Law

National Health Service Act 2006

United Kingdom · statute

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In force since 2026-10-01, as the publisher states.

Copy read on 2026-11-08. The page it was read from

Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.

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Contents: 516 provisions
  1. Title and introductory text
  2. 1 Secretary of State's duty to promote comprehensive health service
  3. 1A Duty as to improvement in quality of services
  4. 1B Duty as to the NHS Constitution
  5. 1C Duty as to reducing inequalities
  6. 1D Duty as to promoting autonomy
  7. 1E Duty as to research
  8. 1F Duty as to education and training
  9. 1G Secretary of State's duty as to reporting on and reviewing treatment of providers
  10. 1GA Secretary of State’s duty to report on workforce systems
  11. 1H NHS England and its general functions
  12. 1I General functions of integrated care boards
  13. 2. General power
  14. 2A Secretary of State's duty as to protection of public health
  15. 2B Functions of local authorities and Secretary of State as to improvement of public health
  16. 3. Duties of integrated care boards as to commissioning certain health services
  17. 3A. Power of integrated care boards to commission certain health services
  18. 3B Secretary of State's power to require NHS England to commission services
  19. 4 High security psychiatric services
  20. 5 Other services
  21. 6 Performance of functions outside England
  22. 6A Reimbursement of cost of services provided in another EEA state
  23. 6B Prior authorisation for the purposes of section 6A
  24. 6BA Reimbursement of cost of services provided in another EEA state where expenditure incurred on or after 25 October 2013.
  25. 6BB Prior authorisation for the purposes of section 6BA
  26. 6C Regulations as to the exercise by local authorities of certain public health functions
  27. 6D Regulations relating to EU obligations
  28. 6E Regulations as to the exercise of functions by NHS England or integrated care boards
  29. 6F Enforcement of section 6E regulations relating to patient choice
  30. 6G Guidance relating to patient choice
  31. 7 Functions of Special Health Authorities
  32. 7A. Exercise of Secretary of State’s public health functions
  33. 7B Directions requiring NHS bodies to exercise public health functions
  34. 7C Power of direction: investigation functions
  35. 7D Transfer schemes in connection with a direction under section 7C
  36. 7E Transfer schemes under section 7D: taxation
  37. 8 Secretary of State's directions to certain health service bodies
  38. 9 NHS contracts
  39. 10 Provision for bodies in Northern Ireland
  40. 10A Provision for bodies in Scotland
  41. 11 Arrangements to be treated as NHS contracts
  42. 12 Secretary of State's arrangements with other bodies
  43. 12ZA Commissioning arrangements by NHS England or integrated care boards
  44. 12ZB Procurement regulations
  45. 12ZC Eradicating slavery and human trafficking in supply chains
  46. 12A Direct payments for health care
  47. 12B Regulations about direct payments
  48. 12C Direct payments pilot schemes
  49. 12D Arrangements with other bodies relating to direct payments
  50. 12E Secretary of State's duty as respects variation in provision of health services
  51. 12F Expected mental health spending
  52. 13A Mandate to NHS England
  53. 13B Review of NHS England’s performance in implementing the mandate
  54. 13C Duty to promote NHS Constitution
  55. 13D Duty as to effectiveness, efficiency etc.
  56. 13E Duty as to improvement in quality of services
  57. 13F Duty as to promoting autonomy
  58. 13G Duty as to reducing inequalities
  59. 13H Duty to promote involvement of each patient
  60. 13I Duty as to patient choice
  61. 13J Duty to obtain appropriate advice
  62. 13K Duty to promote innovation
  63. 13L Duty in respect of research
  64. 13M Duty as to promoting education and training
  65. 13N Duty as to promoting integration
  66. 13NA Duty to have regard to wider effect of decisions
  67. 13NB Guidance about discharge of duty
  68. 13NC Duties as to climate change etc
  69. 13ND Guidance about discharge of duty under section 13NC etc
  70. 13O Duty to have regard to impact on services in certain areas
  71. 13P Duty as respects variation in provision of health services
  72. 13PA Duty to cooperate for education and training functions and specified functions
  73. 13Q Public involvement and consultation by NHS England
  74. 13R Information on safety of services provided by the health service
  75. 13S Guidance in relation to processing of information
  76. 13SA Information about inequalities
  77. 13SB Minimising conflicts between regulatory and other functions
  78. 13SC Provision of regulatory information or assistance to the CMA
  79. 13T Business plan
  80. 13U Annual report
  81. 13UA Guidance about joint appointments
  82. 13V Establishment of pooled funds
  83. 13W NHS England’s power to generate income, etc.
  84. 13X Power to make grants etc.
  85. 13Y NHS England’s incidental powers: further provision
  86. 13YA Power of NHS England to provide assistance and support
  87. 13YB Directions in respect of functions relating to provision of services
  88. 13Z Exercise of functions
  89. 13ZA Section 13Z: further provision in relation to devolved arrangements
  90. 13ZB Section 13Z: arrangements in relation to the function under section 3B(1)(d)
  91. 13ZC Secretary of State directions as to exercise of NHS England functions
  92. 13ZD Power to give directions: exceptions
  93. 13ZE Compliance with directions: significant failure
  94. 13ZF Secretary of State directions to provide information
  95. 13Z1 Power to confer additional functions on NHS England
  96. 13Z2 Failure by the Board to discharge any of its functions
  97. 13Z3 Permitted disclosures of information
  98. 13Z4 Interpretation
  99. 14G Mergers
  100. 14Z25 Duty to establish integrated care boards
  101. 14Z26 Process for establishing initial integrated care boards
  102. 14Z27 Abolition of clinical commissioning groups
  103. 14Z28 Transfer schemes in connection with integrated care boards
  104. 14Z29 Duty for integrated care board to publish constitution
  105. 14Z30 Register of interests and management of conflicts of interests
  106. 14Z31 People for whom integrated care board has responsibility
  107. 14Z32 Duty to promote NHS Constitution
  108. 14Z33 Duty as to effectiveness, efficiency etc
  109. 14Z34 Duty as to improvement in quality of services
  110. 14Z35 Duties as to reducing inequalities
  111. 14Z36 Duty to promote involvement of each patient
  112. 14Z37 Duty as to patient choice
  113. 14Z38 Duty to obtain appropriate advice
  114. 14Z39 Duty to promote innovation
  115. 14Z40 Duty in respect of research
  116. 14Z41 Duty to promote education and training
  117. 14Z42 Duty to promote integration
  118. 14Z43 Duty to have regard to wider effect of decisions
  119. 14Z44 Duties as to climate change etc
  120. 14Z45 Public involvement and consultation by integrated care boards
  121. 14Z46 Joint exercise of functions with Local Health Boards
  122. 14Z47 Raising additional income
  123. 14Z48 Power to make grants
  124. 14Z49 Duty to keep experience of members under review etc
  125. 14Z50 Responsibility for payments to providers
  126. 14Z51 Guidance by NHS England
  127. 14Z52 Joint forward plans for integrated care board and its partners
  128. 14Z53 Revision of forward plans
  129. 14Z54 Consultation about forward plans
  130. 14Z55 Opinion of Health and Wellbeing Boards on forward plan
  131. 14Z56 Joint capital resource use plan for integrated care board and its partners
  132. 14Z57 Revision of joint capital resource use plans
  133. 14Z58 Annual report
  134. 14Z59 Performance assessment of integrated care boards
  135. 14Z60 Power of NHS England to obtain information
  136. 14Z61 Power to give directions to integrated care boards
  137. 14Z62 Section 14Z61 directions: consultation and cooperation
  138. 14Z63 Permitted disclosures of information
  139. 14Z64 Interpretation
  140. 25 NHS trusts
  141. 26 General duty of NHS trusts
  142. 26A Duty to have regard to wider effect of decisions
  143. 26B Duties in relation to climate change etc
  144. 27 Financial provisions relating to NHS trusts
  145. 27A Oversight and support of NHS trusts
  146. 27B NHS England’s directions to NHS trusts
  147. 27C Recommendations about restructuring
  148. 27D Intervention in NHS trusts: recommendations etc by NHS England
  149. 28 Special Health Authorities
  150. 28A Special Health Authorities: further provision
  151. 29 Exercise of Special Health Authority functions
  152. 29A Special Health Authorities: accounts and audit
  153. 30 NHS foundation trusts
  154. 31 Independent Regulator of NHS Foundation Trusts
  155. 32 General duty of regulator
  156. 33 Applications by NHS trusts
  157. 34 Other applications
  158. 35 Authorisation of NHS foundation trusts
  159. 36 Effect of authorisation
  160. 37 Amendments of constitution
  161. 38 Variation of authorisation
  162. 39 Register of NHS foundation trusts
  163. 39A Panel for advising governors
  164. 40 Power of Secretary of State to give financial assistance
  165. 41 Prudential borrowing code
  166. 42 Public dividend capital
  167. 42A Criteria for making loans etc.
  168. 42B Limits on capital expenditure
  169. 42C Guidance in relation to orders under section 42B
  170. 43 Provision of goods and services
  171. 44 Power to charge for accommodation etc.
  172. 45 Protection of property
  173. 46 Financial powers
  174. 47 General powers
  175. 47A Joint exercise of functions
  176. 48 Information
  177. 49 Entry and inspection of premises
  178. 50 Fees
  179. 51 Trust funds and trustees
  180. 51A Significant transactions
  181. 52 Failing NHS foundation trusts
  182. 52A Application of sections 52B to 52E
  183. 52B De-authorisation: regulator's notice
  184. 52C Grounds for de-authorisation notice
  185. 52D De-authorisation
  186. 52E Secretary of State's request
  187. 53 Voluntary arrangements
  188. 54 Dissolution etc
  189. 55 Sections 53 and 54: supplementary
  190. 56 Mergers
  191. 56A Acquisitions
  192. 56AA Acquisitions under section 56A: supplementary
  193. 56B Separations
  194. 57 Sections 56 to 56B: supplementary
  195. 57A Dissolution
  196. 58 Taxation
  197. 59 Conduct of elections
  198. 60 Voting and standing for election
  199. 61 Representative membership
  200. 62 Audit
  201. 63 General duty of NHS foundation trusts
  202. 63A Duty to have regard to wider effect of decisions
  203. 63B Duties in relation to climate change etc
  204. 64 Orders and regulations under this Chapter
  205. 65 Interpretation of this Chapter
  206. 65A Application
  207. 65B NHS trusts: appointment of trust special administrator
  208. 65BA Care Quality Commission report on safety and quality of services
  209. 65C Suspension of directors
  210. 65D NHS foundation trusts: appointment of trust special administrator
  211. 65DA Objective of trust special administration
  212. 65E NHS foundation trusts: de-authorisation and appointment of trust special administrator
  213. 65F Draft report
  214. 65G Consultation plan
  215. 65H Consultation requirements
  216. 65I Final report
  217. 65J Power to extend time
  218. 65K. Decision of NHS England or Secretary of State in case of NHS trust
  219. 65KA NHS England’s decision in case of NHS foundation trust
  220. 65KB Secretary of State's response to NHS England’s decision
  221. 65KC Action following Secretary of State's rejection of final report
  222. 65KD Secretary of State's response to re-submitted final report
  223. 65L Trusts coming out of administration
  224. 65LA Trusts to be dissolved
  225. 65M Replacement of trust special administrator
  226. 65N Guidance
  227. 65O Interpretation of this Chapter
  228. 65Z4 Consolidated accounts for NHS trusts and NHS foundation trusts
  229. 65Z5 Joint working and delegation arrangements
  230. 65Z6 Joint committees and pooled funds
  231. 65Z7 Joint working and delegation: guidance by NHS England
  232. 66 Intervention orders
  233. 67 Effect of intervention orders
  234. 68 Default powers
  235. 68A Reconfiguration of NHS services
  236. 69 Protection from personal liability
  237. 69A Transfer schemes: NHS trusts and NHS foundation trusts
  238. 70 Transfer of residual liabilities of certain health service bodies
  239. 71 Schemes for meeting losses and liabilities etc of certain health service bodies
  240. 72 Co-operation between NHS bodies
  241. 72A Exemption from Part 3 of the Enterprise Act 2002
  242. 73 Directions and regulations under this Part
  243. 73A Appointment of directors of public health
  244. 73B Exercise of public health functions of local authorities: further provision
  245. 73C Complaints about exercise of public health functions by local authorities
  246. 74 Supply of goods and services by local authorities
  247. 75 Arrangements between NHS bodies and local authorities
  248. 76 Power of local authorities to make payments
  249. 77 Care Trusts
  250. 78 Directed partnership arrangements
  251. 79 Further provision about directions and directed partnership arrangements
  252. 80 Supply of goods and services by the Secretary of State , NHS England and integrated care boards
  253. 81 Conditions of supply under section 80
  254. 82 Co-operation between NHS bodies and local authorities
  255. 83 Primary medical services
  256. 84. General medical services contracts: introductory
  257. 85 Requirement to provide certain primary medical services
  258. 86. Persons eligible to enter into GMS contracts
  259. 87. GMS contracts: payments
  260. 88 GMS contracts: prescription of drugs, etc
  261. 89 GMS contracts: other required terms
  262. 90 GMS contracts: disputes and enforcement
  263. 91 Persons performing primary medical services
  264. 92. Arrangements by the Board for the provision of primary medical services
  265. 93. Persons with whom agreements may be made under section 92
  266. 94 Regulations about section 92 arrangements
  267. 95 Transfer of liabilities relating to section 92 arrangements
  268. 96. Assistance and support: primary medical services
  269. 97. Local Medical Committees
  270. 98 Use of accommodation: provision of primary medical services
  271. 98A. Exercise of functions
  272. 99. Primary dental services
  273. 100 General dental services contracts: introductory
  274. 101 Requirement to provide certain primary dental services
  275. 102 Persons eligible to enter into GDS contracts
  276. 103 GDS contracts: payments
  277. 104 GDS contracts: other required terms
  278. 105 GDS contracts: disputes and enforcement
  279. 106 Persons performing primary dental services
  280. 107 Arrangements by the Board for the provision of primary dental services
  281. 108 Persons with whom agreements may be made under section 107
  282. 109 Regulations about section 107 arrangements
  283. 110 Transfer of liabilities relating to section 107 arrangements
  284. 111 Dental public health
  285. 112 Assistance and support: primary dental services
  286. 113 Local Dental Committees
  287. 114 Use of accommodation: provision of primary dental services
  288. 114A. Exercise of functions
  289. 115. Primary ophthalmic services
  290. 116 Regulations under section 115: supplementary
  291. 117 General ophthalmic services contracts: introductory
  292. 118 Persons eligible to enter into GOS contracts
  293. 119 Exclusion of contractors
  294. 120 GOS contracts: payments
  295. 121 GOS contracts: other required terms
  296. 122 GOS contracts: disputes and enforcement
  297. 123 Persons performing primary ophthalmic services
  298. 124 Assistance and support: primary ophthalmic services
  299. 125 Local Optical Committees
  300. 125A Exercise of functions
  301. 126 Arrangements for pharmaceutical services
  302. 127 Arrangements for additional pharmaceutical services
  303. 128 Terms and conditions, etc
  304. 128A Pharmaceutical needs assessments
  305. 129 Regulations as to pharmaceutical services
  306. 130 Regulations under section 129: appeals, etc
  307. 131 Power to charge
  308. 132 Persons authorised to provide pharmaceutical services
  309. 133 Inadequate provision of pharmaceutical services
  310. 134 Pilot schemes
  311. 135 Making pilot schemes
  312. 136 Designation of priority neighbourhoods or premises
  313. 137 Reviews of pilot schemes
  314. 138 Variation and termination of pilot schemes
  315. 139 NHS contracts and the provision of piloted services
  316. 140 Funding of preparatory work
  317. 141 Application of this Act
  318. 142 Premises from which piloted services may be provided
  319. 143 Control of entry regulations
  320. 144 Local pharmaceutical services schemes
  321. 145 Application of enactments
  322. 146 Persons performing local pharmaceutical services
  323. 147 Assistance and support: local pharmaceutical services
  324. 147A Performers of pharmaceutical services and assistants
  325. 147B Further provision about regulations under section 147A
  326. 148 Conditional inclusion in pharmaceutical lists
  327. 149 Supplementary lists
  328. 150 Further provision about regulations under section 149
  329. 150A Notices and penalties
  330. 151 Disqualification of practitioners
  331. 152 Contingent removal
  332. 153 Fraud and unsuitability cases: supplementary
  333. 154 Suspension
  334. 155 Suspension pending appeal
  335. 156 Effect of suspension
  336. 157 Review of decisions
  337. 158 Appeals
  338. 159 National disqualification
  339. 160 Notification of decisions
  340. 161 Withdrawal from lists
  341. 162 Regulations about decisions under this Chapter
  342. 163 Corresponding provisions in Scotland and Northern Ireland
  343. 164 Remuneration for persons providing pharmaceutical services
  344. 165 Section 164: supplementary
  345. 165A Pharmaceutical remuneration: further provision
  346. 166 Indemnity cover
  347. 167 Local Pharmaceutical Committees
  348. 168 Use of accommodation: provision of pharmaceutical services and local pharmaceutical services
  349. 168A Exercise of functions
  350. 169 Appeals to the First-tier Tribunal
  351. 170 FHSAA: financial provisions
  352. 171 Conditions of use of services of persons under section 169
  353. 172 Charges for drugs, medicines or appliances, or pharmaceutical services
  354. 173 Exemptions from general charging
  355. 174 Pre-payment certificates
  356. 175 Charges in respect of non-residents
  357. 176 Dental charging
  358. 177 Exemptions from dental charging
  359. 178 Charges, recovery of payments and penalties
  360. 179 Charges for optical appliances
  361. 180 Payments in respect of costs of optical appliances and sight tests
  362. 181 Section 180: supplementary
  363. 182 Remission and repayment of charges
  364. 183 Payment of travelling expenses
  365. 184 Sections 182 and 183: supplementary
  366. 185 Charges for more expensive supplies
  367. 186 Charges for repairs and replacements in certain cases
  368. 186A Charges in respect of public health functions
  369. 187 Charges for designated services or facilities
  370. 188 Sums otherwise payable to those providing services
  371. 189 Hospital accommodation on part payment
  372. 190 Expenses payable by employed patients
  373. 191 Recovery of charges
  374. 192 Recovery of charges and payments in relation to goods and services
  375. 193 Penalties relating to charges
  376. 194 Offences relating to charges
  377. 195 Compulsory disclosure of documents
  378. 196 Persons and bodies about which provision is made by this Part
  379. 197 Notice requiring production of documents
  380. 198 Production of documents
  381. 199 Delegation of functions
  382. 200 Code of practice relating to delegated functions
  383. 201 Disclosure of information
  384. 202 Protection of personal information disclosed for purposes of proceedings
  385. 203 Manner in which disclosure notice may be served
  386. 204 Offences in connection with production of documents
  387. 205 Offences relating to disclosure or use of information
  388. 206 Offences by bodies corporate etc
  389. 207 Offences committed by partnerships and other unincorporated associations
  390. 208 Penalties for offences under this Part: transitional modification
  391. 209 Orders and regulations under this Part
  392. 210 Interpretation of this Part
  393. 211 Acquisition, use and maintenance of property
  394. 212 Special trustees for a university hospital or teaching hospital
  395. 213 Transfers of trust property
  396. 214 Transfer of functions and property to or from Welsh special trustees
  397. 215 Trustees and property under section 222
  398. 216 Application of trust property: further provisions
  399. 217 Trusts: supplementary provisions
  400. 218 Private trusts for hospitals
  401. 219 Transferred property free of trusts
  402. 220 Trust property previously held for general hospital purposes
  403. 221 Voluntary hospitals
  404. 222 Power to raise money
  405. 223 Public-private partnerships
  406. 223A. Application of section 223 to integrated care boards
  407. 223B Funding of NHS England
  408. 223C. Financial duties of NHS England: expenditure
  409. 223CA NHS England: banking facilities
  410. 223D. Financial duties of NHS England: controls on total resource use
  411. 223E. Financial duties of NHS England: additional controls on resource use
  412. 223F Power to establish contingency fund
  413. 223G Means of meeting expenditure of integrated care boards out of public funds
  414. 223GA Expenditure on integration
  415. 223GB Power to impose financial requirements on integrated care boards
  416. 223GC Financial duties of integrated care boards: expenditure limits
  417. 223GD Integrated care boards: banking facilities
  418. 223H Financial duties of clinical commissioning groups: expenditure
  419. 223I Financial duties of clinical commissioning groups: use of resources
  420. 223J Financial duties of clinical commissioning groups: additional controls on resource use
  421. 223K Payments in respect of quality
  422. 223L Joint financial objectives for integrated care boards etc
  423. 223M Financial duties of integrated care boards etc: use of resources
  424. 223N Financial duties of integrated care boards etc: additional controls on resource use
  425. 223O Resources etc relevant to section 223D, 223E or 223M
  426. 224 Means of meeting expenditure of Strategic Health Authorities out of public funds
  427. 225 Means of meeting expenditure of Special Health Authorities out of public funds
  428. 226 Financial duties of ... Special Health Authorities
  429. 227 Resource limits for ... Special Health Authorities
  430. 228 Public funding of Primary Care Trusts
  431. 229 Financial duties of Primary Care Trusts
  432. 230 Resource limits for Primary Care Trusts
  433. 231 Further provision about the expenditure of Primary Care Trusts
  434. 232 Accounts and audit
  435. 233 Allowances for members of certain bodies
  436. 234 Special arrangement as to payment of remuneration
  437. 235 Superannuation of officers of certain hospitals
  438. 236 Payments for certain medical examinations
  439. 237 Establishment of Patients' Forums
  440. 238 Additional functions of PCT Patients' Forums
  441. 239 Entry and inspection of premises
  442. 240 Annual reports
  443. 241 Further provision about Patients' Forums
  444. 242 Public involvement and consultation
  445. 242A Strategic Health Authorities: further duty to involve users
  446. 242B Directions in cases where Strategic Health Authority arranges involvement
  447. 243 The Commission for Patient and Public Involvement in Health
  448. 244 Review and scrutiny by local authorities
  449. 245 Joint overview and scrutiny committees etc
  450. 246 Business relating to functions of local authorities by virtue of section 244: exempt information
  451. 247 Application to the City of London
  452. 247A Application to certain other local authorities without overview and scrutiny committees
  453. 247B Co-operation in relation to public health functions
  454. 247C Secretary of State's duty to keep health service functions under review
  455. 247D Secretary of State's annual report
  456. 248 Independent advocacy services
  457. 249 Joint working with the prison service
  458. 250 Secretary of State's standing advisory committees
  459. 250A National Information Governance Board: functions
  460. 250B National Information Governance Board: Wales
  461. 250C National Information Governance Board: further provisions.
  462. 250D National Information Governance Board: annual reports
  463. 251 Control of patient information
  464. 252 Consultation with the Care Quality Commission
  465. 252A Role of NHS England and integrated care boards in respect of emergencies
  466. 253 Emergency powers
  467. 254 Local social service authorities
  468. 254A
  469. 255 Supplies not readily obtainable
  470. 256 Power of NHS England or an integrated care board to make payments towards expenditure on community services
  471. 257 Payments in respect of voluntary organisations under section 256
  472. 258 University clinical teaching and research
  473. 259 Sale of medical practices
  474. 260 Control of maximum price of medical supplies other than health service medicines
  475. 261 Powers relating to voluntary schemes
  476. 262 Power to control prices
  477. 263 Statutory schemes
  478. 264 Statutory schemes: supplementary
  479. 264A Provision of information about health service products
  480. 264B Disclosure of information
  481. 264C Sections 264A and 264B: supplementary
  482. 265 Enforcement
  483. 266 Controls: supplementary
  484. 267 Permission for use of facilities in private practice
  485. 268 Persons displaced by health service development
  486. 269 Special notices of births and deaths
  487. 270 Provision of information by Registrar General
  488. 271 Territorial limit of exercise of functions
  489. 271A Services to be treated as services of the Crown for certain purposes
  490. 272 Orders, regulations, rules and directions
  491. 273 Further provision about orders and directions under this Act
  492. 274 Supplementary regulatory powers
  493. 275 Interpretation
  494. 275A References to functions: delegation etc
  495. 276 Index of defined expressions
  496. 277 Commencement
  497. 278 Short title, extent and application
  498. SCHEDULE A1 NHS England
  499. SCHEDULE 1 Further provision about the Secretary of State and services under this Act
  500. SCHEDULE 1ZA Patient choice: undertakings by integrated care boards
  501. SCHEDULE 1A Clinical commissioning groups
  502. SCHEDULE 1B Integrated care boards
  503. SCHEDULE 4 NHS trusts established under section 25
  504. SCHEDULE 5 Financial provision about NHS trusts established under section 25
  505. SCHEDULE 6 Special Health Authorities established under section 28
  506. SCHEDULE 7 Constitution of public benefit corporations
  507. SCHEDULE 10 Audit of accounts of NHS foundation trusts
  508. SCHEDULE 10A Intervention powers in relation to the reconfiguration of NHS services
  509. SCHEDULE 11 Pilot schemes
  510. SCHEDULE 12 LPS schemes
  511. SCHEDULE 12A Pharmaceutical remuneration
  512. SCHEDULE 16 The Commission for Patient and Public Involvement in Health
  513. SCHEDULE 17 Exempt information relating to health services
  514. SCHEDULE 18 Section 75 arrangements: transfer of staff
  515. SCHEDULE 21 Prohibition of sale of medical practices
  516. SCHEDULE 22 Control of maximum prices for medical supplies

Proposed changes to this act

No one has proposed a change to this act yet.

516 provisions

14Z46 Joint exercise of functions with Local Health Boards

(1) Regulations may provide for any prescribed functions of an integrated care board to be exercised jointly with a Local Health Board. (2) The regulations may permit or require any functions that are exercisable jointly by an integrated care board and a Local Health Board by virtue of the regulations to be exercised by a joint committee of those bodies. (3) Arrangements made by virtue of this section do not affect the liability of an integrated care board for the exercise of any of its functions.

Propose a change

14Z47 Raising additional income

(1) An integrated care board has power to do anything specified in section 7(2)(a), (b) and (e) to (h) of the Health and Medicines Act 1988 (provision of goods etc) for the purpose of making additional income available for improving the health service. (2) An integrated care board may exercise a power conferred by subsection (1) only to the extent that its exercise does not to any significant extent interfere with the exercise by the board of its other functions.

Propose a change

14Z48 Power to make grants

(1) An integrated care board may make payments— (a) by way of grant to any of its partner NHS trusts or NHS foundation trusts; (b) by way of grant or loan to a voluntary organisation which provides or arranges for the provision of services which are similar to the services in respect of which the integrated care board has functions. (2) The payments may be made subject to such terms as the integrated care board considers appropriate. (3) For the purposes of this Act an NHS trust or NHS foundation trust is a “partner” of an integrated care board if the trust— (a) provides services for the purposes of the health service within the integrated care board’s area, and (b) has the function, under the integrated care board’s constitution, of participating in the nomination of members as a result of falling within a description prescribed for the purposes paragraph 8(2)(a) of Schedule 1B.

Propose a change

14Z49 Duty to keep experience of members under review etc

An integrated care board must— (a) keep under review the skills, knowledge and experience that it considers necessary for members of the board to possess (when taken together) in order for the board effectively to carry out its functions, and (b) if it considers that the board as constituted lacks the necessary skills, knowledge and experience, take such steps as it considers necessary to address or mitigate that shortcoming.

Propose a change

14Z50 Responsibility for payments to providers

(1) NHS England may publish a document specifying— (a) circumstances in which an integrated care board is liable to make a payment to a person in respect of services provided by that person in pursuance of arrangements made by another integrated care board in the discharge of commissioning functions, and (b) how the amount of any such payment is to be determined. (2) An integrated care board is required to make payments in accordance with any document published under subsection (1). (3) Where an integrated care board is required to make a payment by virtue of subsection (2), no other integrated care board is liable to make it. (4) Accordingly, any obligation of another integrated care board to make the payment ceases to have effect. (5) Any sums payable by virtue of subsection (2) may be recovered summarily as a civil debt (but this does not affect any other method of recovery). (6) NHS England may publish guidance for integrated care boards for the purpose of assisting them in understanding and applying any document published under subsection (1). (7) In this section “commissioning functions” means the functions of integrated care boards in arranging for the provision of services as part of the health service.

Propose a change

14Z51 Guidance by NHS England

(1) NHS England must publish guidance for integrated care boards on the discharge of their functions. (2) Each integrated care board must have regard to guidance under this section.

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14Z52 Joint forward plans for integrated care board and its partners

(1) Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out how they propose to exercise their functions in the next five years. (2) The plan must, in particular— (a) describe the health services for which the integrated care board proposes to make arrangements in the exercise of its functions by virtue of this Act; (b) explain how the integrated care board proposes to discharge its duties under— (i) sections 14Z34 to 14Z45 (general duties of integrated care boards), and (ii) sections 223GB to 223N (financial duties); (c) set out any steps that the integrated care board proposes to take to implement any joint local health and wellbeing strategy to which it is required to have regard under section 116B(1) of the Local Government and Public Involvement in Health Act 2007; (d) set out any steps that the integrated care board proposes to take to address the particular needs of children and young persons under the age of 25; (e) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults). (3) The integrated care board and its partner NHS trusts and NHS foundation trusts must publish the plan. (4) The integrated care board and its partner NHS trusts and NHS foundation trusts must give a copy of the plan to— (a) the integrated care partnership for the board’s area, (b) each relevant Health and Wellbeing Board, and (c) NHS England. (5) NHS England may give a direction as to the date by which subsection (4) must be complied with. (6) An integrated care board and its partner NHS trusts and NHS foundation trusts must have regard to the plan under subsection (1). (7) In this Chapter “relevant Health and Wellbeing Board”, in relation to an integrated care board (or an integrated care board and its partner NHS trusts and NHS foundation trusts), means a Health and Wellbeing Board established by a local authority whose area coincides with, or includes the whole or any part of, the area of the integrated care board. (8) In this Act “financial year”, in relation to an integrated care board, means— (a) the period beginning with the date on which the integrated care board is established and ending with the 31 March following that date, and (b) each successive period of twelve months.

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14Z53 Revision of forward plans

(1) An integrated care board and its partner NHS trusts and NHS foundation trusts may revise a plan published under section 14Z52. (2) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in a way that they consider to be significant, section 14Z52(3) and (4) apply in relation to the revised plan as they applied in relation to the original plan. (3) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in any other way they must— (a) publish a document setting out the changes, and (b) give a copy of the document to— (i) the integrated care partnership for the board’s area, (ii) each relevant Health and Wellbeing Board, and (iii) NHS England.

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14Z54 Consultation about forward plans

(1) This section applies where an integrated care board and its partner NHS trusts and NHS foundation trusts are— (a) preparing a plan under section 14Z52, or (b) revising a plan under section 14Z53 in a way that they consider to be significant. (2) The integrated care board and its partner NHS trusts and NHS foundation trusts must consult— (a) the group of people for whom the integrated care board has core responsibility, and (b) any other persons they consider it appropriate to consult. (3) The integrated care board and its partner NHS trusts and NHS foundation trusts must involve each relevant Health and Wellbeing Board in preparing or revising the plan. (4) The integrated care board and its partner NHS trusts and NHS foundation trusts must, in particular— (a) give each relevant Health and Wellbeing Board a draft of the plan or (as the case may be) the plan as revised, and (b) consult each relevant Health and Wellbeing Board on whether the draft takes proper account of each joint local health and wellbeing strategy published by it which relates to the period (or any part of the period) to which the plan relates. (5) Where a Health and Wellbeing Board is consulted under subsection (4)(b)— (a) it must respond with its opinion on the matter mentioned there; (b) it may also give that opinion to NHS England. (6) Where a Health and Wellbeing Board gives its opinion to NHS England under subsection (5)(b) it must inform the integrated care board and its partner NHS trusts and NHS foundation trusts that it has done so (unless it informed them, in advance, that it was planning to do so). (7) If an integrated care board and its partner NHS trusts and NHS foundation trusts revise or further revise a draft after it has been given to each relevant Health and Wellbeing Board under subsection (4), subsections (4) and (5) apply in relation to the revised draft as they applied in relation to the original draft. (8) An integrated care board and its partner NHS trusts and NHS foundation trusts must include in a plan published under section 14Z52(3)— (a) a summary of the views expressed by anyone consulted under subsection (2), (b) an explanation of how they took account of those views, and (c) a statement of the final opinion of each relevant Health and Wellbeing Board consulted in relation to the plan under subsection (4). (9) In this section, “joint local health and wellbeing strategy” means a strategy under section 116A of the Local Government and Public Involvement in Health Act 2007.

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14Z55 Opinion of Health and Wellbeing Boards on forward plan

(1) A relevant Health and Wellbeing Board— (a) may give NHS England its opinion on whether a plan published by an integrated care board and its partner NHS trusts and NHS foundation trusts under section 14Z52(3) takes proper account of each joint local health and wellbeing strategy published by the Health and Wellbeing Board which relates to the period (or any part of the period) to which the plan relates, and (b) if it does so, must give the integrated care board and its partner NHS trusts and NHS foundation trusts a copy of its opinion. (2) In this section, “joint local health and wellbeing strategy” has the same meaning as in section 14Z54(9).

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14Z56 Joint capital resource use plan for integrated care board and its partners

(1) Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out their planned capital resource use. (2) The plan must relate to such period as may be specified in a direction by the Secretary of State. (3) The Secretary of State must publish any direction under subsection (2). (4) The integrated care board and its partner NHS trusts and NHS foundation trusts must publish the plan. (5) The integrated care board and its partner NHS trusts and NHS foundation trusts must give a copy of the plan to— (a) the integrated care partnership for the board’s area, (b) each relevant Health and Wellbeing Board, and (c) NHS England. (6) NHS England may give a direction as to the date by which subsection (5) must be complied with. (7) NHS England may publish guidance about the discharge by an integrated care board and its partner NHS trusts and NHS foundation trusts of their functions under this section. (8) An integrated care board and its partner NHS trusts and NHS foundation trusts must have regard to any guidance published under subsection (7). (9) NHS England may give directions, in relation to a financial year— (a) specifying descriptions of resources which must, or must not, be treated as capital resources for the purposes of this section; (b) specifying uses of capital resources which must, or must not, be taken into account for the purposes of this section. (10) The reference in subsection (1) to the use of capital resources is a reference to its expenditure, consumption or reduction in value.

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14Z57 Revision of joint capital resource use plans

(1) An integrated care board and its partner NHS trusts and NHS foundation trusts may revise a plan published under section 14Z56. (2) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in a way that they consider to be significant, section 14Z56(4) and (5) apply in relation to the revised plan as they applied in relation to the original plan. (3) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in any other way, they must— (a) publish a document setting out the changes, and (b) give a copy of the document to— (i) the integrated care partnership for the board’s area, (ii) each relevant Health and Wellbeing Board, and (iii) NHS England.

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14Z58 Annual report

(1) An integrated care board must, in each financial year, prepare a report (an “annual report”) on how it has discharged its functions in the previous financial year. (2) An annual report must, in particular— (a) explain how the integrated care board has discharged its duties under sections 14Z34 to 14Z45 and 14Z49 (general duties of integrated care boards), (b) review the extent to which the board has exercised its functions in accordance with the plans published under— section 14Z52 (forward plan), and section 14Z56 (capital resource use plan), (c) review the extent to which the board has exercised its functions consistently with NHS England’s views set out in the latest statement published under section 13SA(1) (views about how functions relating to inequalities information should be exercised), and (d) review any steps that the board has taken to implement any joint local health and wellbeing strategy to which it was required to have regard under section 116B(1) of the Local Government and Public Involvement in Health Act 2007. (3) In undertaking the review required by subsection (2)(d), an integrated care board must consult each relevant Health and Wellbeing Board. (4) An annual report must include— (a) a statement of the amount of expenditure incurred by the integrated care board during the financial year in relation to mental health, (b) a calculation of the proportion of the expenditure incurred by the integrated care board during the financial year that relates to mental health, and (c) an explanation of the statement and calculation. (5) NHS England may give directions to integrated care boards as to the form and content of an annual report. (6) An integrated care board must— (a) give a copy of its annual report to NHS England before the date specified by NHS England in a direction, and (b) publish a copy of the annual report.

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14Z59 Performance assessment of integrated care boards

(1) NHS England must conduct a performance assessment of each integrated care board in respect of each financial year. (2) A performance assessment is an assessment of how well the integrated care board has discharged its functions during that year. (3) The assessment must, in particular, include an assessment of how well the integrated care board has discharged its duties under— (a) section 14Z34 (improvement in quality of services), (b) section 14Z35 (reducing inequalities), (c) section 14Z38 (obtaining appropriate advice), (d) section 14Z40 (duty in respect of research), (e) section 14Z43 (duty to have regard to effect of decisions), (f) section 14Z45 (public involvement and consultation), (g) sections 223GB to 223N (financial duties), and (h) section 116B(1) of the Local Government and Public Involvement in Health Act 2007 (duty to have regard to assessments and strategies). (4) In conducting a performance assessment, NHS England must consult each relevant Health and Wellbeing Board as to its views on any steps that the board has taken to implement any joint local health and wellbeing strategy to which the board was required to have regard under section 116B(1) of that Act of 2007. (5) In conducting a performance assessment, NHS England must, in particular, have regard to— (a) any guidance published by the Secretary of State for the purposes of this section, and (b) any guidance published under section 14Z51. (6) NHS England must publish a report in respect of each financial year containing a summary of the results of each performance assessment conducted by NHS England in respect of that year.

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14Z60 Power of NHS England to obtain information

(1) NHS England may require an integrated care board to provide NHS England with information. (2) The information must be provided in such form, and at such time or within such period, as NHS England may require.

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14Z61 Power to give directions to integrated care boards

(1) This section applies if NHS England is satisfied that— (a) an integrated care board is failing or has failed to discharge any of its functions, or (b) there is a significant risk that an integrated care board will fail to do so. (2) NHS England may direct the integrated care board to discharge such of those functions in such manner and within such period or periods as may be specified in the direction. (3) NHS England may direct— (a) the integrated care board, or (b) the chief executive of the integrated care board, to cease to perform any functions for such period or periods as may be specified in the direction. (4) NHS England may— (a) terminate the appointment of the integrated care board’s chief executive, and (b) direct the chair of the board as to which individual to appoint as a replacement and on what terms. (5) Where a direction is given under subsection (3)(a) NHS England may— (a) exercise, on behalf of the integrated care board, any of the functions that are the subject of the direction; (b) direct another integrated care board to perform any of those functions on behalf of the integrated care board, in such manner and within such period or periods as may be specified in the direction. (6) A direction under subsection (5)(b) may include provision prohibiting or restricting the integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction. (7) In subsection (6) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else. (8) Where a direction is given under subsection (3)(b) NHS England may— (a) exercise, on behalf of the chief executive, any of the functions that are the subject of the direction; (b) direct the chief executive of another integrated care board to perform any of those functions on behalf of the chief executive, in such manner and within such period or periods as may be specified in the direction. (9) For the purposes of this section— (a) a failure to discharge a function includes a failure to discharge it properly, and (b) a failure to discharge a function properly includes a failure to discharge it consistently with what NHS England considers to be the interests of the health service.

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14Z62 Section 14Z61 directions: consultation and cooperation

(1) Before exercising the power conferred by section 14Z61(5)(b) or (8)(b) NHS England must consult the integrated care board to which it is proposing to give the direction or to whose chief executive it is proposing to give the direction. (2) Where a direction is given under section 14Z61(3)(b) to the chief executive of an integrated care board, that board must co-operate with any chief executive to whom a direction is given under subsection (8)(b).

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14Z63 Permitted disclosures of information

(1) An integrated care board may disclose information obtained by it in the exercise of its functions if— (a) the information has previously been lawfully disclosed to the public, (b) the disclosure is made under or pursuant to regulations under section 113 or 114 of the Health and Social Care (Community Health and Standards) Act 2003 (complaints about health care or social services), (c) the disclosure is made in accordance with any enactment or court order, (d) the disclosure is necessary or expedient for the purposes of protecting the welfare of any individual, (e) the disclosure is made to any person in circumstances where it is necessary or expedient for the person to have the information for the purpose of exercising functions of that person under any enactment, (f) the disclosure is made for the purpose of facilitating the exercise of any of the integrated care board’s functions, (g) the disclosure is made in connection with the investigation of a criminal offence (whether or not in the United Kingdom), or (h) the disclosure is made for the purpose of criminal proceedings (whether or not in the United Kingdom). (2) Subsection (1)(a) to (c) and (h) have effect notwithstanding any rule of common law which would otherwise prohibit or restrict the disclosure.

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14Z64 Interpretation

In this Chapter— “the health service” means the health service in England; “health services” means services provided as part of the health service; “integrated care partnership” has the meaning given by section 116ZA(1) of the Local Government and Public Involvement in Health Act 2007; “relevant Health and Wellbeing Board”, in relation to an integrated care board, has the meaning given by section 14Z52(7).

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25 NHS trusts

(1) The Secretary of State may by order establish bodies, called National Health Service trusts (“NHS trusts”), to provide goods and services for the purposes of the health service. (2) An order under subsection (1) is referred to in this Act as “an NHS trust order”. (3) No NHS trust order may be made until after the completion of such consultation as may be prescribed. (4) Schedule 4 makes further provision about NHS trusts.

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26 General duty of NHS trusts

An NHS trust must exercise its functions effectively, efficiently and economically.

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26A Duty to have regard to wider effect of decisions

(1) In making a decision about the exercise of its functions, an NHS trust established under section 25 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 trusts 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.

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26B Duties in relation to climate change etc

(1) An NHS trust established under section 25 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 trusts must have regard to guidance published by NHS England under section 13ND.

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27 Financial provisions relating to NHS trusts

Schedule 5 makes provision about the financing of NHS trusts.

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27A Oversight and support of NHS trusts

NHS England must— (a) monitor NHS trusts established under section 25 in the carrying out of their functions, and (b) provide such advice, guidance or other support as it considers appropriate to help NHS trusts established under section 25 in the carrying out of their functions.

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27B NHS England’s directions to NHS trusts

(1) NHS England may give directions to an NHS trust established under section 25 about its exercise of any functions. (2) In so far as a direction under this section conflicts with a direction under section 8 or paragraph 25(3) of Schedule 4, it is of no effect.

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27C Recommendations about restructuring

(1) NHS England may— (a) make recommendations to NHS trusts for or in connection with the making of restructuring applications; (b) take such other steps as it considers appropriate to facilitate restructuring applications involving NHS trusts. (2) In this section “restructuring application”, in relation to an NHS trust, means an application by the NHS trust under— (a) section 56 (mergers involving NHS foundation trusts); (b) section 56A (acquisitions by NHS foundation trusts); (c) section 69A (transfer of property etc between NHS bodies); (d) paragraph 28 of Schedule 4 (dissolution of NHS trusts).

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27D Intervention in NHS trusts: recommendations etc by NHS England

(1) If NHS England considers that Secretary of State ought to make an order under section 66(2) or 68(2) in relation to an NHS trust established under section 25, NHS England must— (a) make a recommendation to that effect, (b) set out its reasons for the recommendation, and (c) make any recommendations it considers appropriate as to the contents of the order. (2) NHS England must make any inquiries, and provide any other assistance, that the Secretary of State may require in connection with deciding whether to make an order under section 66(2) or 68(2) in relation to an NHS trust established under section 25 and, if so, on what terms.

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28 Special Health Authorities

(1) The Secretary of State may by order establish special bodies for the purpose of exercising any functions which may be conferred on them by or under this Act. (2) The Secretary of State may make such further provision relating to a body established under subsection (1) as he considers appropriate. (3) A body established under this section is called a Special Health Authority. (4) An order may, in particular, contain provisions as to— (a) the membership of the body established by the order, (b) the transfer to the body of officers, property and liabilities, and (c) the name of the body. (5) The liabilities which may be transferred by virtue of this section, section 272(8) and section 273(1) to an NHS body on the abolition of a Special Health Authority include criminal liabilities. (6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (7) The Secretary of State must, before he makes an order under this section, consult with respect to the order such bodies as he may recognise as representing officers who in his opinion are likely to be transferred or affected by transfers in pursuance of the order. (8) Schedule 6 makes further provision about Special Health Authorities.

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28A Special Health Authorities: further provision

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29 Exercise of Special Health Authority functions

(1) Regulations may provide for any functions which are exercisable by a Special Health Authority under section 7 to be exercised— (a) by another Special Health Authority, or (b) jointly with one or more other Special Health Authorities. (2) Regulations may provide— (a) for any functions which are exercisable by a Special Health Authority under section 7 ... ... or this section to be exercised on behalf of that Special Health Authority by a committee, sub-committee or officer of the Special Health Authority, (b) for any functions exercisable jointly under subsection (1)(b) to be exercised, on behalf of the Special Health Authorities in question, by a joint committee or joint sub-committee.

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29A Special Health Authorities: accounts and audit

(1) In this section a reference to a Special Health Authority is to a Special Health Authority which— (a) performs functions only or mainly in respect of England, or (b) neither performs functions only or mainly in respect of England, nor performs functions only or mainly in respect of Wales. (2) A Special Health Authority must keep proper accounts and proper records in relation to the accounts. (3) The Secretary of State may give a Special Health Authority directions as to the form in which its accounts must be kept. (4) A Special Health Authority must prepare, in respect of each financial year, annual accounts in such form as the Secretary of State may direct. (5) A Special Health Authority must send copies of any annual accounts prepared by it under subsection (4)— (a) to the Secretary of State, by such date as the Secretary of State may direct, and (b) to the Comptroller and Auditor General, as soon as is reasonably practicable following the end of the financial year in question. (6) The Comptroller and Auditor General must examine, certify and report on the annual accounts. (7) The Special Health Authority must lay before Parliament— (a) a copy of the annual accounts, and (b) the Comptroller and Auditor General’s report on them. (8) Nothing in subsection (2) requires any annual accounts prepared by a Special Health Authority to include matters relating to a charitable trust of which it is a trustee. (9) Nothing in subsection (4) has effect in relation to accounts relating to a charitable trust of which the Special Health Authority is a trustee.

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30 NHS foundation trusts

(1) An NHS foundation trust is a public benefit corporation the function of which is to provide in accordance with this Chapter goods and services for the purposes of the health service in England. (2) A public benefit corporation is a body corporate which, in pursuance of an application under this Chapter, is constituted in accordance with Schedule 7.

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31 Independent Regulator of NHS Foundation Trusts

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32 General duty of regulator

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33 Applications by NHS trusts

(1) An NHS trust may make an application to NHS England for authorisation to become an NHS foundation trust .... (2) The application must— (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) be accompanied by a copy of the proposed constitution of the NHS foundation trust, and must give any further information which NHS England requires the applicant to give. (3) The applicant may modify the application with the agreement of NHS England at any time before authorisation is given under section 35. (4) Once an NHS trust has made the application— (a) the provisions of the proposed constitution which give effect to paragraphs 3 to 19 of Schedule 7 have effect, but only for the purpose of establishing the initial membership of the NHS foundation trust and of the council of governors, and the initial directors, and enabling the council of governors and board of directors to make preparations for the performance of their functions, (b) the NHS trust may do anything (including the things mentioned in paragraph 14 of Schedule 4) which appears to it to be necessary or expedient for the purpose of preparing it for NHS foundation trust status.

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34 Other applications

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35 Authorisation of NHS foundation trusts

(1) NHS England may give an authorisation under this section— (a) to an NHS trust which has applied under section 33, ... (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . if the Secretary of State approves the authorisation and NHS England is satisfied as to the following matters. (2) The matters are that— (a) the applicant's constitution will be in accordance with Schedule 7 and will otherwise be appropriate, (b) the applicant has taken steps to secure that (taken as a whole) the actual membership of any public constituency, and (if there is one) of the patients' constituency, will be representative of those eligible for such membership, (c) there will be a council of governors, and a board of directors, constituted in accordance with the constitution, (d) the steps necessary to prepare for NHS foundation trust status have been taken, (e) the applicant will be able to provide goods and services for the purposes of the health service in England, (f) any other requirements which NHS England considers appropriate are met. (3) In deciding whether it is satisfied as to the matters referred to in subsection (2)(e), NHS England must consider (among other things)— (a) any report or recommendation in respect of the applicant made by the Care Quality Commission, (b) the financial position of the applicant. (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) NHS England must not give an authorisation unless it is satisfied that the applicant has sought the views about the application of the following— (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) individuals who live in any area specified in the proposed constitution as the area for a public constituency, (c) any local authority that would be authorised by the proposed constitution to appoint a member of the council of governors, (d) if the proposed constitution provides for a patients' constituency, individuals who would be able to apply to become members of that constituency, (e) any prescribed persons. (6) If regulations make provision about consultation, NHS England may not give an authorisation unless it is satisfied that the applicant has complied with the regulations. (7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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36 Effect of authorisation

(1) On an authorisation being given to a body corporate which is an NHS trust— (a) it ceases to be an NHS trust and becomes an NHS foundation trust, (b) the proposed constitution has effect, and (c) any order under section 25(1) is revoked. (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) The authorisation is conclusive evidence that the body in question is an NHS foundation trust. (4) Subsections (1) to (3) do not affect the continuity of the body or of its property or liabilities (including its criminal liabilities). (5) The validity of any act of an NHS foundation trust is not affected by any vacancy among the directors or by any defect in the appointment of any director. (6) An NHS foundation trust must not be regarded as the servant or agent of the Crown or as enjoying any status, immunity or privilege of the Crown; and an NHS foundation trust's property must not be regarded as property of, or property held on behalf of, the Crown.

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37 Amendments of constitution

(1) An NHS foundation trust may make amendments of its constitution only if— (a) more than half of the members of the council of governors of the trust voting approve the amendments, and (b) more than half of the members of the board of directors of the trust voting approve the amendments. (2) Amendments made under this section take effect as soon as the conditions in subsection (1)(a) and (b) are satisfied. (3) But an amendment is of no effect in so far as the constitution would, as a result of the amendment, not accord with Schedule 7. (4) The trust must inform NHS England of amendments made under this section; but NHS England’s functions do not include a power or duty to determine whether or not the constitution, as a result of the amendments, accords with Schedule 7.

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