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Part 1E+WPromotion and provision of the health service in England

[F1[F2Direct payments for health careE+W

Textual Amendments

F2Ss. 12A-12D and cross-heading inserted (19.1.2010) by Health Act 2009 (c. 21), ss. 11, 40(1); S.I. 2010/30, art. 2(b)

12ADirect payments for health careE+W

(1)The Secretary of State [F3, [F4NHS England], [F5an integrated care board] or a local authority] may, for the purpose of securing the provision to a patient of anything to which this subsection applies, make payments, with the patient's consent, to the patient or to a person nominated by the patient.

(2)Subsection (1) applies to—

[F6(a)anything that the Secretary of State or a local authority has a duty or power to provide or arrange under section 2A or 2B or Schedule 1;]

[F7(aa)anything that [F4NHS England] or [F8an integrated care board] may or must arrange for the provision of under this Act or any other enactment.]

F9(b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F9(c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3)Subsection (1) is subject to any provision made by regulations under section 12B.

(4)If regulations so provide, [F10an integrated care board] may, for the purpose of securing the provision for a patient of services that [F11the board] must provide under section 117 of the Mental Health Act 1983 (after-care), make payments, with the patient's consent, to the patient or to a person nominated by the patient [F12; and the references in this subsection to [F10an integrated care board] are, so far as necessary for the purposes of regulations under subsection (2E) of that section, to be read as references to [F4NHS England].]

(5)A payment under subsection (1) F13... is referred to in this Part as a “direct payment”.

F14(6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F15(7)In this section and sections 12B to 12D, “local authority” has the same meaning as in section 2B.]

Textual Amendments

F13Words in s. 12A(5) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 10(5); S.I. 2013/160, art. 2(2) (with arts. 7-9)

12BRegulations about direct paymentsE+W

(1)The Secretary of State may make regulations about direct payments.

(2)The regulations may in particular make provision—

(a)as to circumstances in which, and descriptions of persons and services in respect of which, direct payments may or must be made;

(b)as to circumstances in which direct payments may or must be made to a person nominated by the patient;

(c)as to the making of direct payments (and, in particular, as to persons to whom payments may or must be made) where the patient lacks capacity to consent to the making of the payments;

(d)as to conditions that the Secretary of State [F16, [F4NHS England], [F17an integrated care board] or a local authority] must comply with before, after or at the time of making a direct payment;

(e)as to conditions that the patient or (if different) the payee may or must be required to comply with before, after, or at the time when a direct payment is made;

(f)as to the amount of any direct payment or how it is to be calculated;

(g)as to circumstances in which the Secretary of State [F18, [F4NHS England], [F19an integrated care board] or a local authority] may or must stop making direct payments;

(h)as to circumstances in which the Secretary of State [F20, [F4NHS England], [F21an integrated care board] or a local authority] may or must require all or part of a direct payment to be repaid, by the payee or otherwise;

(i)as to monitoring of the making of direct payments, of their use by the payee, or of services which they are used to secure;

(j)as to arrangements to be made by the Secretary of State [F22, [F4NHS England], [F23an integrated care board] or a local authority] for providing patients, payees or their representatives with information, advice or other support in connection with direct payments;

(k)for such support to be treated to any prescribed extent as a service in respect of which direct payments may be made.

(3)If the regulations make provision in the case of a person who lacks capacity to consent to direct payments being made, they may apply that provision, or make corresponding provision, with or without modifications, in the case of a person who has lacked that capacity but no longer does so (whether because of fluctuating capacity, or regaining or gaining capacity).

(4)The regulations may provide for a sum which must be repaid to the Secretary of State [F24, [F4NHS England], [F25an integrated care board] or a local authority] by virtue of a condition or other requirement imposed by or under the regulations to be recoverable as a debt due to the Secretary of State [F26[F4NHS England], a clinical commissioning group or a local authority (as the case may be)].

(5)The regulations may make provision—

(a)for a service in respect of which a direct payment has been made under section 12A(1) to be regarded, only to such extent and subject to such conditions as may be prescribed, as provided or arranged for by the Secretary of State [F27or a local authority or as arranged for by [F4NHS England] or [F28an integrated care board] (as the case may be)] under an enactment mentioned in section 12A(2);

(b)displacing functions or obligations of [F29[F4NHS England], [F30an integrated care board] or a local authority with respect to the arrangement for the provision of] after-care services under section 117 of the Mental Health Act 1983, only to such extent and subject to such conditions as may be prescribed.

(6)In this section—

(a)service” includes anything in respect of which direct payments may be made;

(b)references to a person lacking capacity are references to a person lacking capacity within the meaning of the Mental Capacity Act 2005.

Textual Amendments

12CDirect payments pilot schemesE+W

F31(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F31(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F31(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F31(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(5)Provision as to the review of a pilot scheme may in particular include provision—

(a)for a review to be carried out by an independent person;

(b)for publication of the findings of a review;

(c)as to matters to be considered on a review.

(6)Those matters may in particular include any of the following—

(a)the administration of the scheme;

(b)the effect of direct payments on the cost or quality of care received by patients;

(c)the effect of direct payments on the behaviour of patients, carers or persons providing services in respect of which direct payments are made.

(7)After any review of one or more pilot schemes, the Secretary of State may make an order under subsection (8) or (10).

(8)An order under this subsection is an order making provision for either or both of the following—

(a)repealing section 12A(6) and subsections (1) to (4) of this section;

(b)amending, repealing, or otherwise modifying any other provision of this Act.

(9)An order may make provision within subsection (8)(b) only if it appears to the Secretary of State to be necessary or expedient for the purpose of facilitating the exercise of the powers conferred by section 12A(1) or by regulations under section 12A(4).

(10)An order under this subsection is an order repealing sections 12A, 12B, 12D and this section.

12DArrangements with other bodies relating to direct paymentsE+W

(1)The Secretary of State [F32, [F4NHS England], [F33an integrated care board] or a local authority] may arrange with any person or body to give assistance in connection with direct payments.

(2)Arrangements may be made under subsection (1) with voluntary organisations.

(3)Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by the Secretary of State [F34, [F4NHS England], [F35an integrated care board] or a local authority].]]