(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 relevant NHS commissioner;
a relevant NHS provider;
“relevant NHS commissioner” means—
NHS England;
an integrated care board;
“relevant NHS provider” means—
an NHS trust established under section 25;
an NHS foundation trust.
(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.
(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.
(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).
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.
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 health functions);
(d) any other functions of NHS England so far as exercisable in connection with any functions within paragraphs (a) to (c).
(3) Regulations may—
(a) provide that the power in subsection (1) does not apply, or applies only to a prescribed extent, in relation to a prescribed function;
(b) impose conditions on the exercise of the power.
(4) A direction under subsection (1) may include provision prohibiting or restricting the integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction.
(5) In subsection (4) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else.
(6) NHS England may make payments to an integrated care board in respect of the exercise by it of a function by virtue of a direction under subsection (1).
(7) NHS England may give directions to an integrated care board as to the exercise by it of any functions in pursuance of a direction under subsection (1).
(8) As soon as reasonably practicable after giving a direction under subsection (1), NHS England must publish it.
(9) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by an integrated care board of any function by virtue of this section are enforceable by or against it (and no other person).
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.
(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.
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.
(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.
(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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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.
(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.
(8) A transfer scheme may provide—
(a) for modifications by agreement;
(b) for modifications to have effect from the date when the original scheme came into effect.
(9) In subsection (7)(f), “the TUPE regulations” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).
(10) In this section—
(a) references to rights and liabilities include rights and liabilities relating to a contract of employment;
(b) references to the transfer of property include the grant of a lease.
14Z29 Duty for integrated care board to publish constitution
Each integrated care board must publish its constitution (as varied from time to time by order under section 14Z25 or under provision included in its constitution by virtue of paragraph 15 of Schedule 1B).
14Z30 Register of interests and management of conflicts of interests
(1) Each integrated care board must maintain one or more registers of the interests of—
(a) members of the board,
(b) members of its committees or sub-committees, and
(c) its employees.
(2) Each integrated care board must publish the registers maintained under subsection (1) or make arrangements to ensure that members of the public have access to the registers on request.
(3) Each integrated care board must make arrangements to ensure—
(a) that a person mentioned in subsection (1) declares any conflict or potential conflict of interest that the person has in relation to a decision to be made in the exercise of the commissioning functions of the integrated care board,
(b) that any such declaration is made as soon as practicable after the person becomes aware of the conflict or potential conflict and, in any event, within 28 days of the person becoming aware, and
(c) that any such declaration is included in the registers maintained under subsection (1).
(4) Each integrated care board must make arrangements for managing conflicts and potential conflicts of interest in such a way as to ensure that they do not, and do not appear to, affect the integrity of the board’s decision-making processes.
(5) For the purposes of this section, the commissioning functions of an integrated care board are the functions of the board in arranging for the provision of services as part of the health service.
14Z31 People for whom integrated care board has responsibility
(1) NHS England must from time to time publish rules for determining the group of people for whom each integrated care board has core responsibility.
(2) The rules must ensure that the following are allocated to at least one group—
(a) everyone who is provided with NHS primary medical services, and
(b) everyone who is usually resident in England and is not provided with NHS primary medical services.
(3) Regulations may create exceptions to subsection (2) in relation to people of a prescribed description (which may include a description framed by reference to the primary medical services with which the people are provided).
(4) References in this Act to the group of people for whom an integrated care board has core responsibility are to be read in accordance with this section.
(5) In this section, “NHS primary medical services” means services provided by a person, other than NHS England or an integrated care board, in pursuance of—
(a) a general medical services contract to provide primary medical services of a prescribed description,
(b) arrangements under section 83(2) for the provision of primary medical services of a prescribed description, or
(c) section 92 arrangements for the provision of primary medical services of a prescribed description.
(1) Each integrated care board must, in the exercise of its functions—
(a) act with a view to securing that health services are provided in a way which promotes the NHS Constitution, and
(b) promote awareness of the NHS Constitution among patients, staff and members of the public.
(2) In this section, “patients” and “staff” have the same meaning as in Chapter 1 of Part 1 of the Health Act 2009 (see section 3(7) of that Act).
14Z34 Duty as to improvement in quality of services
(1) Each integrated care board must exercise its functions with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness.
(2) In discharging its duty under subsection (1), an integrated care board must, in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services.
(3) The outcomes relevant for the purposes of subsection (2) include, in particular, outcomes which show—
(a) the effectiveness of the services,
(b) the safety of the services, and
(c) the quality of the experience undergone by patients.
Each integrated care board must, in the exercise of its functions, have regard to the need to—
(a) reduce inequalities between persons with respect to their ability to access health services, and
(b) reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services (including the outcomes described in section 14Z34(3)).
Each integrated care board must, in the exercise of its functions, promote the involvement of patients, and their carers and representatives (if any), in decisions which relate to—
(a) the prevention or diagnosis of illness in the patients, or
(b) their care or treatment.
Each integrated care board must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them.
Each integrated care board must obtain advice appropriate for enabling it effectively to discharge its functions from persons who (taken together) have a broad range of professional expertise in—
(a) the prevention, diagnosis or treatment of illness, and
(b) the protection or improvement of public health.
Each integrated care board must, in the exercise of its functions, promote innovation in the provision of health services (including innovation in the arrangements made for their provision).
Each integrated care board must, in the exercise of its functions, facilitate or otherwise promote—
(a) research on matters relevant to the health service, and
(b) the use in the health service of evidence obtained from research.
Each integrated care board must, in exercising its functions, have regard to the need to promote education and training for the persons mentioned in section 1F(1) so as to assist the Secretary of State and NHS England in the discharge of the duty under that section.
(1) Each integrated care board must exercise its functions with a view to securing that health services are provided in an integrated way where it considers that this would—
(a) improve the quality of those services (including the outcomes that are achieved from their provision),
(b) reduce inequalities between persons with respect to their ability to access those services, or
(c) reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services.
(2) Each integrated care board must exercise its functions with a view to securing that the provision of health services is integrated with the provision of health-related services or social care services where it considers that this would—
(a) improve the quality of the health services (including the outcomes that are achieved from the provision of those services),
(b) reduce inequalities between persons with respect to their ability to access those services, or
(c) reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services.
(3) In this section—
“health-related services” means services that may have an effect on the health of individuals but are not health services or social care services;
“social care services” means services that are provided in pursuance of the social services functions of local authorities (within the meaning of the Local Authority Social Services Act 1970 or for the purposes of the Social Services and Well-being (Wales) Act 2014).
(4) For the purposes of this section, the provision of housing accommodation is a health-related service.
14Z43 Duty to have regard to wider effect of decisions
(1) In making a decision about the exercise of its functions, an integrated care board must have regard to all likely effects of the decision in relation to—
(a) the health and well-being of the people of England;
(b) the quality of services provided to individuals—
(i) by relevant bodies, or
(ii) in pursuance of arrangements made by relevant bodies,
for or in connection with the prevention, diagnosis or treatment of illness, as part of the health service in England;
(c) efficiency and sustainability in relation to the use of resources by relevant bodies for the purposes of the health service in England.
(2) In subsection (1)—
(a) the reference to a decision does not include a reference to a decision about the services to be provided to a particular individual for or in connection with the prevention, diagnosis or treatment of illness;
(b) the reference to effects of a decision in relation to the health and well-being of the people of England includes a reference to its effects in relation to inequalities between the people of England with respect to their health and well-being;
(c) the reference to effects of a decision in relation to the quality of services provided to individuals includes a reference to its effects in relation to inequalities between individuals with respect to the benefits that they can obtain from those services.
(3) In discharging the duty under this section, integrated care boards must have regard to guidance published by NHS England under section 13NB.
(4) In this section “relevant bodies” means—
(a) NHS England,
(b) integrated care boards,
(c) NHS trusts established under section 25, and
(d) NHS foundation trusts.
(1) Each integrated care board must, in the exercise of its functions, have regard to the need to—
(a) contribute towards compliance with—
(i) section 1 of the Climate Change Act 2008 (UK net zero emissions target), and
(ii) section 5 of the Environment Act 2021 (environmental targets), and
(b) adapt to any current or predicted impacts of climate change identified in the most recent report under section 56 of the Climate Change Act 2008.
(2) In discharging the duty under this section, integrated care boards must have regard to guidance published by NHS England under section 13ND.
14Z45 Public involvement and consultation by integrated care boards
(1) This section applies in relation to any health services which are, or are to be, provided pursuant to arrangements made by an integrated care board in the exercise of its functions (“commissioning arrangements”).
(2) The integrated care board must make arrangements to secure that individuals to whom the services are being or may be provided, and their carers and representatives (if any), are involved (whether by being consulted or provided with information or in other ways)—
(a) in the planning of the commissioning arrangements by the integrated care board,
(b) in the development and consideration of proposals by the integrated care board for changes in the commissioning arrangements where the implementation of the proposals would have an impact on—
(i) the manner in which the services are delivered to the individuals (at the point when the service is received by them), or
(ii) the range of health services available to them, and
(c) in decisions of the integrated care board affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.
(3) This section does not require an integrated care board to make arrangements in relation to matters to which a trust special administrator’s draft or final report under section 65F or 65I relates before—
(a) in a case where the administrator’s report relates to an NHS trust, NHS England and the Secretary of State have made their decisions under section 65K(1) and (2), or
(b) in a case where the administrator’s report relates to an NHS foundation trust, the Secretary of State is satisfied as mentioned in section 65KB(1) or 65KD(1) or makes a decision under section 65KD(9).