secretary of State includes any functions of the Secretary of State exercisable in connection with those functions (including the powers conferred by section 12).

aa

section 7B,

7CPower of direction: investigation functions

1

The Secretary of State may direct—

a

NHS England, or

b

any other public body,

to exercise any of the investigation functions which are specified in the direction.

2

A direction under subsection (1) may include provision prohibiting or restricting the body directed 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 a person for the exercise of a function by someone else.

4

The Secretary of State may make payments to NHS England or any other body in respect of the exercise by it of a function by virtue of a direction under subsection (1).

5

The Secretary of State may give directions to any body on whom functions are conferred by virtue of subsection (1)(b) as to the exercise of those functions.

6

For power to give directions to NHS England as to the exercise of functions, see section 13ZC.

7

As soon as reasonably practicable after giving a direction under subsection (1) or (5), the Secretary of State must publish it.

8

Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by NHS England or any other body of any function by virtue of this section are enforceable by or against it (and no other person).

9

In this section “the investigation functions” are functions which, immediately before the coming into force of section 36 of the Health and Care Act 2022, were exercised by the Special Health Authority called the National Health Service Trust Development Authority pursuant to—

a

the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) Directions 2016 made under sections 7 and 8 of the National Health Service Act 2006, or

b

the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) (Additional Investigatory Functions in respect of Maternity Cases) Directions 2018 made under sections 7 and 8 of the National Health Service Act 2006.

7DTransfer schemes in connection with a direction under section 7C

1

The Secretary of State may, in connection with a direction under section 7C, make one or more transfer schemes.

2

A “transfer scheme” is a scheme for the transfer to NHS England or any other public body of any property, rights or liabilities relating to the discharge of functions pursuant to any directions made by the Secretary of State under the power conferred by section 7C.

3

The things that may be transferred under a transfer scheme include—

a

property, rights and liabilities that could not otherwise be transferred;

b

property acquired, and rights and liabilities arising, after the making of the scheme;

c

criminal liabilities.

4

A transfer scheme may—

a

create rights, or impose liabilities, in relation to property or rights transferred;

b

make provision about the continuing effect of things done by, or on behalf of or in relation to the transferor in respect of anything transferred;

c

make provision about the continuation of things (including legal proceedings) in the process of being done by, on behalf of or in relation to the transferor in respect of anything transferred;

d

make provision for references to the transferor in an instrument or other document in respect of anything transferred to be treated as references to the transferee;

e

make provision for the shared ownership or use of property;

f

make provision which is the same as or similar to the TUPE regulations;

g

make other consequential, supplementary, incidental or transitional provision.

5

A transfer scheme may provide—

a

for modifications by agreement;

b

for modifications to have effect from the date when the original scheme came into effect.

6

In subsection (4)(f), “the TUPE regulations” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).

7

For the purposes of this section—

a

references to rights and liabilities include rights and liabilities relating to a contract of employment;

b

references to the transfer of property include the grant of a lease.

8

For the purposes of subsection (7)(a)—

a

an individual who holds employment in the civil service of the State is to be treated as employed by virtue of a contract of employment, and

b

the terms of the individual’s employment in the civil service are to be regarded as constituting the terms of the contract of employment.

7ETransfer schemes under section 7D: taxation

1

The Treasury may by regulations make provision varying the way in which a relevant tax has effect in relation to—

a

anything transferred under a scheme under section 7D, or

b

anything done for the purposes of, or in relation to, a transfer under such a scheme.

2

The provision which may be made under subsection (1)(a) includes in particular provision for—

a

a tax provision not to apply, or to apply with modifications, in relation to anything transferred;

b

anything transferred to be treated in a specified way for the purposes of a tax provision;

c

the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything transferred.

3

The provision which may be made under subsection (1)(b) includes in particular provision for—

a

a tax provision not to apply, or to apply with modifications, in relation to anything done for the purposes of or in relation to the transfer;

b

anything done for the purposes of, or in relation to, the transfer to have or not have a specified consequence or be treated in a specified way;

c

the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything done for the purposes of, or in relation to, the transfer.

4

In this section references to the transfer of property include the grant of a lease.

5

In this section—

• “relevant tax” means income tax, corporation tax, capital gains tax, value added tax, stamp duty or stamp duty reserve tax;

• “tax provision” means a provision of an enactment about a relevant tax.

ab

section 7C,

Powers of direction

13ZCSecretary of State directions as to exercise of NHS England functions

1

The Secretary of State may give NHS England directions as to the exercise of any of its functions.

2

The directions that may be given include a direction as to whether a power is to be exercised or not.

3

The directions that may be given include a direction as to—

a

when or how a function is, or is not, to be exercised;

b

conditions that must be met before a function is exercised (for example, conditions relating to the provision of information, consultation or approval);

c

matters to be taken into account in exercising a function.

4

For exceptions to the power to give directions under subsection (1), see section 13ZD.

5

A direction under subsection (1) must include a statement that the Secretary of State considers the direction to be in the public interest.

6

As soon as reasonably practicable after giving a direction under subsection (1), the Secretary of State must publish it.

7

The fact that the Secretary of State has a function under any other enactment in relation to NHS England’s exercise of functions is not to be read as limiting the power conferred by subsection (1).

8

The reference in subsection (7) to a function of the Secretary of State does not include a function of making subordinate legislation.

13ZDPower to give directions: exceptions

1

A direction under section 13ZC may not be given in relation to a function relating to the appointment or employment of a person.

2

A direction under section 13ZC 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 13ZC may not be given in relation to the provision of any drug, medicine or other treatment, or the use of any diagnostic technique, unless NICE has made a recommendation or issued guidance as to its clinical and cost effectiveness and the direction is not inconsistent with that recommendation or guidance.

13ZECompliance with directions: significant failure

1

This section applies where—

a

NHS England is given a direction under section 13ZC,

b

the direction —

i

states that the Secretary of State considers that NHS England is failing or has failed to discharge any of its functions, and

ii

states that the Secretary of State considers that the failure is significant and explains why,

c

the direction states that it is given for the purposes of addressing that failure, and

d

NHS England fails to comply with the direction.

2

The Secretary of State may—

a

discharge the functions to which the direction relates, or

b

make arrangements for any other person to discharge them on the Secretary of State’s behalf.

3

Where the Secretary of State exercises the power under subsection (2), the Secretary of State must publish the reasons for doing so.

4

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.

13ZFSecretary of State directions to provide information

1

The Secretary of State may direct NHS England to provide the Secretary of State with any documents or other information that may be specified in the direction.

2

The directions that may be given include a direction to provide documents or other information that NHS England would need to obtain from others in the exercise of some other power.

3

The directions may include provision as to—

a

the form or manner in which the documents or information must be provided;

b

the time at which or period within which the documents or information must be provided.

Reconfiguration of NHS services

68AReconfiguration of NHS services

Schedule 10A confers intervention powers on the Secretary of State in relation to the reconfiguration of NHS services.

87AApplication and grant: NHS trusts

1

An NHS trust established under section 25 of the National Health Service Act 2006 is to be treated, on its establishment, as—

a

having made an application for a licence under section 85, and

b

having met the criteria for holding a licence for the time being published under section 86.

2

An NHS trust established under section 25 of the National Health Service Act 2006 before the day on which section 51(1) of the Health and Care Act 2022 comes into force is to be treated, for the purposes of subsection (1), as having been established on that day.

27AOversight and support of NHS trusts

NHS England must—

a

monitor NHS trusts established under section 25 in the carrying out of their functions, and

b

provide such advice, guidance or other support as it considers appropriate to help NHS trusts established under section 25 in the carrying out of their functions.

27BNHS England’s directions to NHS trusts

1

NHS England may give directions to an NHS trust established under section 25 about its exercise of any functions.

2

In so far as a direction under this section conflicts with a direction under section 8 or paragraph 25(3) of Schedule 4, it is of no effect.

bb

section 27B,

42BLimits on capital expenditure

1

NHS England may make an order imposing a limit on the capital expenditure of an NHS foundation trust in respect of a single financial year.

2

The order must specify—

a

the trust,

b

the capital expenditure limit, and

c

the financial year to which the limit relates.

3

NHS England must consult the trust before making the order.

4

NHS England must publish each order under this section.

5

An order under this section may be made at any time during or before the financial year to which it relates.

6

A trust that is the subject of an order under this section must not exceed the capital expenditure limit imposed by the order during the financial year to which it relates.

7

In this section “capital expenditure”, in relation to an NHS foundation trust, means expenditure of the trust which falls to be capitalised in its annual accounts.

42CGuidance in relation to orders under section 42B

1

NHS England must publish guidance about the exercise of its power to make orders under section 42B, including guidance about—

a

the circumstances in which it is likely to make an order, and

b

the method it will use to determine the capital expenditure limit.

2

NHS England must consult the Secretary of State before it publishes guidance, or revised guidance, under this section.

3

NHS England must have regard to the guidance in exercising its power to make orders under section 42B.

4

NHS England must grant the application if—

a

it is 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

b

the Secretary of State approves the grant of the application,

and must otherwise refuse the application.

Joint working arrangements and delegation

65Z5Joint working and delegation arrangements

1

A relevant body may arrange for any functions exercisable by it 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.

2

In this section “relevant body” means—

a

NHS England,

b

an integrated care board,

c

an NHS trust established under section 25,

d

an NHS foundation trust, or

e

such other body as may be prescribed.

3

Regulations may—

a

provide that the power in subsection (1) does not apply, or applies only to a prescribed extent, in relation to prescribed functions;

b

impose conditions on the exercise of the power.

4

Arrangements under this section may be made on such terms as may be agreed between the parties, including—

a

terms as to payment;

b

terms prohibiting or restricting a body from making delegation arrangements in relation to a function that is exercisable by it by virtue of arrangements under this section.

5

In subsection (4)(b) “delegation arrangements” means arrangements made by a body for the exercise of a function by someone else.

6

Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a body of any function by virtue of this section are enforceable by or against that body (and no other person).

65Z6Joint committees and pooled funds

1

This section applies where a function is exercisable jointly (by virtue of section 65Z5 or otherwise) by a relevant body and 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.

2

The bodies by whom the function is exercisable jointly may—

a

arrange for the function to be exercised by a joint committee of theirs;

b

arrange for one or more of the bodies, or a joint committee of the bodies, 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 arrangements from relevant bodies that are party to the arrangements, and

b

out of which payments may be made in accordance with the arrangements 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).

65Z7Joint working and delegation: guidance by NHS England

1

NHS England may publish guidance for relevant bodies about the exercise of their powers under sections 65Z5 and 65Z6.

2

A relevant body must have regard to any guidance published under this section.

3

In this section “relevant body” has the meaning given by section 65Z5(2).

275AReferences to functions: delegation etc

1

A reference in this Act to the functions of a person includes functions of others that are exercisable by the person by virtue of any provision of any enactment (unless the context otherwise requires).

2

Regulations may create exceptions to subsection (1).