Legislation – Health and Care Act 2022

“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).”