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 13The Health Services Safety Investigations Body

Section 109

PART 1Constitution

Status

1

(1)

The HSSIB is not to be regarded—

(a)

as the servant or agent of the Crown, or

(b)

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

(2)

The HSSIB’s property is not to be regarded—

(a)

as the property of the Crown, or

(b)

as property held on behalf of the Crown.

Membership

2

(1)

The HSSIB is to consist of—

(a)

a Chief Investigator appointed in accordance with paragraph 3,

(b)

other members appointed in accordance with paragraph 4, and

(c)

a chair and at least four other members appointed by the Secretary of State.

(2)

The Chief Investigator is to be the chief executive of the HSSIB.

(3)

The HSSIB must have more non-executive than executive members.

(4)

In this Schedule—

(a)

references to executive members of the HSSIB are references to the members mentioned in sub-paragraph (1)(a) and (b), and

(b)

references to non-executive members of the HSSIB are references to the members mentioned in sub-paragraph (1)(c).

The Chief Investigator: appointment and status

3

(1)

The Chief Investigator is to be appointed by the non-executive members with the consent of the Secretary of State.

(2)

The Chief Investigator is to be an employee of the HSSIB.

Other executive members: appointment and status

4

(1)

The other executive members of the HSSIB are to be appointed by the non-executive members.

(2)

The non-executive members may not appoint more than five other executive members without the consent of the Secretary of State.

(3)

The other executive members are to be employees of the HSSIB.

Non-executive members: tenure

5

(1)

A person holds and vacates office as a non-executive member of the HSSIB in accordance with that person’s terms of appointment (subject to the following provisions of this paragraph).

(2)

A person may at any time resign from office as a non-executive member by giving notice to the Secretary of State.

(3)

The Secretary of State may at any time remove a person from office as a non-executive member on any of the following grounds—

(a)

incapacity,

(b)

misbehaviour, or

(c)

failure to carry out the person’s duties as a non-executive member.

(4)

The Secretary of State may suspend a person from office as a non-executive member if it appears to the Secretary of State that there are or may be grounds to remove the person from office under sub-paragraph (3).

(5)

A person may be appointed as a non-executive member for an initial term of up to three years.

(6)

A person who has been appointed as a non-executive member for an initial term may be re-appointed, but only for one further term of up to three years.

(7)

The further term must begin at the end of the initial term.

Non-executive members: suspension from office

6

(1)

This paragraph applies where a person is suspended under paragraph 5(4).

(2)

The Secretary of State must give notice of the decision to suspend to the person.

(3)

The suspension takes effect on receipt by the person of the notice.

(4)

The notice may be—

(a)

delivered in person (in which case the person is taken to receive it when it is delivered), or

(b)

sent by first class post to the person’s last known address (in which case the person is taken to receive it on the third day after the day on which it is posted).

(5)

The initial period of suspension must not exceed six months.

(6)

The Secretary of State may review the suspension at any time.

(7)

The Secretary of State—

(a)

must review the suspension if requested in writing by the person to do so, but

(b)

is not required to review the suspension before the end of the period of three months beginning with the start of the initial period of suspension.

(8)

Following a review during a period of suspension, the Secretary of State may—

(a)

confirm the suspension,

(b)

revoke the suspension, or

(c)

suspend the person for another period of not more than six months beginning with the expiry of the current period.

(9)

The Secretary of State must revoke the suspension if the Secretary of State—

(a)

decides that there are no grounds to remove the person from office under paragraph 5(3), or

(b)

decides that there are grounds to do so but does not remove the person from office under that provision.

7

(1)

Where a person is suspended from office as the chair under paragraph 5(4), the Secretary of State may appoint a non-executive member as interim chair to exercise the chair’s functions.

(2)

Appointment as interim chair is for a term not exceeding the shorter of—

(a)

the period ending with either—

(i)

the appointment of a new chair, or

(ii)

the revocation or expiry of the existing chair’s suspension, and

(b)

the remainder of the interim chair’s term as a non-executive member.

(3)

Sub-paragraph (4) applies if—

(a)

a person’s initial term as interim chair is to cease as a result of the expiry of the person’s initial term as a non-executive member, and

(b)

that person is to be re-appointed as a non-executive member.

(4)

The person may be re-appointed as interim chair for a further term determined in accordance with sub-paragraph (2).

(5)

That further term must begin at the end of the person’s initial term as interim chair.

Non-executive members: payment

8

(1)

The HSSIB must pay to the non-executive members such remuneration as the Secretary of State may determine.

(2)

The HSSIB must pay or make provision for the payment of such pensions, allowances or gratuities as the Secretary of State may determine to or in respect of any person who is or has been a non-executive member.

(3)

If a person ceases to be a non-executive member and the Secretary of State decides that there are exceptional circumstances which mean that the person should be compensated, the HSSIB must pay compensation to the person of such amount as the Secretary of State may determine.

Staff

9

(1)

The HSSIB may appoint such persons to be employees of the HSSIB as it considers appropriate.

(2)

Employees of the HSSIB are to be paid such remuneration as the HSSIB may determine.

(3)

Employees of the HSSIB are to be appointed on such other terms and conditions as the HSSIB may determine.

(4)

The HSSIB 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 HSSIB.

(5)

Before making a determination as to remuneration, pensions, allowances or gratuities for the purposes of sub-paragraph (2) or (4), the HSSIB must obtain the approval of the Secretary of State to its policy on that matter.

Procedure

10

(1)

The HSSIB may regulate its own procedure.

(2)

The validity of any act of the HSSIB is not affected by any vacancy among the members or by any defect in the appointment of any member.

Committees

11

(1)

The HSSIB may appoint such committees and sub-committees as it considers appropriate.

(2)

A committee or sub-committee may consist of or include persons who are not members or employees of the HSSIB.

(3)

The HSSIB may pay such remuneration and allowances as it may determine to any person who—

(a)

is a member of a committee or a sub-committee, but

(b)

is not an employee of the HSSIB,

whether or not that person is a non-executive member of the HSSIB.

(4)

Before making a determination as to remuneration or allowances for the purposes of sub-paragraph (3), the HSSIB must consult the Secretary of State.

Exercise of functions

12

(1)

The HSSIB must exercise the functions conferred on it by this Part effectively, efficiently and economically.

(2)

The HSSIB may arrange for the exercise of any of its functions on its behalf by—

(a)

any non-executive member,

(b)

any employee (including any executive member), or

(c)

a committee or sub-committee.

Assistance in exercise of functions

13

(1)

The HSSIB may arrange for persons to assist it in the exercise of its functions in relation to—

(a)

a particular case, or

(b)

cases of a particular description.

(2)

Such arrangements may include provision with respect to the payment of remuneration and allowances to, or amounts in respect of, such persons.

Funding

14

(1)

The Secretary of State may make payments to the HSSIB out of money provided by Parliament of such amounts as the Secretary of State considers appropriate.

(2)

Payments made under sub-paragraph (1) may be made at such times and on such conditions (if any) as the Secretary of State considers appropriate.

Supplementary powers

15

(1)

The HSSIB may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any function conferred on it by this Part.

(2)

The power under sub-paragraph (1) includes power for the HSSIB to do the following—

(a)

enter into agreements;

(b)

acquire and dispose of property;

(c)

supply materials, facilities and services to any person;

(d)

develop and exploit ideas and exploit intellectual property.

(3)

But the HSSIB requires the consent of the Secretary of State to borrow money temporarily by way of overdraft.

Use of income from charges

16

Where the HSSIB receives income from imposing charges under section 127(8) or 128(4), it must ensure that the income is used for exercising its functions.

Losses and liabilities etc

17

(1)

Section 265 of the Public Health Act 1875 (which relates to the protection of members and officers of certain authorities from personal liability) has effect as if the HSSIB were an authority of the kind referred to in that section.

(2)

In its application to the HSSIB as a result of sub-paragraph (1), section 265 of that Act has effect as if the references in that section to that Act were references to this Part of this Act.

Accounts

18

(1)

The HSSIB must keep proper accounts and proper records in relation to the accounts.

(2)

The Secretary of State may give directions to the HSSIB as to—

(a)

the content and form of its accounts, and

(b)

the methods and principles to be applied in the preparation of its accounts.

19

(1)

The HSSIB must prepare annual accounts in respect of each financial year.

(2)

The HSSIB must send copies of the annual accounts to the Secretary of State and the Comptroller and Auditor General within such period after the end of the financial year to which the accounts relate as the Secretary of State may direct.

(3)

The Comptroller and Auditor General must—

(a)

examine, certify and report on the annual accounts, and

(b)

lay copies of them and the report before Parliament.

(4)

In this paragraph and paragraph 20, “financial year” means a period of 12 months ending with 31 March.

Reports and other information

20

(1)

As soon as practicable after the end of each financial year, the HSSIB must prepare an annual report on how it has exercised its functions during the financial year to which the report relates.

(2)

The report must, among other things, set out the measures that the HSSIB has taken to ensure that its functions are exercised effectively, efficiently and economically.

(3)

The HSSIB must send a copy of the report to the Secretary of State.

(4)

The Secretary of State must lay a copy of the report before Parliament.

(5)

The HSSIB must publish the report once it has been laid before Parliament.

(6)

Subject to sub-paragraph (7), the Secretary of State may require the HSSIB to provide to the Secretary of State such other reports and information relating to the exercise of its functions as the Secretary of State may request.

(7)

The Secretary of State may not require the HSSIB to provide any reports or information that relate to an investigation that the HSSIB is carrying out or has carried out.

Seal and signature

21

(1)

The application of the HSSIB’s seal must be authenticated by the signature of any member of the HSSIB or any other person who has been authorised (generally or specially) for that purpose.

(2)

A document purporting to be duly executed under the HSSIB’s seal or to be signed on its behalf must be received in evidence and, unless the contrary is proved, taken to be so executed or signed.

PART 2Transfer schemes

22

(1)

The Secretary of State may, in connection with the establishment of the HSSIB by this Act, make one or more transfer schemes.

(2)

A “transfer scheme” is a scheme for the transfer to the HSSIB of any property, rights or liabilities of NHS England relating to the discharge of NHS England’s functions pursuant to any directions made by the Secretary of State under the power conferred by section 44 which are in force at the time the scheme is made.

(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, on behalf of or in relation to NHS England 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 NHS England in respect of anything transferred;

(d)

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

(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 sub-paragraph (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 paragraph—

(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 sub-paragraph (7)(a)

(a)

an individual who holds employment in the civil service 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 of the State are to be regarded as constituting the terms of the contract of employment.

23

(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 paragraph 22, 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 sub-paragraph (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 sub-paragraph (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)

Regulations under this paragraph are subject to annulment in pursuance of a resolution of the House of Commons.

(5)

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

(6)

In this paragraph—

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.