National Health Service Act 2006

Part 2E+WHealth service bodies

[F1CHAPTER A1E+W [F2NHS England]

Secretary of State's mandate to [F2NHS England]E+W

13AMandate to [F3NHS England]E+W

(1)F4... The Secretary of State must publish and lay before Parliament a document to be known as “the mandate”.

(2)The Secretary of State must specify in the mandate—

(a)the objectives that the Secretary of State considers [F2NHS England] should seek to achieve in the exercise of its functions F5..., and

(b)any requirements that the Secretary of State considers it necessary to impose on [F2NHS England] for the purpose of ensuring that it achieves those objectives.

[F6(2A)The objectives specified by the Secretary of State under subsection (2)(a) for NHS England must include objectives relating to outcomes for cancer patients, and those objectives are to be treated by NHS England as having priority over any other objectives relating specifically to cancer.]

F7(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F8(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(5)The Secretary of State may also specify in the mandate the matters by reference to which the Secretary of State proposes to assess [F2NHS England’s] performanceF9....

(6)The Secretary of State may not specify in the mandate an objective or requirement about the exercise of [F2NHS England’s] functions in relation to only one [F10integrated care board].

[F11(6A)The Secretary of State may revise the mandate.

(6B)If the Secretary of State revises the mandate, the Secretary of State must publish and lay before Parliament the mandate as revised.]

(7)[F2NHS England] must—

(a)seek to achieve the objectives specified in the mandate, and

(b)comply with any requirements so specified.

(8)Before specifying any objectives or requirements in the mandate, the Secretary of State must consult—

(a)[F2NHS England],

(b)the Healthwatch England committee of the Care Quality Commission, and

(c)such other persons as the Secretary of State considers appropriate.

(9)Requirements included in the mandate have effect only if regulations so provide.

13B[F12Review of NHS England’s performance in implementing the mandate]E+W

(1)The Secretary of State must keep [F2NHS England’s] performance in achieving any objectives or requirements specified in the mandate under review.

F13(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F13(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F13(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F13(5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General duties of [F2NHS England]E+W

13CDuty to promote NHS ConstitutionE+W

(1)[F2NHS England] 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).

13DDuty as to effectiveness, efficiency etc.E+W

[F2NHS England] must exercise its functions effectively, efficiently and economically.

13EDuty as to improvement in quality of servicesE+W

(1)[F2NHS England] must exercise its functions with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with—

(a)the prevention, diagnosis or treatment of illness, or

(b)the protection or improvement of public health.

(2)In discharging its duty under subsection (1), [F2NHS England] 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.

(4)In discharging its duty under subsection (1), [F2NHS England] must have regard to—

(a)any document published by the Secretary of State for the purposes of this section, and

(b)the quality standards prepared by NICE under section 234 of the Health and Social Care Act 2012.

F1413FDuty as to promoting autonomyE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13GDuty as to reducing inequalitiesE+W

[F2NHS England] must, in the exercise of its functions, have regard to the need to—

(a)reduce inequalities between [F15persons] 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 [F16(including the outcomes described in section 13E(3))].

13HDuty to promote involvement of each patientE+W

[F2NHS England] 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.

13IDuty as to patient choiceE+W

[F2NHS England] 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.

13JDuty to obtain appropriate adviceE+W

[F17(1)] [F2NHS England] 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.

[F18(2)Subsection (1) does not apply in relation to NHS England’s education and training functions (see section 102 of the Care Act 2014 for the obtaining of advice in relation to those functions).]

13KDuty to promote innovationE+W

(1)[F2NHS England] must, in the exercise of its functions, promote innovation in the provision of health services (including innovation in the arrangements made for their provision).

(2)[F2NHS England] may make payments as prizes to promote innovation in the provision of health services.

(3)A prize may relate to—

(a)work at any stage of innovation (including research);

(b)work done at any time (including work before the commencement of section 23 of the Health and Social Care Act 2012).

13LDuty in respect of researchE+W

[F2NHS England] must, in the exercise of its functions, [F19facilitate 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.

13MDuty as to promoting education and trainingE+W

[F2NHS England] must, in exercising its functions [F20other than its education and training functions], have regard to the need to promote education and training for the persons mentioned in section 1F(1) so as to assist F21... in the discharge of the duty under that section.

13NDuty as to promoting integrationE+W

(1)[F2NHS England] 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)[F2NHS England] 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.

[F22(2A)Subsections (1) and (2) do not apply in relation to the exercise of NHS England’s education and training functions.]

(3)[F2NHS England] must encourage [F23integrated care boards] to enter into arrangements with local authorities in pursuance of regulations under section 75 where it considers that this would secure—

(a)that health services are provided in an integrated way and that this would have any of the effects mentioned in subsection (1)(a) to (c), or

(b)that the provision of health services is integrated with the provision of health-related services or social care services and that this would have any of the effects mentioned in subsection (2)(a) to (c).

(4)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 [F24or for the purposes of the Social Services and Well-being (Wales) Act 2014]).

[F25(5)For the purposes of this section, the provision of housing accommodation is a health-related service.]

[F2613NADuty to have regard to wider effect of decisionsE+W

(1)In making a decision about the exercise of its functions, NHS England 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, NHS England must have regard to guidance published by it 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.

13NBGuidance about discharge of dutyE+W

(1)NHS England may publish guidance about the discharge of—

(a)the duty imposed on it by section 13NA;

(b)the duty imposed on integrated care boards by section 14Z43;

(c)the duty imposed on NHS trusts by section 26A;

(d)the duty imposed on NHS foundation trusts by section 63A.

(2)NHS England must consult any persons NHS England considers it appropriate to consult—

(a)before first publishing guidance under this section, and

(b)before publishing any revised guidance containing changes that are, in the opinion of NHS England, significant.]

[F2713NCDuties as to climate change etcE+W

(1)NHS England 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, NHS England must have regard to guidance published by it under section 13ND.

13NDGuidance about discharge of duty under section 13NC etcE+W

NHS England may publish guidance about the discharge of—

(a)the duty imposed on it by section 13NC;

(b)the duty imposed on integrated care boards by section 14Z44;

(c)the duty imposed on NHS trusts by section 26B;

(d)the duty imposed on NHS foundation trusts by section 63B.]

13ODuty to have regard to impact on services in certain areasE+W

(1)In making commissioning decisions, [F2NHS England] must have regard to the likely impact of those decisions on the provision of health services to persons who reside in an area of Wales or Scotland that is close to the border with England.

(2)In this section, “commissioning decisions”, in relation to [F2NHS England], means decisions about the carrying out of its functions in arranging for the provision of health services.

13PDuty as respects variation in provision of health servicesE+W

[F2NHS England] must not exercise its functions for the purpose of causing a variation in the proportion of services provided as part of the health service that is provided by persons of a particular description if that description is by reference to—

(a)whether the persons in question are in the public or (as the case may be) private sector, or

(b)some other aspect of their status.

[F2813PA.Duty to cooperate for education and training functions and specified functionsE+W

(1)NHS England must, in exercising its education and training functions, co-operate with the Secretary of State in the exercise of the public health functions of the Secretary of State.

(2)Regulations may require NHS England and a person specified in those regulations to co-operate with each other in the exercise of—

(a)NHS England’s education and training functions;

(b)the functions of the specified person;

(c)such of the functions in paragraphs (a) or (b) as may be specified.]

Public involvementE+W

13QPublic involvement and consultation by [F2NHS England]E+W

(1)This section applies in relation to any health services which are, or are to be, provided pursuant to arrangements made by [F2NHS England] in the exercise of its functions (“commissioning arrangements”).

(2)[F2NHS England] must make arrangements to secure that individuals to whom the services are being or may be provided [F29, 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 [F2NHS England],

(b)in the development and consideration of proposals by [F2NHS England] for changes in the commissioning arrangements where the implementation of the proposals would have an impact on the manner in which the services are delivered to the individuals or the range of health services available to them, and

(c)in decisions of [F2NHS England] affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.

(3)The reference in subsection (2)(b) to the delivery of services is a reference to their delivery at the point when they are received by users.

[F30(4)This section does not require NHS England 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).]

Functions in relation to informationE+W

13RInformation on safety of services provided by the health serviceE+W

(1)[F2NHS England] must establish and operate systems for collecting and analysing information relating to the safety of the services provided by the health service.

(2)[F2NHS England] must make information collected by virtue of subsection (1), and any other information obtained by analysing it, available to such persons as [F2NHS England] considers appropriate.

(3)[F2NHS England] may impose charges, calculated on such basis as it considers appropriate, in respect of information made available by it under subsection (2).

(4)[F2NHS England] must give advice and guidance, to such persons as it considers appropriate, for the purpose of maintaining and improving the safety of the services provided by the health service.

(5)[F2NHS England] must monitor the effectiveness of the advice and guidance given by it under subsection (4).

(6)[F31An integrated care board] must have regard to any advice or guidance given to it under subsection (4).

(7)[F2NHS England] may arrange for any other person (including another NHS body) to exercise any of [F2NHS England’s] functions under this section.

(8)Arrangements made under subsection (7) do not affect the liability of [F2NHS England] for the exercise of any of its functions.

13SGuidance in relation to processing of informationE+W

(1)[F2NHS England] must publish guidance for registered persons on the practice to be followed by them in relation to the processing of—

(a)patient information, and

(b)any other information obtained or generated in the course of the provision of the health service.

(2)Registered persons who carry on an activity which involves, or is connected with, the provision of health care must have regard to any guidance published under this section.

(3)In this section, “patient information”, “processing” and “registered person” have the same meaning as in section 20A of the Health and Social Care Act 2008.

[F3213SAInformation about inequalitiesE+W

(1)NHS England must publish a statement setting out—

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

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

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

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

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

(3)In this section “relevant NHS bodies” means—

(a)integrated care boards,

(b)NHS trusts established under section 25, and

(c)NHS foundation trusts.]

[F33Regulatory functionsE+W

13SBMinimising conflicts between regulatory and other functionsE+W

(1)NHS England must make arrangements for—

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

(b)managing any conflicts that arise.

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

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

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

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

(3)Those provisions are—

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

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

(i)Chapter 3 (licensing);

(ii)Chapter 4 (NHS payment scheme);

(iii)Chapter 5 (health special administration);

(iv)Chapter 6 (financial assistance in special administration cases).]

[F3413SCProvision of regulatory information or assistance to the CMAE+W

(1)NHS England must give the Competition and Markets Authority (“the CMA”)—

(a)any regulatory information that the CMA may require to enable the CMA to exercise its relevant functions,

(b)any other regulatory information it considers would assist the CMA in exercising its relevant functions, and

(c)any other assistance the CMA may require to assist the CMA in exercising its relevant functions.

(2)In this section—

• “regulatory information” means information held by NHS England in connection with—

  (a)

  its regulatory functions falling within section 13SB(2)(a) or (b), or

  (b)

  its functions under—

  (i)

  sections 6F and Schedule 1ZA (patient choice: enforcement);

  (ii)

  sections 27A and 27C (NHS trusts: oversight and support and recommendations about restructuring);

• “relevant functions”, in relation to the CMA, means its functions under the Competition Act 1998 and the Enterprise Act 2002 so far as those functions are exercisable on behalf of the CMA by the CMA Board or a CMA group (within the meaning of Schedule 4 to the Enterprise and Regulatory Reform Act 2013).]

Business plan and reportE+W

13TBusiness planE+W

(1)Before the start of each financial year, [F2NHS England] must publish a business plan setting out how it proposes to exercise its functions in that year and each of the next two financial years.

(2)The business plan must, in particular, explain how [F2NHS England] proposes to discharge its duties under—

(a)sections 13E, 13G [F35, 13L] and 13Q, and

(b)sections 223C to 223E.

(3)The business plan must, in particular, explain how [F2NHS England] proposes to achieve the objectives, and comply with the requirements, specified in the mandate F36....

[F37(3A)The fact that the mandate is revised during the period to which a business plan relates does not require NHS England to revise the plan.]

(4)[F2NHS England] may revise the plan.

(5)[F2NHS England] must publish any revised plan.

13UAnnual reportE+W

(1)As soon as practicable after the end of each financial year, [F2NHS England] must publish an annual report on how it has exercised its functions during the year.

(2)The annual report must, in particular, contain an assessment of—

[F38(a)the extent to which, in that year, it met any objectives or requirements specified in the mandate,]

(b)the extent to which it gave effect to the proposals for that year in its business plan, F39...

(c)how effectively it discharged its duties under [F40or by virtue of—

• section 6E(1A) and (1B);

• section 13E;

• section 13G;

• section 13I;

• [F41section 13L;]

• section 13Q.]

(d)how effectively it discharged its relevant data functions (as defined by section 253(3) of the Health and Social Care Act 2012)[F42, and

(e)how effectively it has discharged its education and training functions including, in particular, the extent to which it has during the year achieved the outcomes set by the Secretary of State for the purpose of section 100(2) of the Care Act 2014.]

[F43(2A)The annual report must include a statement explaining what NHS England has done, during the financial year, to comply with its duties under section 13SB.]

[F44(2B)The annual report must include—

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

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

(c)an explanation of the statement and calculation.]

(3)[F2NHS England] must—

(a)lay the annual report before Parliament, and

(b)once it has done so, send a copy of it to the Secretary of State.

(4)The Secretary of State must, having considered the annual report, set out in a letter to [F2NHS England] the Secretary of State's assessment of [F2NHS England’s] performance of its functions in the financial year in question.

(5)The letter must, in particular, contain the Secretary of State's assessment of the matters mentioned in subsection (2)(a) to (c).

(6)The Secretary of State must—

(a)publish the letter to [F2NHS England], and

(b)lay it before Parliament.

[F45Joint appointmentsE+W

13UAGuidance about joint appointmentsE+W

(1)NHS England may publish guidance for a relevant NHS body about the making of a joint appointment to which this section applies.

(2)A joint appointment to which this section applies is an appointment of a person to a position in—

(a)one or more relevant NHS commissioner and one or more relevant NHS provider,

(b)one or more relevant NHS body and one or more local authority, F46...

(c)one or more relevant NHS body and one or more combined authority[F47, or

(d)one or more relevant NHS body and one or more combined county authority.]

(3)A relevant NHS body must have regard to guidance published under this section.

(4)NHS England must consult such persons as NHS England considers appropriate—

(a)before it first publishes guidance under this section, and

(b)before it publishes any revised guidance containing changes that are, in the opinion of NHS England, significant.

(5)In this section—

• “local authority” has the same meaning as in section 2B;

• “relevant NHS body” means—

  (a)

  a relevant NHS commissioner;

  (b)

  a relevant NHS provider;

• “relevant NHS commissioner” means—

  (a)

  NHS England;

  (b)

  an integrated care board;

• “relevant NHS provider” means—

  (a)

  an NHS trust established under section 25;

  (b)

  an NHS foundation trust.]

Additional powersE+W

13VEstablishment of pooled fundsE+W

(1)[F2NHS England] and one or more [F48integrated care boards] may establish and maintain a pooled fund.

(2)A pooled fund is a fund—

(a)which is made up of contributions by the bodies which established it, and

(b)out of which payments may be made, with the agreement of those bodies, towards expenditure incurred in the discharge of any of their commissioning functions.

(3)In this section, “commissioning functions” means functions in arranging for the provision of services as part of the health service.

13W [F49NHS England’s] power to generate income, etc.E+W

(1)[F2NHS England] has power to do anything specified in section 7(2) of the Health and Medicines Act 1988 (provision of goods, services, etc.) for the purpose of making additional income available for improving the health service.

(2)[F2NHS England] may exercise a power conferred by subsection (1) only to the extent that its exercise does not to any significant extent interfere with the performance by [F2NHS England] of its functions.

13XPower to make grants etc.E+W

(1)[F2NHS England] may make payments 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 [F2NHS England] has functions.

(2)The payments may be made subject to such terms and conditions as [F2NHS England] considers appropriate.

13Y [F50NHS England’s] incidental powers: further provisionE+W

The power conferred on [F2NHS England] 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 [F2NHS England]).

[F51Assistance and supportE+W

13YAPower of NHS England to provide assistance and supportE+W

(1)NHS England may provide assistance or support to—

(a)any person providing or proposing to provide services as part of the health service;

(b)any person, not within paragraph (a), exercising functions in relation to the health service.

[F52(c)any public authority, where the assistance or support is in relation to the education or training of health care workers.]

[F53(1A)In subsection (1), “health care workers” means persons in relation to whom the Secretary of State’s duty under section 1F(1) is to be performed.]

(2)The assistance that may be provided under [F54subsection (1)] includes making available the services of NHS England’s employees or any other resources of NHS England.

[F55(3)The assistance that may be provided under subsection (1)(a) or (c), or that may be provided under subsection (1)(b) to integrated care boards, also includes financial assistance.]

(4)Assistance or support provided under this section may be provided on such terms, including terms as to payment, as NHS England considers appropriate.]

[F56(5)In this section, a reference to a public authority—

(a)includes a public authority in the Channel Islands or the Isle of Man, but

(b)subject to that, does not include a reference to a public authority outside the United Kingdom.]

[F57Discharge of functionsE+W

13YBDirections in respect of functions relating to provision of servicesE+W

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

(2)In this section “relevant function” means—

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

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

(i)primary medical services,

(ii)primary dental services,

(iii)primary ophthalmic services, or

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

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

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

(3)Regulations may—

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

(b)impose conditions on the exercise of the power.

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

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

(6)NHS England may make payments to an integrated care board in respect of the exercise by it of a function by virtue of a direction under subsection (1).

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

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

(9)Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by an integrated care board of any function by virtue of this section are enforceable by or against it (and no other person).]

F58...E+W

F5813ZExercise of functionsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F5813ZASection 13Z: further provision in relation to devolved arrangementsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F5813ZBSection 13Z: arrangements in relation to the function under section 3B(1)(d)E+W

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[F59Powers of directionE+W

13ZCSecretary of State directions as to exercise of NHS England functionsE+W

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

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

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

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

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

(c)matters to be taken into account in exercising a function.

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

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

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

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

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

13ZDPower to give directions: exceptionsE+W

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

(2)A direction under section 13ZC may not be given in relation to a decision about the services to be provided to a particular individual for or in connection with the prevention, diagnosis or treatment of illness.

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

13ZECompliance with directions: significant failureE+W

(1)This section applies where—

(a)NHS England is given a direction under section 13ZC,

(b)the direction —

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

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

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

(d)NHS England fails to comply with the direction.

(2)The Secretary of State may—

(a)discharge the functions to which the direction relates, or

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

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

(4)For the purpose of this section—

(a)a failure to discharge a function includes a failure to discharge it properly, and

(b)a failure to discharge a function properly includes a failure to discharge it consistently with what the Secretary of State considers to be the interests of the health service.

13ZFSecretary of State directions to provide informationE+W

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

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

(3)The directions may include provision as to—

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

(b)the time at which or period within which the documents or information must be provided.]

Power to confer additional functionsE+W

13Z1Power to confer additional functions on [F2NHS England]E+W

(1)Regulations may provide that [F2NHS England] is to have such additional functions in relation to the health service as may be specified in the regulations.

(2)A function may be specified in regulations under subsection (1) only if the function is connected to another function of [F2NHS England].

F60...E+W

F6013Z2Failure by the Board to discharge any of its functionsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Disclosure of informationE+W

13Z3Permitted disclosures of informationE+W

(1)[F2NHS England] 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 [F2NHS England’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)Paragraphs (a) to (c) and (h) of subsection (1) have effect notwithstanding any rule of common law which would otherwise prohibit or restrict the disclosure.

InterpretationE+W

13Z4InterpretationE+W

(1)In this Chapter—

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

• “health services” means services provided as part of the health service and, in sections 13O and 13Q, also includes services that are to be provided as part of the health service.

F61(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F61(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F61(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .]

F62CHAPTER A2E+WClinical commissioning groups

Establishment of clinical commissioning groupsE+W

F6214AGeneral duties of Board in relation to clinical commissioning groupsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214BApplications for the establishment of clinical commissioning groupsE+W

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F6214CDetermination of applicationsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214DEffect of grant of applicationE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Variation of constitutionE+W

F6214EApplications for variation of constitutionE+W

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F6214FVariation of constitution otherwise than on applicationE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mergers, dissolution etc.E+W

F6214GMergersE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214HDissolutionE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplemental provision about applications, variation, mergers etc.E+W

F6214ITransfers in connection with variation, merger, dissolution etc.E+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214JPublication of constitution of clinical commissioning groupsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214KGuidance about the establishment of clinical commissioning groups etc.E+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Governing bodies of clinical commissioning groupsE+W

F6214LGoverning bodies of clinical commissioning groupsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214MAudit and remuneration committees of governing bodiesE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214NRegulations as to governing bodies of clinical commissioning groupsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Conflicts of interestE+W

F6214ORegisters of interests and management of conflicts of interestE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General duties of clinical commissioning groupsE+W

F6214PDuty to promote NHS ConstitutionE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214QDuty as to effectiveness, efficiency etc.E+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214RDuty as to improvement in quality of servicesE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214SDuty in relation to quality of primary medical servicesE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214TDuties as to reducing inequalitiesE+W

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F6214UDuty to promote involvement of each patientE+W

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F6214VDuty as to patient choiceE+W

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F6214WDuty to obtain appropriate adviceE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214XDuty to promote innovationE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214YDuty in respect of researchE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214ZDuty as to promoting education and trainingE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z1Duty as to promoting integrationE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Public involvementE+W

F6214Z2Public involvement and consultation by clinical commissioning groupsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Arrangements with othersE+W

F6214Z3Arrangements by clinical commissioning groups in respect of the exercise of functionsE+W

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F6214Z3AJoint exercise of functions with combined authoritiesE+W

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F6214Z4Joint exercise of functions with Local Health BoardsE+W

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Additional powers of clinical commissioning groupsE+W

F6214Z5Raising additional incomeE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z6Power to make grantsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Board's functions in relation to clinical commissioning groupsE+W

F6214Z7Responsibility for payments to providersE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z8Guidance on commissioning by the BoardE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z9Exercise of functions by, or jointly with, the BoardE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z10Power of Board to provide assistance or supportE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Commissioning plans and reportsE+W

F6214Z11Commissioning planE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z12Revision of commissioning plansE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z13Consultation about commissioning plansE+W

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F6214Z14Opinion of Health and Wellbeing Boards on commissioning plansE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6214Z15Reports by clinical commissioning groupsE+W

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Performance assessment of clinical commissioning groupsE+W

F6214Z16Performance assessment of clinical commissioning groupsE+W

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Powers to require information etc.E+W

F6214Z17Circumstances in which powers in sections 14Z18 and 14Z19 applyE+W

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F6214Z18Power to require documents and information etc.E+W

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F6214Z19Power to require explanationE+W

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F6214Z20Use of informationE+W

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Intervention powersE+W

F6214Z21Power to give directions, dissolve clinical commissioning groups etc.E+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Procedural requirements in connection with certain powersE+W

F6214Z22Procedural requirements in connection with certain powersE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Disclosure of informationE+W

F6214Z23Permitted disclosures of informationE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

InterpretationE+W

F6214Z24InterpretationE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F63CHAPTER A3E+WIntegrated care boards

Establishment of integrated care boards (including by re-purposing clinical commissioning groups)E+W

14Z25Duty to establish integrated care boardsE+W

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

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

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

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

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

(6)In Schedule 1B—

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

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

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

(8)NHS England must publish orders under this section.

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

14Z26Process for establishing initial integrated care boardsE+W

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

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

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

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

(a)the proposal is inappropriate, or

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

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

(5)Nothing in this section—

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

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

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

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

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

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

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

14Z27Abolition of clinical commissioning groupsE+W

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

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

14Z28Transfer schemes in connection with integrated care boardsE+W

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

(2)NHS England may, in connection with the establishment of an integrated care board, make a scheme for the transfer of property, rights or liabilities to the board from—

(a)NHS England,

(b)an NHS trust established under section 25,

(c)an NHS foundation trust, or

(d)a Special Health Authority established under section 28.

(3)NHS England may, in connection with the variation of the constitution of an integrated care board or the abolition of an integrated care board, make a scheme for the transfer of the board’s property, rights or liabilities to NHS England or an integrated care board.

(4)The reference in subsection (3) to the variation of the constitution of an integrated care board is to its variation by order under section 14Z25 or under provision included in its constitution by virtue of paragraph 14 of Schedule 1B.

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

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

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

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

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

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

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

(c)criminal liabilities.

(7)A transfer scheme may—

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

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

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

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

(e)make provision for the shared ownership or use of property;

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

(g)make other consequential, supplementary, incidental or transitional provision.

(8)A transfer scheme may provide—

(a)for modifications by agreement;

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

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

(10)In this section—

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

(b)references to the transfer of property include the grant of a lease.

Constitution: publicationE+W

14Z29Duty for integrated care board to publish constitutionE+W

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

Conflicts of interestE+W

14Z30Register of interests and management of conflicts of interestsE+W

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

(a)members of the board,

(b)members of its committees or sub-committees, and

(c)its employees.

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

(3)Each integrated care board must make arrangements to ensure—

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

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

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

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

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

[F64People for whom integrated care board has responsibilityE+W

14Z31People for whom integrated care board has responsibilityE+W

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

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

(a)everyone who is provided with NHS primary medical services, and

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

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

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

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

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

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

(c)section 92 arrangements for the provision of primary medical services of a prescribed description.]

[F65General duties of integrated care boardsE+W

14Z32Duty to promote NHS ConstitutionE+W

(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 etcE+W

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

14Z34Duty as to improvement in quality of servicesE+W

(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 inequalitiesE+W

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 patientE+W

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 choiceE+W

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 adviceE+W

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 innovationE+W

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 researchE+W

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 trainingE+W

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 [F66NHS England] in the discharge of the duty under that section.

14Z42Duty to promote integrationE+W

(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 decisionsE+W

(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 etcE+W

(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 publicE+W

14Z45Public involvement and consultation by integrated care boardsE+W

(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 BoardsE+W

14Z46Joint exercise of functions with Local Health BoardsE+W

(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 boardsE+W

14Z47Raising additional incomeE+W

(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 grantsE+W

(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 membersE+W

14Z49Duty to keep experience of members under review etcE+W

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 boardsE+W

14Z50Responsibility for payments to providersE+W

(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 EnglandE+W

(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 reportsE+W

14Z52Joint forward plans for integrated care board and its partnersE+W

(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 plansE+W

(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 plansE+W

(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 planE+W

(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 partnersE+W

(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 plansE+W

(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 reportE+W

(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 boardsE+W

14Z59Performance assessment of integrated care boardsE+W

(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 informationE+W

14Z60Power of NHS England to obtain informationE+W

(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 powersE+W

14Z61Power to give directions to integrated care boardsE+W

(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—