Legislation – Health and Care Act 2022

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Introduction

PART 1
Health service in England: integration, collaboration and other changes

1 NHS Commissioning Board renamed NHS England

2 Power to require commissioning of specialised services

3 Spending on mental health

4 NHS England mandate: general

5 NHS England mandate: cancer outcome targets

6 Duties as to reducing inequalities

7 Duties in respect of research: business plan and annual report etc

8 NHS England: wider effect of decisions

9 NHS England: duties in relation to climate change etc

10 Public involvement: carers and representatives

11 Information about inequalities

12 Support and assistance by NHS England

13 Exercise of functions relating to provision of services

14 Preparation of consolidated accounts for providers

15 Funding for service integration

16 Payments in respect of quality

17 Secondments to NHS England

18 Role of integrated care boards

19 Establishment of integrated care boards

20 People for whom integrated care boards have responsibility

21 Commissioning hospital and other health services

22 Commissioning primary care services etc

23 Transfer schemes in connection with transfer of primary care functions

24 Commissioning arrangements: conferral of discretions

25 General functions

26 Integrated care partnerships and strategies

27 NHS England’s financial responsibilities

28 Expansion of NHS England’s duties in respect of expenditure

29 Financial responsibilities of integrated care boards and their partners

30 Expansion of financial duties of integrated care boards and their partners

31 Care Quality Commission reviews etc of integrated care system

32 Integrated care system: further amendments

33 Abolition of Monitor and transfer of functions to NHS England

34 Exercise by NHS England of new regulatory functions

35 Modification of standard licence conditions

36 Abolition of NHS Trust Development Authority

37 Merger of bodies: consequential amendment

38 Transfer schemes in connection with abolished bodies

39 Transfer schemes under section 38: taxation

40 Duties in respect of research

41 Report on assessing and meeting workforce needs

42 Arrangements for exercise of public health functions

43 Power of direction: public health functions

44 Power of direction: investigation functions

45 General power to direct NHS England

46 Reconfiguration of services: intervention powers

47 Review into NHS supply chains

48 NHS trusts in England

49 Removal of power to appoint trust funds and trustees

50 Sections 48 and 49: consequential amendments

51 Licensing of NHS trusts

52 NHS trusts: wider effect of decisions

53 NHS trusts: duties in relation to climate change

54 Oversight and support of NHS trusts

55 Directions to NHS trusts

56 Recommendations about restructuring of NHS trusts

57 Intervention in NHS trusts

58 NHS trusts: conversion to NHS foundation trusts and dissolution

59 Appointment of chair of NHS trusts

60 Financial objectives for NHS trusts

61 Licensing of NHS foundation trusts

62 Capital spending limits for NHS foundation trusts

63 Accounts, reports and forward plans

64 NHS foundation trusts: joint exercise of functions

65 NHS foundation trusts: mergers, acquisitions and separations

66 Transfers on dissolution of NHS foundation trusts

67 NHS foundation trusts: wider effect of decisions

68 NHS foundation trusts: duties in relation to climate change

69 Transfer schemes between trusts

70 Trust special administrators

71 Joint working and delegation arrangements

72 References to functions: treatment of delegation arrangements etc

73 Repeal of duties to promote autonomy

74 Guidance about joint appointments

75 Co-operation by NHS bodies etc

76 Wider effect of decisions: licensing of health care providers

77 The NHS payment scheme

78 Regulations as to patient choice

79 Procurement regulations

80 Procurement and patient choice: consequential amendments etc

81 Eradicating slavery and human trafficking in supply chains

82 Duty to provide assistance to the CMA

83 Mergers of providers: removal of CMA powers

84 Removal of functions relating to competition etc

85 Removal of CMA’s involvement in licensing etc

86 Special Health Authorities: removal of 3 year limit

87 Tidying up etc provisions about accounts of certain NHS bodies

88 Meaning of “health” in NHS Act 2006

89 Repeal of spent powers to make transfer schemes etc

90 Abolition of Local Education and Training Boards

91 Hospital patients with care and support needs: repeals etc

PART 2
Health and adult social care: information

92 Information about payments etc to persons in the health care sector

93 Regulations under section 92: enforcement

94 Regulations under section 92: consent

95 Information standards

96 Sharing anonymous health and social care information

97 General duties of the Health and Social Care Information Centre etc

98 Collection of information from private health care providers

99 Collection of information about adult social care

100 Enforcement of duties against private providers

101 Medicine information systems

PART 3
Secretary of State’s powers to transfer or delegate functions

102 Relevant bodies and Special Health Authorities

103 Power to transfer functions between bodies

104 Power to provide for exercise of functions of Secretary of State

105 Scope of powers

106 Transfer schemes in connection with regulations

107 Transfer schemes: taxation

108 Consent and consultation

PART 4
The Health Services Safety Investigations Body

109 Establishment of the HSSIB

110 Investigation of incidents with safety implications

111 Deciding which incidents to investigate

112 Criteria, principles and processes

113 Final reports

114 Interim reports

115 Draft reports

116 Response to reports

117 Admissibility of reports

118 Powers of entry, inspection and seizure

119 Powers to require information etc

120 Voluntary provision of information etc

121 Offences relating to investigations

122 Prohibition on disclosure of HSSIB material

123 Exceptions to prohibition on disclosure

124 Offences of unlawful disclosure

125 Restriction of statutory powers requiring disclosure

126 Co-operation

127 Assistance of NHS bodies

128 Investigations relating to Wales and Northern Ireland

129 Failure to exercise functions

130 Review

131 Offences by bodies corporate

132 Offences by partnerships

133 Obligations of confidence etc

134 Consequential amendments relating to Part 4

135 Interpretation of Part 4

PART 5
Virginity testing and hymenoplasty offences

CHAPTER 1 Virginity testing offences

Virginity testing offences: England and Wales

136 Offence of virginity testing: England and Wales

137 Offence of offering to carry out virginity testing: England and Wales

138 Offence of aiding or abetting etc a person to carry out virginity testing: England and Wales

139 Virginity testing offences in England and Wales: penalties

Virginity testing offences: Scotland

140 Offence of virginity testing: Scotland

141 Offence of offering to carry out virginity testing: Scotland

142 Offence of aiding or abetting etc a person to carry out virginity testing: Scotland

143 Virginity testing offences in Scotland: penalties and supplementary

Virginity testing offences: Northern Ireland

144 Offence of virginity testing: Northern Ireland

145 Offence of offering to carry out virginity testing: Northern Ireland

146 Offence of aiding or abetting etc a person to carry out virginity testing: Northern Ireland

147 Virginity testing offences in Northern Ireland: penalties

CHAPTER 2 Hymenoplasty offences

Hymenoplasty offences: England and Wales

148 Offence of carrying out hymenoplasty: England and Wales

149 Offence of offering to carry out hymenoplasty: England and Wales

150 Offence of aiding or abetting etc a person to carry out hymenoplasty: England and Wales

151 Hymenoplasty offences in England and Wales: penalties

Hymenoplasty offences: Scotland

152 Offence of carrying out hymenoplasty: Scotland

153 Offence of offering to carry out hymenoplasty: Scotland

154 Offence of aiding or abetting etc a person to carry out hymenoplasty: Scotland

155 Hymenoplasty offences in Scotland: penalties and supplementary

Hymenoplasty offences: Northern Ireland

156 Offence of carrying out hymenoplasty: Northern Ireland

157 Offence of offering to carry out hymenoplasty: Northern Ireland

158 Offence of aiding or abetting etc a person to carry out hymenoplasty: Northern Ireland

159 Hymenoplasty offences in Northern Ireland: penalties

CHAPTER 3 Consequential amendments

160 Consequential amendments relating to Part 5

PART 6
Miscellaneous

161 Pharmaceutical services: remuneration in respect of vaccines etc

162 International healthcare arrangements

163 Regulation of local authority functions relating to adult social care

164 Default powers of Secretary of State in relation to adult social care

165 Care Quality Commission’s powers in relation to local authority failings

166 Cap on care costs for charging purposes

167 Provision of social care services: financial assistance

168 Regulation of health care and associated professions

169 Medical examiners

170 Commercial dealings in organs for transplantation: extra-territorial offences

171 Storage of gametes and embryos

172 Advertising of less healthy food and drink

173 Hospital food standards

174 Food information for consumers: power to amend retained EU law

175 Fluoridation of water supplies

176 Fluoridation of water supplies: transitional provision

177 Review into disputes relating to treatment of critically ill children

178 Early medical termination of pregnancy

179 Child safeguarding etc in health and care: policy about information sharing

180 Licensing of cosmetic procedures

181 Mandatory training on learning disability and autism

PART 7
General

182 Power to make consequential provision

183 Regulations

184 Financial provision

185 Extent

186 Commencement

187 Short title

SCHEDULES

SCHEDULE 1 Renaming of NHS Commissioning Board

SCHEDULE 2 Integrated care boards: constitution etc

SCHEDULE 3 Conferral of primary care functions on integrated care boards etc

SCHEDULE 4 Integrated care system: minor and consequential amendments

SCHEDULE 5 Abolition of Monitor and transfer of its functions

SCHEDULE 6 Intervention powers over the reconfiguration of NHS services

SCHEDULE 7 NHS trusts in England and removal of power to appoint trustees: consequential amendments

SCHEDULE 8 Trust special administrators: NHS trusts and NHS foundation trusts

SCHEDULE 9 References to functions: treatment of delegation arrangements etc

SCHEDULE 10 The NHS payment scheme

SCHEDULE 11 Patient choice: undertakings by integrated care boards

SCHEDULE 12 Removal of functions relating to competition etc

SCHEDULE 13 The Health Services Safety Investigations Body

SCHEDULE 14 Prohibition on disclosure of HSSIB material: exceptions

SCHEDULE 15 Consequential amendments relating to Part 4

SCHEDULE 16 Virginity testing and hymenoplasty: consequential amendments

SCHEDULE 17 Storage of gametes and embryos

SCHEDULE 18 Advertising of less healthy food and drink

SCHEDULE 19 Licensing of cosmetic procedures

Changes to legislation:

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SCHEDULES

SCHEDULE 2Integrated care boards: constitution etc

Section 19

1

Before Schedule 4 to the National Health Service Act 2006 insert—

“SCHEDULE 1BIntegrated care boards

PART 1Constitution of integrated care boards

Introduction

1

An integrated care board must have a constitution.

Name and area

2

The constitution must specify—

(a)

the name of the integrated care board, and

(b)

the area for which it is established.

Membership: general

3

(1)

The constitution must provide for the integrated care board to consist of—

(a)

a chair (see paragraphs 5 and 6),

(b)

a chief executive (see paragraph 7), and

(c)

at least three other members (see paragraph 8).

(2)

In this Part of this Schedule a reference to an “ordinary member” is to a member other than the chair or chief executive.

4

The constitution must prohibit a person from appointing someone as a member (“the candidate”) if they consider that the appointment could reasonably be regarded as undermining the independence of the health service because of the candidate’s involvement with the private healthcare sector or otherwise.

Chair

5

The constitution must provide for the chair to be appointed by NHS England, with the approval of the Secretary of State.

6

The constitution may not confer power to remove the chair from office on any person other than NHS England, and any such power must be expressed to be subject to the approval of the Secretary of State.

Chief executive

7

(1)

The constitution must provide for the chief executive to be appointed by the chair, with the approval of NHS England.

(2)

The constitution must provide that a person is eligible to become or remain the chief executive only if the person is an employee of the integrated care board.

Ordinary members

8

(1)

The constitution must—

(a)

specify who is to appoint the ordinary members, and

(b)

provide that the appointment of an ordinary member is subject to the approval of the chair.

(2)

The constitution must provide for the ordinary members to include—

(a)

at least one member nominated jointly by the NHS trusts and NHS foundation trusts that—

(i)

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

(ii)

are of a prescribed description,

(b)

at least one member nominated jointly by persons who—

(i)

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

(ii)

are of a prescribed description,

(c)

at least one member nominated jointly by the local authorities whose areas coincide with, or include the whole or any part of, the integrated care board’s area.

(3)

The constitution must set out the process for nominating the ordinary members mentioned in sub-paragraph (2).

(4)

A person participating in the process for nominating the ordinary members mentioned in sub-paragraph (2) must have regard to any guidance published by NHS England in relation to the selection of candidates.

(5)

The descriptions of trusts or other persons that may be prescribed for the purposes of sub-paragraph (2)(a) or (b) may, in particular, be framed by reference to the nature of the services that they provide or the proportion of their services that are provided within the integrated care board’s area.

(6)

The chair must exercise the approval function mentioned in sub-paragraph (1)(b) with a view to ensuring that at least one of the ordinary members has knowledge and experience in connection with services relating to the prevention, diagnosis and treatment of mental illness.

(7)

In this paragraph “local authority” has the meaning given by section 2B(5).

Further provision in connection with membership

9

The constitution may make further provision in connection with the membership of the integrated care board, including provision about—

(a)

how members are to be appointed;

(b)

qualification and disqualification for membership;

(c)

the tenure of members (including the circumstances in which a member ceases to hold office or may be removed or suspended from office);

(d)

eligibility for re-appointment;

(e)

terms of appointment (including provision about the remuneration or allowances of the chair and ordinary members);

(f)

the validation of proceedings in the event of a vacancy or defect in an appointment.

10

(1)

The constitution of an integrated care board must comply with any requirements in connection with membership that are imposed by regulations.

(2)

The regulations may impose requirements in connection with any provision that may be included in an integrated care board’s constitution by virtue of paragraphs 3 to 9.

Arrangements for discharging functions

11

(1)

The constitution must specify arrangements for the exercise of the integrated care board’s functions (including its functions in determining the terms and conditions of its employees).

(2)

The arrangements may include provision—

(a)

for the appointment of committees or sub-committees of the integrated care board, and

(b)

for any such committees to consist of or include persons other than members or employees of the integrated care board.

(3)

The arrangements may include provision for any functions of the integrated care board to be exercised on its behalf by—

(a)

any of its members or employees;

(b)

a committee or sub-committee of the board.

(4)

If the constitution includes provision under this paragraph allowing committees or sub-committees to exercise commissioning functions, the constitution must—

(a)

provide for the members of any such committee or sub-committee to be approved or appointed by the chair of the integrated care board, and

(b)

prohibit the chair from approving or appointing someone as a member of any such committee or sub-committee (“the candidate”) if the chair considers that the appointment could reasonably be regarded as undermining the independence of the health service because of the candidate’s involvement with the private healthcare sector or otherwise.

(5)

In sub-paragraph (4) “commissioning functions” means the functions of an integrated care board in arranging for the provision of services as part of the health service.

12

(1)

The constitution must specify the procedure to be followed by the integrated care board in making decisions.

(2)

The constitution must also specify the arrangements to be made by the integrated care board for securing that there is transparency about the decisions of the board and the manner in which they are made.

Arrangements for conflicts of interests

13

The constitution must include—

(a)

provision about the arrangements to be made by the integrated care board for discharging its functions under section 14Z30(1) to (4), and

(b)

a statement of the principles to be followed by the board in implementing those arrangements.

Arrangements for public involvement

14

The constitution must include—

(a)

provision about the arrangements to be made by the integrated care board for discharging its functions under section 14Z45(2), and

(b)

a statement of the principles to be followed by the board in implementing those arrangements.

Variation of constitution

15

(1)

The constitution must include a power to vary the constitution in accordance with a procedure set out there.

(2)

The provision made by the constitution in accordance with sub-paragraph (1) must—

(a)

include power for NHS England to vary the constitution on its own initiative, and

(b)

require NHS England’s approval to be obtained before any other variation is made.

Further provision

16

In addition to the provision authorised or required to be included under this Part of this Schedule, the constitution may make further provision.

PART 2Further provision about integrated care boards

Status

17

(1)

An integrated care board is a body corporate.

(2)

An integrated care board is not to be regarded—

(a)

as a servant or agent of the Crown, or

(b)

as enjoying any status, privilege or immunity of the Crown.

(3)

An integrated care board’s property is not to be regarded as property of, or property held on behalf of, the Crown.

Staff

18

(1)

An integrated care board may appoint employees.

(2)

Employees of an integrated care board are to be paid such remuneration and allowances as the board may determine.

(3)

Employees of an integrated care board are to be appointed on such other terms and conditions as the board may determine.

(4)

An integrated care board may pay or make provision for the payment of such pensions, allowances or gratuities as it may determine to or in respect of any person who is or has been an employee of the board.

19

(1)

An integrated care board may make arrangements for a person to be seconded to the board to serve as a member of the board’s staff.

(2)

A period of secondment to an integrated care board does not affect the continuity of a person’s employment with the employer from whose service the person is seconded.

(3)

In paragraphs 11 and 18 a reference to an employee of an integrated care board includes a person seconded to the board.

(4)

In paragraph 7(2) the reference to an employee of an integrated care board includes any of the following seconded to the board—

(a)

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

(b)

a person employed by—

(i)

NHS England,

(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 an integrated care board include persons, or persons of a prescribed description, seconded to the board.

Additional powers in respect of payment of allowances

20

An integrated care board may pay such allowances as it considers appropriate to a member of a committee or sub-committee of the integrated care board who is not a member of the board.

Externally financed development agreements

21

(1)

The powers of an integrated care board include power to enter into externally financed development agreements.

(2)

For the purposes of this paragraph, an agreement is an externally financed development agreement if it is certified as such in writing by the Secretary of State.

(3)

The Secretary of State may give a certificate under this paragraph if—

(a)

in the Secretary of State’s opinion the purpose or main purpose of the agreement is the provision of services or facilities in connection with the exercise by an integrated care board of any of its functions, and

(b)

a person proposes to make a loan to, or provide any other form of finance for, another party in connection with the agreement.

(4)

If an integrated care board enters into an externally financed development agreement it may also, in connection with that agreement, enter into an agreement with a person who falls within sub-paragraph (3)(b) in relation to the externally financed development agreement.

(5)

In sub-paragraph (3)(b) “another party” means any party to the agreement other than the integrated care board.

(6)

The fact that an agreement made by an integrated care board has not been certified under this paragraph does not affect its validity.

Accounts and audits

22

(1)

An integrated care board must keep proper accounts and proper records in relation to the accounts.

(2)

An integrated care board must prepare annual accounts in respect of each financial year.

(3)

NHS England may, with the approval of the Secretary of State, direct an integrated care board to prepare accounts in respect of such period or periods as may be specified in the direction.

(4)

NHS England may, with the approval of the Secretary of State, give directions to an integrated care board as to—

(a)

the methods and principles according to which any accounts under this paragraph must be prepared, and

(b)

the form and content of any accounts prepared under this paragraph.

(5)

For the audit of the annual accounts, see the Local Audit and Accountability Act 2014 (and, in particular, section 4 of that Act).

(6)

Accounts prepared under sub-paragraph (3) are also to be audited under that Act if NHS England so directs.

(7)

The Comptroller and Auditor General may examine—

(a)

the annual accounts and any records relating to them, and

(b)

any report on them by the auditor or auditors.

(8)

An integrated care board must send any audited accounts prepared under this paragraph to NHS England by the date specified in a direction by NHS England.

(9)

NHS England may direct an integrated care board to send it any unaudited accounts prepared under this paragraph by the date specified in a direction by NHS England.

Incidental powers

23

The power conferred on an integrated care board by section 2 includes, in particular, power to—

(a)

enter into agreements,

(b)

acquire and dispose of property, and

(c)

accept gifts (including property to be held on trust for the purposes of the integrated care board).

Seal and evidence

24

(1)

The application of an integrated care board’s seal must be authenticated by the signature of any person who has been authorised (generally or specially) for that purpose.

(2)

A document purporting to be duly executed under an integrated care board’s seal or to be signed on its behalf must be received in evidence and, unless the contrary is proven, taken to be so executed or signed.”

2

In section 272 of that Act (orders, regulations, rules and directions), in subsection (6), after paragraph (d) (inserted by section 17 of this Act), insert—

“(e)

regulations under paragraph 19(5) of Schedule 1B.”