Part 1 Promotion and provision of the health service in England

The Secretary of State and the health service in England

1 Secretary of State's duty to promote comprehensive health service

(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—

(a) in the physical and mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of physical and mental illness.

(2) For that purpose, the Secretary of State must exercise the functions conferred by this Act so as to secure that services are provided in accordance with this Act.

(3) The Secretary of State retains ministerial responsibility to Parliament for the provision of the health service in England.

(4) The services provided as part of the health service in England must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.

1A Duty as to improvement in quality of services

(1) The Secretary of State must exercise the functions of the Secretary of State in relation to the health service 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 the duty under subsection (1) the Secretary of State 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 the duty under subsection (1), the Secretary of State must have regard to the quality standards prepared by NICE under section 234 of the Health and Social Care Act 2012.

1B Duty as to the NHS Constitution

(1) In exercising functions in relation to the health service, the Secretary of State must have regard to the NHS Constitution.

(2) In this Act, “ NHS Constitution ” has the same meaning as in Chapter 1 of Part 1 of the Health Act 2009(see section 1 of that Act).

1C Duty as to reducing inequalities

In exercising functions in relation to the health service, the Secretary of State must have regard to the need to reduce inequalities between the people of England with respect to the benefits that they can obtain from the health service.

1D Duty as to promoting autonomy

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1E Duty as to research

In exercising functions in relation to the health service, the Secretary of State must 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.

1F Duty as to education and training

(1) The Secretary of State must exercise the functions of the Secretary of State under any relevant enactment so as to secure that there is an effective system for the planning and delivery of education and training to persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service in England.

(2) Any arrangements made with a person under this Act for the provision of services as part of that health service must include arrangements for securing that the person co-operates with the Secretary of State and NHS England in the discharge of the duty under subsection (1) (or, where a Special Health Authority is discharging that duty by virtue of a direction under section 7, with the Special Health Authority).

(3) In subsection (1), “ relevant enactment ” means—

(a) section 63 of the Health Services and Public Health Act 1968,

(b) this Act,

(c) the Health and Social Care Act 2008,

(d) the Health Act 2009, and

(e) the Health and Social Care Act 2012.

1G Secretary of State's duty as to reporting on and reviewing treatment of providers

(1) The Secretary of State must, within one year of the passing of the Health and Social Care Act 2012, lay a report before Parliament on the treatment of NHS health care providers as respects any matter, including taxation, which might affect their ability to provide health care services for the purposes of the NHS or the reward available to them for doing so.

(2) The report must include recommendations as to how any differences in the treatment of NHS health care providers identified in the report could be addressed.

(3) The Secretary of State must keep under review the treatment of NHS health care providers as respects any such matter as is mentioned in subsection (1).

(4) In this section—

(a) “ NHS health care providers ” means persons providing or intending to provide health care services for the purposes of the NHS , and

(b) “ health care services for the purposes of the NHS ” has the same meaning as in Part 3 of the Health and Social Care Act 2012.

1GA Secretary of State’s duty to report on workforce systems

(1) The Secretary of State must, at least once every five years, publish a report describing the system in place for assessing and meeting the workforce needs of the health service in England.

(2) NHS England ...must assist in the preparation of a report under this section, if requested to do so by the Secretary of State.

Role of NHS England in the health service in England

1H NHS England and its general functions

(1) There is to be a body corporate known as NHS England .

(2) NHS England

is subject to the duty under section 1(1) concurrently with the Secretary of State except in relation to the part of the health service that is provided in pursuance of the public health functions of the Secretary of State or local authorities.

(3) For the purpose of discharging that duty, NHS England —

(a) has the function of arranging for the provision of services for the purposes of the health service in England in accordance with this Act, and

(b) must exercise the functions conferred on it by this Act in relation to integrated care boards , NHS trusts established under section 25 and NHS foundation trusts so as to secure that services are provided for those purposes in accordance with this Act.

(4) Schedule A1 makes further provision about NHS England .

(5) In this Act—

(a) any reference to the public health functions of the Secretary of State is a reference to the functions of the Secretary of State under sections 2A and 2B and paragraphs 7C, 8 and 12 of Schedule 1, and

(b)

any reference to the public health functions of local authorities is a reference to the functions of local authorities under sections 2B and 111 and paragraphs 1 to 7B and 13 of Schedule 1.

Role of integrated care boards in the health service in England

1I General functions of integrated care boards

An integrated care board established under Chapter A3 of Part 2 has the function of arranging for the provision of services for the purposes of the health service in England in accordance with this Act.

General power

2. General power

(1) The Secretary of State may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any function conferred on the Secretary of State by this Act.

(2) NHS England or an integrated care board may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any of its functions.

Provision for protection or improvement of public health

2A Secretary of State's duty as to protection of public health

(1) The Secretary of State must take such steps as the Secretary of State considers appropriate for the purpose of protecting the public in England from disease or other dangers to health.

(2) The steps that may be taken under subsection (1) include—

(a) the conduct of research or such other steps as the Secretary of State considers appropriate for advancing knowledge and understanding;

(b) providing microbiological or other technical services (whether in laboratories or otherwise);

(c) providing vaccination, immunisation or screening services;

(d) providing other services or facilities for the prevention, diagnosis or treatment of illness;

(e) providing training;

(f) providing information and advice;

(g) making available the services of any person or any facilities.

(3) Subsection (4) applies in relation to any function under this section which relates to—

(a) the protection of the public from ionising or non-ionising radiation, and

(b) a matter in respect of which a relevant body has a function.

(4) In exercising the function, the Secretary of State must—

(a) consult the relevant body , and

(b) have regard to its policies.

(5) For the purposes of subsections (3) and (4), each of the following is a relevant body—

(a) the Health and Safety Executive;

(b) the Office for Nuclear Regulation.

2B Functions of local authorities and Secretary of State as to improvement of public health

(1) Each local authority must take such steps as it considers appropriate for improving the health of the people in its area.

(2) The Secretary of State may take such steps as the Secretary of State considers appropriate for improving the health of the people of England.

(3) The steps that may be taken under subsection (1) or (2) include—

(a) providing information and advice;

(b) providing services or facilities designed to promote healthy living (whether by helping individuals to address behaviour that is detrimental to health or in any other way);

(c) providing services or facilities for the prevention, diagnosis or treatment of illness;

(d) providing financial incentives to encourage individuals to adopt healthier lifestyles;

(e) providing assistance (including financial assistance) to help individuals to minimise any risks to health arising from their accommodation or environment;

(f) providing or participating in the provision of training for persons working or seeking to work in the field of health improvement;

(g) making available the services of any person or any facilities.

(4) The steps that may be taken under subsection (1) also include providing grants or loans (on such terms as the local authority considers appropriate).

(5) In this section, “ local authority ” means—

(a) a county council in England;

(b) a district council in England, other than a council for a district in a county for which there is a county council;

(c) a London borough council;

(d) the Council of the Isles of Scilly;

(e) the Common Council of the City of London.

Arrangements for the provision of certain health services

3. Duties of integrated care boards as to commissioning certain health services

(1) An integrated care board must arrange for the provision of the following to such extent as it considers necessary to meet the reasonable requirements of the people for whom it has responsibility—

(a) hospital accommodation,

(b) other accommodation for the purpose of any service provided under this Act,

(c) medical services other than primary medical services (for primary medical services, see Part 4),

(d) dental services other than primary dental services (for primary dental services, see Part 5),

(e) ophthalmic services other than primary ophthalmic services (for primary ophthalmic services, see Part 6),

(f) nursing and ambulance services,

(g) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as the board considers are appropriate as part of the health service,

(h) such other services or facilities for palliative care as the board considers are appropriate as part of the health service,

(i) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as the board considers are appropriate as part of the health service, and

(j) such other services or facilities as are required for the diagnosis and treatment of illness.

(2) For the purposes of this section an integrated care board has responsibility for—

(a) the group of people for whom it has core responsibility (see section 14Z31 ), and

(b) such other people as may be prescribed (whether generally or in relation to a prescribed service or facility).

(3) The duty imposed on an integrated care board by subsection (1) to arrange for the provision of services or facilities does not apply to the extent that—

(a) NHS England has a duty to arrange for their provision;

(b) another integrated care board has a duty to arrange for their provision by virtue of subsection (2)(b) .

(4) In exercising its functions under this section, an integrated care board must act consistently with—

(a) the discharge by the Secretary of State and NHS England of their duty under section 1(1) (duty to promote a comprehensive health service), and

(b) the objectives and requirements for the time being specified in the mandate published under section 13A.

3A. Power of integrated care boards to commission certain health services

(1) Each integrated care board may arrange for the provision of such services or facilities as it considers appropriate for the purposes of the health service that relate to securing improvement—

(a) in the physical and mental health of the people for whom it has responsibility, or

(b) in the prevention, diagnosis and treatment of illness in those people.

(2) For the purposes of this section an integrated care board has responsibility for—

(a) the group of people for whom it has core responsibility (see section 14Z31 ), and

(b) such other people as may be prescribed (whether generally or in relation to a prescribed service or facility).

(3) An integrated care board may not arrange for the provision of a service or facility under subsection (1) if NHS England has a duty to arrange for its provision by virtue of section 3B or 4.

(4) In exercising its functions under this section, an integrated care board must act consistently with—

(a) the discharge by the Secretary of State and NHS England of their duty under section 1(1) (duty to promote a comprehensive health service), and

(b) the objectives and requirements for the time being specified in the mandate published under section 13A.

3B Secretary of State's power to require NHS England to commission services

(1) Regulations may require NHS England to arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of—

(a) dental services of a prescribed description;

(b) services or facilities for members of the armed forces or their families;

(c) services or facilities for persons who are detained in a prison or in other accommodation of a prescribed description;

(d) such other services or facilities as may be prescribed.

(2) A service or facility may be prescribed under subsection (1)(d) only if the Secretary of State considers that it would be appropriate for NHS England to arrange for the provision of that service or facility (whether by NHS England making arrangements itself or by giving directions under section 13YB or making arrangements under section 65Z5).

(3) In deciding whether it would be so appropriate, the Secretary of State must have regard to—

(a) the number of individuals who require the provision of the service or facility;

(b) the cost of providing the service or facility;

(c) the number of persons able to provide the service or facility;

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(4) Before deciding whether to make regulations under this section, the Secretary of State must—

(a) obtain advice appropriate for that purpose, and

(b) consult NHS England .

(4A) If the Secretary of State refuses a request by NHS England to revoke provision made by regulations under subsection (1)(d) prescribing a service or facility, the Secretary of State must explain why to NHS England.

(5) The reference in subsection (1)(b) to members of the armed forces is a reference to persons who are members of—

(a) the regular forces within the meaning of the Armed Forces Act 2006, or

(b) the reserve forces within the meaning of that Act.

4 High security psychiatric services

(1) NHS England must arrange for the provision of hospital accommodation and services for persons who—

(a) are liable to be detained under the Mental Health Act 1983 (c. 20), and

(b) in the opinion of the Secretary of State require treatment under conditions of high security on account of their dangerous, violent or criminal propensities.

(2) The hospital accommodation and services mentioned in subsection (1) are referred to in this section and paragraph 15 of Schedule 4 (NHS trusts) as “high security psychiatric services”.

(3) High security psychiatric services may be provided —

(a) only at hospital premises at which services are provided only for the persons mentioned in subsection (1) , and

(b) only by a person approved by the Secretary of State for the purposes of this subsection.

(3A) The Secretary of State may—

(a) give directions to a person who provides high security psychiatric services about the provision by that person of those services;

(b) give directions to NHS England about the exercise of its functions in relation to high security psychiatric services.

(4) “ Hospital premises ” means—

(a) a hospital, or

(b) any part of a hospital which is treated as a separate unit.

5 Other services

Schedule 1 makes further provision about the provision of services for the purposes of the health service in England .

Provision of services otherwise than in England

6 Performance of functions outside England

(1) Where the Secretary of State has a duty or power to provide anything under section 2A or 2B or Schedule 1, that thing may be provided outside England.

(1A) Where an integrated care board or NHS England has a duty or power to arrange for the provision of anything under section 3, 3A, 3B or 4 or Schedule 1, it may arrange for that thing to be provided outside England.

(2) The functions of the Secretary of State, NHS England and integrated care boards may be performed outside England and Wales, in so far as they relate to—

(a) holidays for patients,

(b) the transfer of patients to or from Scotland, Northern Ireland, the Isle of Man or the Channel Islands, or

(c) the return of patients who have received treatment in England and Wales, to countries or territories outside the British Islands (including for this purpose the Republic of Ireland).

6A. Reimbursement of cost of services provided in another EEA state

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6B. Prior authorisation for the purposes of section 6A

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6BA Reimbursement of cost of services provided in another EEA state where expenditure incurred on or after 25 October 2013.

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6BB Prior authorisation for the purposes of section 6BA

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Regulations as to the exercise of functions

6C Regulations as to the exercise by local authorities of certain public health functions

(1) Regulations may require a local authority to exercise any of the public healthfunctions of the Secretary of State (so far as relating to the health of the public in the authority's area) by taking such steps as may be prescribed.

(2) Regulations may require a local authority to exercise its public healthfunctions by taking such steps as may be prescribed.

(3) Where regulations under subsection (1) require a local authority to exercise any of the public healthfunctions of the Secretary of State, the regulations may also authorise or require the local authority to exercise any prescribedfunctions of the Secretary of State that are exercisable in connection with those functions (including the powers conferred by section 12).

(4) The making of regulations under subsection (1) does not prevent the Secretary of State from taking any step that a local authority is required to take under the regulations.

(5) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a local authority of any of its functions under regulations under subsection (1) are enforceable by or against the local authority (and no other person).

(6) In this section, “ local authority ” has the same meaning as in section 2B.

6D Regulations relating to EU obligations

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6E Regulations as to the exercise of functions by NHS England or integrated care boards

(1) Regulations must impose requirements (to be known as “ standing rules ”) in accordance with this section on NHS England and on integrated care boards .

(1A) The regulations must make provision as to the arrangements that NHS England and integrated care boards must make, in exercising their commissioning functions, for enabling persons to whom specified treatments or other specified services are to be provided to make choices with respect to specified aspects of them.

(1B) The regulations may make other provision for the purpose of securing that, in exercising their commissioning functions, NHS England and integrated care boards protect and promote the rights of persons to make choices in relation to treatments or other services, where those rights—

(a) arise by virtue of regulations under subsection (1A) , or

(b) are described in the NHS Constitution.

(2) The regulations may, in relation to the commissioning functions of NHS England or integrated care boards , make provision—

(a) requiring NHS England or integrated care boards to arrange for specified treatments or other specified services to be provided or to be provided in a specified manner or within a specified period;

(b) as to the arrangements that NHS England or integrated care boards must make for the purpose of making decisions as to—

(i) the treatments or other services that are to be provided;

(ii) the manner in which or period within which specified treatments or other specified services are to be provided;

(iii) the persons to whom specified treatments or other specified services are to be provided;

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(3) Regulations by virtue of paragraph (b) of subsection (2) may, in particular, make provision—

(a) requiring NHS England or an integrated care board to take specified steps before making decisions as to the matters mentioned in that paragraph;

(b) as to reviews of, or appeals from, such decisions.

(4) The regulations may—

(a) specify matters for which provision must be made in commissioning contracts entered into by NHS England or integrated care boards ;

(b) require NHS England to draft terms and conditions making provision for those matters;

(c) require NHS England or integrated care boards to incorporate the terms and conditions drafted by virtue of paragraph (b) in commissioning contracts entered into by NHS England or (as the case may be) integrated care boards .

(5) The regulations must—

(a) require NHS England to draft such terms and conditions as NHS England considers are, or might be, appropriate for inclusion in commissioning contracts entered into by NHS England or integrated care boards (other than terms and conditions that NHS England is required to draft by virtue of subsection (4)(a));

(b) authorise NHS England to require integrated care boards to incorporate terms and conditions prepared by virtue of paragraph (a) in their commissioning contracts;

(c) authorise NHS England to draft model commissioning contracts.

(6) The regulations may require NHS England to consult prescribed persons before exercising any of its functions by virtue of subsection (4)(b) or (5).

(7) The regulations may require NHS England or integrated care boards in the exercise of any of its or their functions—

(a) to provide information of a specified description to specified persons in a specified manner;

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(c) to do such other things as the Secretary of State considers necessary for the purposes of the health service.

(8) The regulations may not impose a requirement on only one integrated care board .

(9) If regulations under this section are made so as to come into force on a day other than 1 April, the Secretary of State must—

(a) publish a statement explaining the reasons for making the regulations so as to come into force on such a day, and

(b) lay the statement before Parliament.

(10) In this section—

(a) “ commissioning contracts ”, in relation to NHS England or integrated care boards , means contracts entered into by NHS England or (as the case may be) integrated care boards in the exercise of its or their commissioning functions;

(b) “ commissioning functions ”, in relation to NHS England or integrated care boards , means the functions of NHS England or (as the case may be) integrated care boards in arranging for the provision of services as part of the health service;

(c) “ specified ” means specified in the regulations.

6F Enforcement of section 6E regulations relating to patient choice

(1) NHS England may investigate whether an integrated care board has failed or is likely to fail to comply with a requirement imposed by regulations under section 6E (1A) or (1B) (a “patient choice requirement”).

(2) NHS England may direct an integrated care board—

(a) to put in place measures for the purpose of preventing failures to comply with patient choice requirements or mitigating the effect of such failures, or

(b) where an investigation under subsection (1) has been carried out, to remedy a failure to comply with patient choice requirements.

(3) Where an investigation under subsection (1) is being or has been carried out, NHS England may accept from the integrated care board an undertaking that it will take any action falling within subsection (2)(a) or (b) that is specified in the undertaking, within a period that is so specified.

(4) Where NHS England accepts an undertaking under subsection (3) , NHS England may not—

(a) continue to carry out any ongoing investigation under subsection (1) so far as relating to matters to which the undertaking relates, or

(b) give a direction under subsection (2) in relation to those matters,

unless the integrated care board fails to comply with the undertaking.

(5) If an integrated care board from which NHS England has accepted an undertaking under subsection (3) complies partially with the undertaking, NHS England must take the partial compliance into account in deciding whether to do something mentioned in subsection (4) (a) or (b) .

(6) Schedule 1ZA makes further provision about undertakings.

6G Guidance relating to patient choice

(1) NHS England must publish guidance about how it intends to exercise powers conferred on it by section 6F and Schedule 1ZA.

(2) Before publishing guidance under this section, NHS England must obtain the approval of the Secretary of State.

Functions of Special Health Authorities

7 Functions of Special Health Authorities

(1) The Secretary of State may direct a Special Health Authority to exercise any functions of the Secretary of State or any other person which relate to the health service in England and are specified in the direction.

(1A) Subsection (1) does not apply to any function of the Secretary of State of making an order or regulations.

(1B) Before exercising the power in subsection (1) in relation to a function of a person other than the Secretary of State, the Secretary of State must consult that person.

(1C) Regulations may provide that a Special Health Authority specified in the regulations is to have such additional functions in relation to the health service in England as may be so specified.

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Exercise of Secretary of State's public health functions

7A. Exercise of Secretary of State’s public health functions

(1) The Secretary of State may arrange for any of the public healthfunctions of the Secretary of State to be exercised by one or more relevant bodies.

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

(a) NHS England,

(b) an integrated care board,

(c) a local authority (within the meaning of section 2B),

(d) a combined authority, or

(da) a combined county authority, or

(e) such other body as may be prescribed.

(3) Arrangements under this section may be made on such terms as may be agreed between the parties including—

(a) terms as to payment;

(b) terms prohibiting or restricting a relevant body from making delegation arrangements in relation to a function that is exercisable by it by virtue of arrangements under this section.

(4) In subsection (3)(b) “ delegation arrangements ” means arrangements made by a person for the exercise of a function by someone else.

(5) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a relevant body of any function by virtue of this section are enforceable by or against that body (and no other person).

(6) The reference in subsection (1) to the public healthfunctions of the Secretary of State includes any functions of the Secretary of State exercisable in connection with those functions (including the powers conferred by section 12).

7B Directions requiring NHS bodies to exercise public health functions

(1) The Secretary of State may by direction provide for any of the public healthfunctions of the Secretary of State to be exercised by one or more relevant bodies.

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

(a) NHS England, or

(b) an integrated care board.

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

(4) In subsection (3) “ delegation arrangements ” means arrangements made by a person for the exercise of a function by someone else.

(5) The Secretary of State may make payments to a relevant body in respect of the exercise by it of a function by virtue of a direction under subsection (1) .

(6) The Secretary of State may give directions to an integrated care board as to the exercise by it of any functions by virtue of this section.

(7) For power to give directions to NHS England as to the exercise of functions, see section 13ZC.

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

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

(10) The reference in subsection (1) to the public healthfunctions of the Secretary of State includes any functions of the Secretary of State exercisable in connection with those functions (including the powers conferred by section 12).

7C Power of direction: investigation functions

(1) The Secretary of State may direct—

(a) NHS England, or

(b) any other public body,

to exercise any of the investigation functions which are specified in the direction.

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

(3) In subsection (2) “ delegation arrangements ” means arrangements made by a person for the exercise of a function by someone else.

(4) The Secretary of State may make payments to NHS England or any other body in respect of the exercise by it of a function by virtue of a direction under subsection (1) .

(5) The Secretary of State may give directions to any body on whom functions are conferred by virtue of subsection (1) (b) as to the exercise of those functions.

(6) For power to give directions to NHS England as to the exercise of functions, see section 13ZC.

(7) As soon as reasonably practicable after giving a direction under subsection (1) or (5) , the Secretary of State must publish it.

(8) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by NHS England or any other body of any function by virtue of this section are enforceable by or against it (and no other person).

(9) In this section “the investigation functions” are functions which, immediately before the coming into force of section 36 of the Health and Care Act 2022, were exercised by the Special Health Authority called the National Health Service Trust Development Authority pursuant to—

(a) the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) Directions 2016 made under sections 7 and 8 of the National Health Service Act 2006, or

(b) the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) (Additional Investigatory Functions in respect of Maternity Cases) Directions 2018 made under sections 7 and 8 of the National Health Service Act 2006.

7D Transfer schemes in connection with a direction under section 7C

(1) The Secretary of State may, in connection with a direction under section 7C , make one or more transfer schemes.

(2) A “transfer scheme” is a scheme for the transfer to NHS England or any other public body of any property, rights or liabilities relating to the discharge of functions pursuant to any directions made by the Secretary of State under the power conferred by section 7C.

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

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

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

(c) criminal liabilities.

(4) A transfer scheme may—

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

(b) make provision about the continuing effect of things done by, or 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.

(5) A transfer scheme may provide—

(a) for modifications by agreement;

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

(6) In subsection (4) (f) , “ the TUPE regulations ” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 ( S.I. 2006/246 ).

(7) For the purposes of this 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.

(8) For the purposes of subsection (7) (a) —

(a) an individual who holds employment in the civil service of the State is to be treated as employed by virtue of a contract of employment, and

(b) the terms of the individual’s employment in the civil service are to be regarded as constituting the terms of the contract of employment.

7E Transfer schemes under section 7D : taxation

(1) The Treasury may by regulations make provision varying the way in which a relevant tax has effect in relation to—

(a) anything transferred under a scheme under section 7D , or

(b) anything done for the purposes of, or in relation to, a transfer under such a scheme.

(2) The provision which may be made under subsection (1)(a) includes in particular provision for—

(a) a tax provision not to apply, or to apply with modifications, in relation to anything transferred;

(b) anything transferred to be treated in a specified way for the purposes of a tax provision;

(c) the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything transferred.

(3) The provision which may be made under subsection (1)(b) includes in particular provision for—

(a) a tax provision not to apply, or to apply with modifications, in relation to anything done for the purposes of or in relation to the transfer;

(b) anything done for the purposes of, or in relation to, the transfer to have or not have a specified consequence or be treated in a specified way;

(c) the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything done for the purposes of, or in relation to, the transfer.

(4) In this section references to the transfer of property include the grant of a lease.

(5) In this section—

• “ relevant tax ” means income tax, corporation tax, capital gains tax, value added tax, stamp duty or stamp duty reserve tax;

• “ tax provision ” means a provision of an enactment about a relevant tax.

Directions to certain NHS bodies

8 Secretary of State's directions to certain health service bodies

(1) The Secretary of State may give directions to any of the bodies mentioned in subsection (2) about its exercise of any functions.

(2) The bodies are—

(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

(c) NHS trusts, and

(d) Special Health Authorities.

(3) Nothing in provision made by or under this or any other Act affects the generality of subsection (1).

NHS contracts

9 NHS contracts

(1)

In this Act, an NHS contract is an arrangement under which one health service body (“

(2) Section 139(6) (NHS contracts and the provision of local pharmaceutical services under pilot schemes) makes further provision about acting as commissioner for the purposes of subsection (1).

(3) Paragraph 15 of Schedule 4 (NHS trusts and NHS contracts) makes further provision about an NHS trust acting as provider for the purposes of subsection (1).

(4) “ Health service body ” means any of the following—

(za) NHS England ,

(zb) an integrated care board,

(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

(c) an NHS trust,

(d) a Special Health Authority,

(e) a Local Health Board,

(f) a Health Board constituted under section 2 of the National Health Service (Scotland) Act 1978 (c. 29),

(fa) a Special Health Board constituted under that section,

(g) the Regional Agency for Public Health and Social Well-being,

(h) the Common Services Agency for the Scottish Health Service,

(i) the Wales Centre for Health,

(j) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(k) the Care Quality Commission,

(ka) NICE,

(kb) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(kc) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(kd) the Health Services Safety Investigations Body,

(l) the Scottish Dental Practice Board,

(m) the Secretary of State,

(n) the Welsh Ministers,

(na) the Scottish Ministers,

(nb) Healthcare Improvement Scotland,

(o) the Regional Business Services Organisation,

(p) a special health and social services agency established under the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990 (S.I. 1990/247 (N.I.3)),

(q) a Health and Social Care trust trust established under the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)),

(r) the Department of Health, Social Services and Public Safety.

(5) Whether or not an arrangement which constitutes an NHS contract would apart from this subsection be a contract in law, it must not be regarded for any purpose as giving rise to contractual rights or liabilities.

(6) But if any dispute arises with respect to such an arrangement, either party may refer the matter to the Secretary of State for determination under this section.

(7) If, in the course of negotiations intending to lead to an arrangement which will be an NHS contract, it appears to a health service body—

(a) that the terms proposed by another health service body are unfair by reason that the other is seeking to take advantage of its position as the only, or the only practicable, provider of the goods or services concerned or by reason of any other unequal bargaining position as between the prospective parties to the proposed arrangement, or

(b) that for any other reason arising out of the relative bargaining position of the prospective parties any of the terms of the proposed arrangement cannot be agreed,

that health service body may refer the terms of the proposed arrangement to the Secretary of State for determination under this section.

(8) Where a reference is made to the Secretary of State under subsection (6) or (7), he may determine the matter himself or appoint a person to consider and determine it in accordance with regulations.

(9) “ The appropriate person ” means the Secretary of State or the person appointed under subsection (8).

(10) By the determination of a reference under subsection (7) the appropriate person may specify terms to be included in the proposed arrangement and may direct that it be proceeded with.

(11) A determination of a reference under subsection (6) may contain such directions (including directions as to payment) as the appropriate person considers appropriate to resolve the matter in dispute.

(12) The appropriate person may by the determination in relation to an NHS contract vary the terms of the arrangement or bring it to an end (but this does not affect the generality of the power of determination under subsection (6)).

(13) Where an arrangement is so varied or brought to an end—

(a) subject to paragraph (b), the variation or termination must be treated as being effected by agreement between the parties, and

(b) the directions included in the determination by virtue of subsection (11) may contain such provisions as the appropriate person considers appropriate in order to give effect to the variation or to bring the arrangement to an end.

10 Provision for bodies in Northern Ireland

(1) Subsection (2) applies where the Regional Agency for Public Health and Social Well-being or a body mentioned in paragraph (o), (p), (q) or (r) of section 9(4) is a party or prospective party to an arrangement or proposed arrangement which—

(a) falls within the definition of NHS contract in section 9(1), and

(b) also falls within the definition of HSS contract in Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)).

(2) Subsections (5) to (13) of section 9 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Secretary of State of references to the Secretary of State and the Department of Health, Social Services and Public Safety acting jointly.

10A Provision for bodies in Scotland

(1) Subsection (2) applies where the Scottish Ministers are, or a body mentioned in paragraph (f), (fa), (h), (l) or (nb) of section 9(4) is, a party or prospective party to an arrangement or proposed arrangement which—

(a) falls within the definition of NHS contract in section 9(1), and

(b) also falls within the definition of NHS contract in section 17A of the National Health Service (Scotland) Act 1978.

(2) Subsections (5) to (13) of section 9 apply in relation to the arrangement or proposed arrangement (except in so far as it relates to reserved matters within the meaning of the Scotland Act 1998) with the substitution for references to the Secretary of State of references to the Secretary of State and the Scottish Ministers acting jointly.

(3) Subsection (4) applies (and subsection (2) does not apply) where a cross-border Special Health authority is a party or prospective party to an arrangement or proposed arrangement which—

(a) falls within the definition of NHS contract in section 9(1), and

(b) also falls within the definition of NHS contract in section 17A of the National Health Service (Scotland) Act 1978 and the definition of NHS contract in section 7(1) of the National Health Service (Wales) Act 2006.

(4) Subsections (5) to (13) of section 9 apply in relation to that arrangement or proposed arrangement (except in so far as it relates to reserved matters within the meaning of the Scotland Act 1998) with the substitution for references to the Secretary of State—

(a) where the cross-border Special Health Authority is exercising functions in relation to England only, of references to the Secretary of State and the Scottish Ministers acting jointly; and

(b) where the Authority is exercising functions in relation to England and Wales, of references to the Secretary of State and the Welsh Ministers acting concurrently with each other and jointly with the Scottish Ministers.

(5) In subsections (3) and (4), “ cross-border Special Health Authority ” means a Special Health Authority which is established under the National Health Service Act 2006 and the National Health Service (Wales) Act 2006 by virtue of—

(a) paragraph 1(2) of Schedule 2 to the National Health Service (Consequential Provisions) Act 2006, or

(b) the power under section 28 of the National Health Service Act 2006 and the power under section 22 of the National Health Service (Wales) Act 2006 being exercised together.

11 Arrangements to be treated as NHS contracts

(1) This section applies to any arrangement under which NHS England , ...... or such other health service body as may be prescribed arrange for the provision to it—

(a) by a contractor under a general ophthalmic services contract,

(b) by a person on an ophthalmic list,

(c) by a person on a pharmaceutical list, or

(d) by a person who has entered into a pharmaceutical care services contract under section 17Q of the National Health Service (Scotland) Act 1978 (c. 29),

of the goods or services mentioned in subsection (2).

(2) The goods or services are those that the body reasonably requires for the purposes of its functions, other than functions under—

(a) section 115 (primary ophthalmic services),

(b) Chapter 1 or 2 of Part 7 (pharmaceutical services and local pharmaceutical services under pilot schemes), or

(c) Part 6 of, or Chapter 1 or 2 of Part 7 of, the National Health Service (Wales) Act 2006 (c. 42) (general ophthalmic services and pharmaceutical services and local pharmaceutical services under pilot schemes).

(3) Any such arrangement must be treated as an NHS contract for the purposes of section 9 (other than subsections (7) and (10)).

(4) “ Health service body ” means a body which is a health service body for the purposes of section 9.

(5) “ Ophthalmic list ” means a list published in accordance with regulations made under—

(a) section 72(1)(a) of the National Health Service (Wales) Act 2006,

(b) section 26(2)(a) of the National Health Service (Scotland) Act 1978, or

(c) Article 62(2)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)).

(6) The reference to a list published in accordance with regulations made under paragraph (a) of section 26(2) of the National Health Service (Scotland) Act 1978 is a reference to the first part of the list (referred to in sub-paragraph (i) of that paragraph) which is published in accordance with regulations under that paragraph.

(7) “ Pharmaceutical list ” includes a list published in accordance with regulations made under—

(a) section 83(2)(a) of the National Health Service (Wales) Act 2006, or

(b) Article 63(2A)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972.

Arrangements with other bodies

12 Secretary of State's arrangements with other bodies

(1) The Secretary of State may arrange with any person or body to provide, or assist in providing, anything which the Secretary of State has a duty or power to provide, or arrange for the provision of, under section 2A or 2B or Schedule 1 .

(2) The bodies with whom arrangements may be made under subsection (1) include—

(a) NHS England ,

(b) integrated care boards,

(c) any other public authorities, and

(d) voluntary organisations.

(3) The Secretary of State may make available any facilities provided by the Secretary of State under section 2A or 2B or Schedule 1 to any service provider or to any eligible voluntary organisation.

(3A) In subsection (3)—

• “ eligible voluntary organisation ” means a voluntary organisation eligible for assistance under section 64 or section 65 of the Health Services and Public Health Act 1968;

• “ service provider ” means a person or body with whom the Secretary of State has made an arrangement under subsection (1).

(4) Where facilities are made available under subsection (3), the Secretary of State may make available the services of any person employed in connection with the facilities by—

(a) the Secretary of State,

(aa) NHS England ,

(ab) an integrated care board,

(ac) a local authority,

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

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

(d) a Special Health Authority, or

(e) a Local Health Board.

(4A) In subsection (4), “ local authority ” has the same meaning as in section 2B.

(5) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Secretary of State.

(6) Goods or materials may be made available either temporarily or permanently.

(7) Any power to supply goods or materials under this section includes—

(a) a power to purchase and store them, and

(b) a power to arrange with third parties for the supply of goods or materials by those third parties.

12ZA Commissioning arrangements by NHS England or integrated care boards

(1) This section applies in relation to arrangements made by NHS England or an integrated care board in the exercise of functions under section 3, 3A, 3B or 4 or Schedule 1.

(2) The arrangements may be made with any person or body (including public authorities and voluntary organisations).

(2A) The arrangements may confer discretions on a person with whom they are made in relation to anything to be provided under the arrangements.

(3) If NHS England or an integrated care board arranges for the provision of facilities by a service provider, it may also make arrangements for those facilities to be made available to another service provider or to an eligible voluntary organisation.

(4) NHS England or an integrated care board may make available any of its facilities to—

(a) a service provider, or

(b) an eligible voluntary organisation.

(5) Where facilities are made available under subsection (4) any of the following persons may make available the services of any employee of that person who is employed in connection with the facilities—

(a) the Secretary of State,

(b) NHS England ,

(c) an integrated care board,

(d) a Special Health Authority, or

(e) a Local Health Board.

(6) Goods or materials may be made available under this section either temporarily or permanently.

(7) Any power to supply goods or materials under this section includes—

(a) a power to purchase or store them, and

(b) a power to arrange with third parties for the supply of goods or materials by those third parties.

(8) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments.

(9) In this section—

• “ eligible voluntary organisation ” means a voluntary organisation eligible for assistance under section 64 or section 65 of the Health Services and Public Health Act 1968;

• “ service provider ” means a person or body with whom NHS England or an integrated care board has made arrangements in the exercise of the functions mentioned in subsection (1).

Procurement

12ZB Procurement regulations

(1) Regulations may make provision in relation to the processes to be followed and objectives to be pursued by relevant authorities in the procurement of—

(a) health care services for the purposes of the health service in England, and

(b) other goods or services that are procured together with those health care services.

(2) Regulations under subsection (1) must include provision specifying steps to be taken when following a competitive tendering process.

(3) Regulations under subsection (1) must, in relation to the procurement of all health care services to which they apply, make provision for the purposes of—

(a) ensuring transparency;

(b) ensuring fairness;

(c) ensuring that compliance can be verified;

(d) managing conflicts of interest.

(4) NHS England must publish such guidance as it considers appropriate about compliance with the regulations.

(5) A relevant authority must have regard to guidance published under this section.

(6) Before publishing guidance under this section, NHS England must obtain the approval of the Secretary of State.

(7) In this section—

• “ health care service ” has the same meaning as in Part 3 of the Health and Social Care Act 2012(see section 150 of that Act);

• “ relevant authority ” means—

  (a)

  a combined authority;

  (aa)

  a combined county authority;

  (c)

  an integrated care board;

  (d)

  a local authority in England;

  (e)

  NHS England;

  (f)

  an NHS foundation trust;

  (g)

  an NHS trust established under section 25.

12ZC Eradicating slavery and human trafficking in supply chains

(1) The Secretary of State must by regulations make such provision as the Secretary of State thinks appropriate with a view to eradicating the use in the health service in England of goods or services that are tainted by slavery and human trafficking.

(2) The regulations may, in particular, include—

(a) provision in connection with the processes to be followed by public bodies in the procurement of goods or services for the purposes of the health service in England (including provision as to circumstances in which a supplier is excluded from consideration for the award of a contract);

(b) provision as to steps that must be taken by public bodies for assessing and addressing the risk of slavery and human trafficking taking place in relation to people involved in health service supply chains;

(c) provision as to matters for which provision must be made in contracts for goods or services entered into by public bodies for the purposes of the health service in England.

(3) In this section—

• “ health service supply chains ” means supply chains for providing goods or services for the purposes of the health service in England;

• “ public body ” means a body exercising functions of a public nature;

• “ slavery and human trafficking ” has the meaning given by section 54(12) of the Modern Slavery Act 2015;

• “tainted”: goods or services are “tainted” by slavery and human trafficking if slavery and human trafficking takes place in relation to anyone involved in the supply chain for providing those goods or services.

Direct payments for health care

12A Direct payments for health care

(1) The Secretary of State , NHS England , an 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—

(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;

(aa) anything that NHS England or an integrated care board may or must arrange for the provision of under this Act or any other enactment.

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

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

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

(4) If regulations so provide, an integrated care board may, for the purpose of securing the provision for a patient of services that the 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 ; and the references in this subsection to an 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 NHS England .

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

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

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

12B Regulations about direct payments

(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 , NHS England , an 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 , NHS England , an integrated care board or a local authority may or must stop making direct payments;

(h) as to circumstances in which the Secretary of State , NHS England , an 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 , NHS England , an 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 , NHS England , an 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 NHS 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 or a local authority or as arranged for by NHS England or an integrated care board (as the case may be) under an enactment mentioned in section 12A(2);

(b) displacing functions or obligations of NHS England , an 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.

12C Direct payments pilot schemes

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

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

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

(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.

12D Arrangements with other bodies relating to direct payments

(1) The Secretary of State , NHS England , an 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 , NHS England , an integrated care board or a local authority .

Miscellaneous

12E Secretary of State's duty as respects variation in provision of health services

(1) The Secretary of State must not exercise the functions mentioned in subsection (2) 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.

(2) The functions mentioned in this subsection are the functions of the Secretary of State under—

(a) section 6E;

(b) section 12ZB;

(c) section 13A.

12F Expected mental health spending

(1) The Secretary of State must, in respect of each financial year, publish and lay before Parliament a document—

(a) stating, by comparison with the previous financial year—

(i) whether the Secretary of State expects there to be an increase in the amount of expenditure incurred by NHS England and integrated care boards (taken together) in relation to mental health, and

(ii) whether the Secretary of State expects there to be an increase in the proportion of the expenditure incurred by NHS England and integrated care boards (taken together) that relates to mental health, and

(b) explaining why.

(2) The Secretary of State must publish and lay the document before the financial year to which it relates.

Part 2 Health service bodies

CHAPTER A1 NHS England

Secretary of State's mandate to NHS England

13A Mandate to NHS England

(1) ... 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 NHS England should seek to achieve in the exercise of its functions..., and

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

(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.

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

(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 NHS England’s performance ....

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

(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) NHS 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) NHS 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 Review of NHS England’s performance in implementing the mandate

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

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

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

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

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

General duties of NHS England

13C Duty to promote NHS Constitution

(1) NHS 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).

13D Duty as to effectiveness, efficiency etc.

NHS England must exercise its functions effectively, efficiently and economically.

13E Duty as to improvement in quality of services

(1) NHS 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), NHS 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), NHS 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.

13F Duty as to promoting autonomy

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

13G Duty as to reducing inequalities

NHS England 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 13E(3)) .

13H Duty to promote involvement of each patient

NHS 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.

13I Duty as to patient choice

NHS 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.

13J Duty to obtain appropriate advice

(1) NHS 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.

(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).

13K Duty to promote innovation

(1) NHS 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) NHS 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).

13L Duty in respect of research

NHS England 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.

13M Duty as to promoting education and training

NHS England must, in exercising its functions other 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 ... in the discharge of the duty under that section.

13N Duty as to promoting integration

(1) NHS 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) NHS 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.

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

(3) NHS England must encourage integrated 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 or for the purposes of the Social Services and Well-being (Wales) Act 2014 ).

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

13NA Duty to have regard to wider effect of decisions

(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.

13NB Guidance about discharge of duty

(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.

13NC Duties as to climate change etc

(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 .

13ND Guidance about discharge of duty under section 13NC etc

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.

13O Duty to have regard to impact on services in certain areas

(1) In making commissioning decisions, NHS 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 NHS England , means decisions about the carrying out of its functions in arranging for the provision of health services.

13P Duty as respects variation in provision of health services

NHS 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.

13PA. Duty to cooperate for education and training functions and specified functions

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

13Q Public involvement and consultation by NHS England

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

(2) NHS England 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 NHS England ,

(b) in the development and consideration of proposals by NHS 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 NHS 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.

(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 information

13R Information on safety of services provided by the health service

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

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

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

(4) NHS 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) NHS England must monitor the effectiveness of the advice and guidance given by it under subsection (4).

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

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

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

13S Guidance in relation to processing of information

(1) NHS 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.

13SA Information about inequalities

(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.

Regulatory functions

13SB Minimising conflicts between regulatory and other functions

(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).

13SC Provision of regulatory information or assistance to the CMA

(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 report

13T Business plan

(1) Before the start of each financial year, NHS 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 NHS England proposes to discharge its duties under—

(a) sections 13E, 13G , 13L and 13Q, and

(b) sections 223C to 223E.

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

(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) NHS England may revise the plan.

(5) NHS England must publish any revised plan.

13U Annual report

(1) As soon as practicable after the end of each financial year, NHS 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—

(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, ...

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

• section 6E(1A) and (1B);

• section 13E;

• section 13G;

• section 13I;

• section 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) , 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.

(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 .

(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) NHS 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 NHS England the Secretary of State's assessment of NHS 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 NHS England , and

(b) lay it before Parliament.

Joint appointments

13UA Guidance about joint appointments

(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, ...

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

13V Establishment of pooled funds

(1) NHS England and one or more integrated 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 NHS England’s power to generate income, etc.

(1) NHS 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) NHS 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 NHS England of its functions.

13X Power to make grants etc.

(1) NHS 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 NHS England has functions.

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

13Y NHS England’s incidental powers: further provision

The power conferred on NHS 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 NHS England ).

Assistance and support

13YA Power of NHS England to provide assistance and support

(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.

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

(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 subsection (1) includes making available the services of NHS England’s employees or any other resources of NHS England.

(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.

(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.

Discharge of functions

13YB Directions in respect of functions relating to provision of services

(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 healthfunctions);

(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 prescribedfunction;

(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).

...

13Z Exercise of functions

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13ZA Section 13Z: further provision in relation to devolved arrangements

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13ZB Section 13Z: arrangements in relation to the function under section 3B(1)(d)

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Powers of direction

13ZC Secretary of State directions as to exercise of NHS England functions

(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.

13ZD Power to give directions: exceptions

(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.

13ZE Compliance with directions: significant failure

(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.

13ZF Secretary of State directions to provide information

(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 functions

13Z1 Power to confer additional functions on NHS England

(1) Regulations may provide that NHS 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 NHS England .

...

13Z2 Failure by the Board to discharge any of its functions

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Disclosure of information

13Z3 Permitted disclosures of information

(1) NHS 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 NHS 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.

Interpretation

13Z4 Interpretation

(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.

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

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

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

CHAPTER A2 Clinical commissioning groups

Establishment of clinical commissioning groups

14A General duties of Board in relation to clinical commissioning groups

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14B Applications for the establishment of clinical commissioning groups

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14C Determination of applications

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14D Effect of grant of application

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Variation of constitution

14E Applications for variation of constitution

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14F Variation of constitution otherwise than on application

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Mergers, dissolution etc.

14G Mergers

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14H Dissolution

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Supplemental provision about applications, variation, mergers etc.

14I Transfers in connection with variation, merger, dissolution etc.

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14J Publication of constitution of clinical commissioning groups

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14K Guidance about the establishment of clinical commissioning groups etc.

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Governing bodies of clinical commissioning groups

14L Governing bodies of clinical commissioning groups

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14M Audit and remuneration committees of governing bodies

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14N Regulations as to governing bodies of clinical commissioning groups

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Conflicts of interest

14O Registers of interests and management of conflicts of interest

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General duties of clinical commissioning groups

14P Duty to promote NHS Constitution

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14Q Duty as to effectiveness, efficiency etc.

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14R Duty as to improvement in quality of services

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14S Duty in relation to quality of primary medical services

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14T Duties as to reducing inequalities

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14U Duty to promote involvement of each patient

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14V Duty as to patient choice

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14W Duty to obtain appropriate advice

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14X Duty to promote innovation

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14Y Duty in respect of research

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14Z Duty as to promoting education and training

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14Z1 Duty as to promoting integration

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Public involvement

14Z2 Public involvement and consultation by clinical commissioning groups

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Arrangements with others

14Z3 Arrangements by clinical commissioning groups in respect of the exercise of functions

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14Z3A Joint exercise of functions with combined authorities

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14Z4 Joint exercise of functions with Local Health Boards

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Additional powers of clinical commissioning groups

14Z5 Raising additional income

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14Z6 Power to make grants

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Board's functions in relation to clinical commissioning groups

14Z7 Responsibility for payments to providers

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14Z8 Guidance on commissioning by the Board

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14Z9 Exercise of functions by, or jointly with, the Board

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14Z10 Power of Board to provide assistance or support

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Commissioning plans and reports

14Z11 Commissioning plan

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14Z12 Revision of commissioning plans

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14Z13 Consultation about commissioning plans

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14Z14 Opinion of Health and Wellbeing Boards on commissioning plans

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14Z15 Reports by clinical commissioning groups

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Performance assessment of clinical commissioning groups

14Z16 Performance assessment of clinical commissioning groups

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Powers to require information etc.

14Z17 Circumstances in which powers in sections 14Z18 and 14Z19 apply

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14Z18 Power to require documents and information etc.

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14Z19 Power to require explanation

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14Z20 Use of information

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Intervention powers

14Z21 Power to give directions, dissolve clinical commissioning groups etc.

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Procedural requirements in connection with certain powers

14Z22 Procedural requirements in connection with certain powers

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Disclosure of information

14Z23 Permitted disclosures of information

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Interpretation

14Z24 Interpretation

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CHAPTER A3 Integrated care boards

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

14Z25 Duty to establish integrated care boards

(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.

14Z26 Process for establishing initial integrated care boards

(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.

14Z27 Abolition of clinical commissioning groups

(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 .

14Z28 Transfer schemes in connection with integrated care boards

(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.