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

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516 provisions

63 General duty of NHS foundation trusts

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

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63A Duty to have regard to wider effect of decisions

(1) In making a decision about the exercise of its functions, an NHS foundation trust 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 foundation 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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63B Duties in relation to climate change etc

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

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64 Orders and regulations under this Chapter

(1) Any power under this Chapter to make an order or regulations , other than the power to make an order under section 42B, is exercisable by statutory instrument. (2) Subject to subsections (3) and (4), a statutory instrument made by virtue of this Chapter is subject to annulment in pursuance of a resolution of either House of Parliament. (3) A statutory instrument containing— (a) the first regulations under section 55(4) or 59, (aa) regulations under paragraph 30(1) of Schedule 7, or (b) an order or regulations under this Chapter making, by virtue of subsection (5)(b), provision which amends or repeals any part of the text of an Act, may not be made unless a draft of the instrument has been laid before, and approved by resolution of, each House of Parliament. (4) Subsection (2) does not apply to a statutory instrument containing an order under— (a) section 51, (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (ba) section 56A(4A), (c) section 57 , or (d) section 57A. (4A) The Statutory Instruments Act 1946 applies in relation to the power of NHS England to make an order under section 56A(4A), 57 or 57A as if NHS England were a Minister of the Crown. (5) Any order or regulations under this Chapter— (a) may make different provision for different purposes, and (b) may make incidental, supplementary, consequential, transitory or transitional or saving provision. (6) Any power under this Chapter to make an order or regulations (as well as being exercisable in relation to all cases to which it extends) may be exercised in relation to all those cases subject to exceptions or in relation to any particular case or class of case.

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65 Interpretation of this Chapter

(1) In this Chapter— “authorisation” means an authorisation under section 35 or 56, “health service body” means a Strategic Health Authority, a Primary Care Trust, an NHS trust, a Special Health Authority or an NHS foundation trust. (2) Any references in this Chapter to goods and services include, in particular, facilities, education and training.

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65A Application

(1) This Chapter applies to— (a) an NHS trust all or most of whose hospitals, establishments and facilities are in England; (b) any NHS foundation trust. (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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65B NHS trusts: appointment of trust special administrator

(1) NHS England may make an order in accordance with this section authorising the appointment of a trust special administrator to exercise the functions of the chair and directors of an NHS trust to which this Chapter applies. (2) NHS England— (a) must make an order under subsection (1) if required to do so by the Care Quality Commission, and (b) may otherwise make an order under subsection (1) only if— (i) NHS England considers it appropriate to do so in the interests of the health service, and (ii) the Secretary of State has approved the making of the order. (3) The Care Quality Commission may require NHS England to make an order under subsection (1) only if it is satisfied that there is a serious failure by the NHS trust to provide services that are of sufficient quality to be provided under this Act. (4) Before requiring NHS England to make an order under subsection (1) the Care Quality Commission must— (a) consult the Secretary of State and NHS England, and (b) having done that, consult— (i) the trust, (ii) any integrated care board in whose area the trust has hospitals, establishments or facilities, and (iii) any person to which the trust provides goods or services under this Act and which the Commission considers it appropriate to consult. (5) Before making an order under subsection (1) in a case where it is not required to do so by the Care Quality Commission, NHS England must consult— (a) the trust, (b) any integrated care board in whose area the trust has hospitals, establishments or facilities, (c) any other person to which the trust provides goods or services under this Act and which NHS England considers it appropriate to consult, and (d) the Care Quality Commission. (6) An order under subsection (1) must specify the date when the appointment is to take effect, which must be within the period of 5 working days beginning with the day on which the order is made. (7) NHS England must lay before Parliament (with the statutory instrument containing the order) a report stating the reasons for making the order. (8) If an order is made under subsection (1), NHS England must— (a) appoint a person as the trust special administrator with effect from the day specified in the order, and (b) publish the name of the person appointed. (9) A person appointed as a trust special administrator holds and vacates office in accordance with the terms of the appointment. (10) NHS England may pay remuneration and expenses to a trust special administrator appointed under this section.

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65BA Care Quality Commission report on safety and quality of services

(1) This section applies where the Care Quality Commission require NHS England to make an order under section 65B(1) in relation to an NHS trust. (2) The Care Quality Commission must, as soon as reasonably practicable after the making of the order, provide to NHS England and the Secretary of State a report on the safety and quality of the services that the trust provides under this Act.

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65C Suspension of directors

(1) When the appointment of a trust special administrator takes effect, the trust's chairman and executive and non-executive directors are suspended from office. (2) Subsection (1) does not affect the employment of the executive directors or their membership of any committee or sub-committee of the trust.

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65D NHS foundation trusts: appointment of trust special administrator

(1) This section applies if NHS England is satisfied that — (a) an NHS foundation trust is, or is likely to become, unable to pay its debts , or (b) there is a serious failure by an NHS foundation trust to provide services that are of sufficient quality to be provided under this Act and it is appropriate to make an order under subsection (2). (1A) This section also applies if the Care Quality Commission— (a) is satisfied that there is a serious failure by an NHS foundation trust to provide services that are of sufficient quality to be provided under this Act and that it is appropriate to make an order under subsection (2), (b) informs NHS England that it is satisfied as mentioned in paragraph (a) and gives NHS England its reasons for being so satisfied, and (c) requires NHS England to make an order under subsection (2). (2) NHS England may or, where this section applies as a result of subsection (1A), must make an order authorising the appointment of a trust special administrator to exercise the functions of the governors, chairman and directors of the trust. (2A) Where NHS England is not required to make an order under this section as a result of subsection (1A), it may do so only if the Secretary of State has approved the making of the order. (3) As soon as reasonably practicable after the making of an order under subsection (2), the Care Quality Commission must provide to NHS England a report on the safety and quality of the services that the trust provides under this Act. (3A) Before imposing a requirement as mentioned in subsection (1A)(c), the Care Quality Commission must— (a) consult the Secretary of State and NHS England, and (b) having done that, consult— (i) the trust, (ii) ... and (iii) any other person to which the trust provides services under this Act and which the Commission considers it appropriate to consult. (4) Before making an order under this section in a case where it is not required to do so as a result of subsection (1A), NHS England must consult— (a) the trust, (b) any person to which the trust provides services under this Act and which NHS England considers it appropriate to consult, and (c) the Care Quality Commission. (5) An order under subsection (2) must specify the date when the appointment is to take effect, which must be within the period of 5 working days beginning with the day on which the order is made. (6) NHS England must lay before Parliament (with the statutory instrument containing the order) a report stating the reasons for making the order. (7) If NHS England makes an order under subsection (2), it must— (a) appoint a person as the trust special administrator with effect from the day specified in the order, and (b) publish the name of the person appointed. (8) A person appointed as a trust special administrator under this section holds and vacates office in accordance with the terms of the appointment. (9) A person appointed as a trust special administrator under this section must manage the trust's affairs, business and property, and exercise the trust special administrator's functions, so as to achieve the objective set out in section 65DA as quickly and as efficiently as is reasonably practicable. (10) When the appointment of a trust special administrator under this section takes effect, the trust's governors, chairman and executive and non-executive directors are suspended from office; and Chapter 5 of this Part, in its application to the trust, is to be read accordingly. (11) But subsection (10) does not affect the employment of the executive directors or their membership of any committee or sub-committee of the trust. (12) NHS England may pay remuneration and expenses to a trust special administrator appointed under this section.

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65DA Objective of trust special administration

(1) The objective of a trust special administration is to secure— (a) the continued provision of such of the services provided for the purposes of the NHS by the NHS foundation trust that is subject to an order under section 65D(2), at such level, as the commissioners of those services determine, and (aa) that the services whose continuous provision is secured as mentioned in paragraph (a) are of sufficient safety and quality to be provided under this Act, (b) that it becomes unnecessary for the order to remain in force for that purpose. (2) The commissioners may determine that the objective set out in subsection (1) is to apply to a service only if they are satisfied that the criterion in subsection (3) is met. (3) The criterion is that ceasing to provide the service under this Act would, in the absence of alternative arrangements for its provision under this Act, be likely to— (a) have a significant adverse impact on the health of persons in need of the service or significantly increase health inequalities, or (b) cause a failure to prevent or ameliorate either a significant adverse impact on the health of such persons or a significant increase in health inequalities. (4) In determining whether that criterion is met, the commissioners must (in so far as they would not otherwise be required to do so) have regard to— (a) the current and future need for the provision of the service under this Act, (b) whether ceasing to provide the service under this Act would significantly reduce equality between those for whom the commissioner arranges for the provision of services under this Act with respect to their ability to access services so provided, and (c) such other matters as may be specified in relation to NHS foundation trusts in guidance published by NHS England. (5) NHS England may revise guidance under subsection (4)(c) and, if it does so, must publish the guidance as revised. (5A) Before publishing guidance under subsection (4)(c), NHS England must consult the Care Quality Commission. (6) Before publishing guidance under subsection (4)(c) or (5), NHS England must obtain the approval of— (a) the Secretary of State; (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (7) NHS England must make arrangements for facilitating agreement between commissioners in determining the services provided by the trust under this Act to which the objective set out in subsection (1) is to apply. (8) Where commissioners fail to reach agreement in pursuance of arrangements under subsection (7), NHS England may make the determination (and the duty imposed by subsection (1)(a), so far as applying to the commissioners concerned, is to be regarded as discharged). (9) In this section— “commissioners” means the persons to which the trust provides services under this Act, and “health inequalities” means the inequalities between persons with respect to the outcomes achieved for them by the provision of services that are provided as part of the health service.

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65E NHS foundation trusts: de-authorisation and appointment of trust special administrator

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65F Draft report

(1) A trust special administrator appointed in relation to an NHS trust must, within the period of 65 working days beginning with the day on which the administrator’s appointment takes effect— (a) provide NHS England and the Secretary of State with a draft report recommending any action that NHS England or the Secretary of State should take in relation to the trust, and (b) publish a copy of that draft report. (1A) A trust special administrator appointed in relation to an NHS foundation trust must, within the period of 65 working days beginning with the day on which the administrator’s appointment takes effect— (a) provide NHS England with a draft report recommending the action that NHS England should take in relation to the trust, and (b) publish a copy of that draft report, unless unable to obtain the statements required by subsections (1B) and (1C). (1B) A trust special administrator may not provide a draft report under subsection (1A)— (a) without having obtained a statement from each commissioner that the commissioner considers that the recommendation in the draft report— (i) would achieve the objective set out in section 65DA(1)(a), and (ii) would do so without harming essential services provided for the purposes of the NHS by any other NHS foundation trust or NHS trust that provides services under this Act to the commissioner, or (b) where the administrator is unable to obtain a statement to that effect from one or more of the commissioners (other than NHS England), without having obtained a statement to that effect from NHS England. (1C) A trust special administrator may not provide a draft report under subsection (1A) without having obtained a statement from the Care Quality Commission that it considers that the recommendation in the draft report would achieve that part of the objective set out in section 65DA(1)(aa). (2) When preparing a draft report under subsection (1) or (1A), the administrator must consult— (a) any person to which the trust provides goods or services under this Act and which NHS England directs the administrator to consult, and (b) the Care Quality Commission. (3) After receiving a draft report under subsection (1) or (1A), NHS England must lay it before Parliament. (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (6) Where NHS England decides not to provide to the administrator a statement to the effect mentioned in subsection (1B)(b), NHS England must— (a) give a notice of the reasons for its decision to the administrator, (b) publish the notice, and (c) lay a copy of it before Parliament. (6A) Where the Care Quality Commission decides not to provide to the administrator a statement to the effect mentioned in subsection (1C), the Commission must— (a) give a notice of the reasons for its decision to the administrator and to NHS England, (b) publish the notice, and (c) lay a copy of it before Parliament. (7) In subsection (5), “commissioner” means a person to which the trust provides services under this Act. (8) Where the administrator recommends taking action in relation to another NHS foundation trust or an NHS trust, the references in subsection (5) to a commissioner also include a reference to a person to which the other NHS foundation trust or the NHS trust provides services under this Act that would be affected by the action. (9) A service provided by an NHS foundation trust or an NHS trust is an essential service for the purposes of subsection (5) if the person making the statement in question is satisfied that the criterion in section 65DA(3) is met. (10) Section 65DA(4) applies to the person making the statement when that person is determining whether that criterion is met.

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65G Consultation plan

(1) At the same time as publishing a draft report under section 65F, a trust special administrator must publish a statement setting out the means by which the administrator will seek responses to the draft report. (2) The statement must specify a period of 40 working days within which the administrator seeks responses (the “consultation period”). (3) The first day of the consultation period must be within the period of 5 working days beginning with the day on which the draft report is published. (4) In the case of an NHS foundation trust, the administrator may not make a variation to the draft report following the consultation period— (a) without having obtained from each commissioner a statement that the commissioner considers that the recommendation in the draft report as so varied — (i) would achieve the objective set out in section 65DA(1)(a), and (ii) would do so without harming essential services provided for the purposes of the NHS by any other NHS foundation trust or NHS trust that provides services under this Act to the commissioner, or (b) where the administrator does not obtain a statement to that effect from one or more commissioners (other than NHS England), without having obtained a statement to that effect from NHS England. (4A) Nor may the administrator make a variation to the draft report following the consultation period without having obtained from the Care Quality Commission a statement that it considers that the recommendation in the draft report as so varied would achieve that part of the objective set out in section 65DA(1)(aa). (5) Where NHS England decides not to provide to the administrator a statement to the effect mentioned in subsection (4)(b), NHS England must— (a) give a notice of the reasons for its decision to the administrator, (b) publish the notice, and (c) lay a copy of it before Parliament. (5A) Where the Care Quality Commission decides not to provide to the administrator a statement to the effect mentioned in subsection (4A), the Commission must— (a) give a notice of the reasons for its decision to the administrator and to NHS England, (b) publish the notice, and (c) lay a copy of it before Parliament. (6) In subsection (4), “commissioner” means a person to which the trust provides services under this Act. (7) Where the administrator recommends taking action in relation to another NHS foundation trust or an NHS trust, the references in subsection (4) to a commissioner also include a reference to a person to which the other NHS foundation trust or the NHS trust provides services under this Act that would be affected by the action.” (8) A service provided by an NHS foundation trust or an NHS trust is an essential service for the purposes of subsection (4) if the person making the statement in question is satisfied that the criterion in section 65DA(3) is met. (9) Section 65DA(4) applies to the person making the statement when that person is determining whether that criterion is met.

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65H Consultation requirements

(1) The following duties apply during the consultation period. (2) The trust special administrator must publish a notice stating that the administrator is seeking responses to the draft report and describing how people can give their responses. (3) A notice under subsection (2) must include details of how responses can be given in writing. (4) The trust special administrator must — (a) hold at least one meeting to seek responses from staff of the trust and from such persons as the trust special administrator may recognise as representing staff of the trust , and (b) in the case of each affected trust, hold at least one meeting to seek responses from staff of the trust and from such persons as the trust special administrator may recognise as representing staff of the trust. (5) The trust special administrator must hold at least one other meeting to seek responses from any person who wishes to attend, after publishing notice of the date, time and place of the meeting. (6) Notices under subsections (2) and (5) must be published at least once in the first 5 working days of the consultation period. (7) The trust special administrator must request a written response from— (za) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) any ... person to which the trust provides goods or services under this Act ...; (bza) any affected trust; (bzb) any person to which an affected trust provides goods or services under this Act that would be affected by the action recommended in the draft report; (bzc) any local authority in whose area the trust provides goods or services under this Act; (bzd) any local authority in whose area an affected trust provides goods or services under this Act; (bze) any Local Healthwatch organisation for the area of a local authority mentioned in paragraph (bzc) or (bzd); (ba) the Care Quality Commission; (c) the member of Parliament for any constituency, if required by directions given by NHS England; (d) any other person specified in a direction given by NHS England. (8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (9) The trust special administrator must — (a) hold at least one meeting to seek responses from representatives of ... each of the persons from whom the administrator must request a written response under subsection (7)(b), (bzb), (ba), (c) or (d), (b) hold at least one meeting to seek responses from representatives of each of the trusts from which the administrator must request a written response under subsection (7)(bza), and (c) hold at least one meeting to seek responses from representatives of each of the local authorities and Local Healthwatch organisations from which the administrator must request a written response under subsection (7)(bzc), (bzd) and (bze). (9A) NHS England may direct the administrator to hold a meeting to seek a response from any person. (10) The Secretary of State may direct NHS England as to the persons from whom it should direct the administrator to— (a) request a written response (for NHS England’s powers of direction, see subsection (7)(c) and (d)); (b) seek a response by holding a meeting (for NHS England’s power of direction, see subsection (9A)). (11) In subsection (4) “staff of the trust” means persons employed by the trust or otherwise working for the trust (whether as or on behalf of a contractor, as a volunteer or otherwise). (11A) In this section, “affected trust” means— (a) where the trust in question is an NHS trust, another NHS trust, or an NHS foundation trust, which provides goods or services under this Act that would be affected by the action recommended in the draft report; (b) where the trust in question is an NHS foundation trust, another NHS foundation trust, or an NHS trust, which provides services under this Act that would be affected by the action recommended in the draft report. (11B) In this section, a reference to a local authority includes a reference to the council of a district only where the district is comprised in an area for which there is no county council. (12) For the purposes of this section in its application to the case of an NHS foundation trust— (a) in subsection (7)(b) , (bzb), (bzc) and (bzd), the words “goods or” are to be ignored, ... (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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65I Final report

(1) A trust special administrator appointed in relation to an NHS trust must, within the period of 15 working days beginning with the end of the consultation period, provide NHS England and the Secretary of State with a final report stating any action that the administrator recommends that NHS England or Secretary of State should take in relation to the trust. (1A) A trust special administrator appointed in relation to an NHS foundation trust must, within the period of 15 working days beginning with the end of the consultation period, provide NHS England with a final report stating the action that the administrator recommends that NHS England should take in relation to the trust. (2) The administrator must attach to the final report mentioned in subsection (1) or (1A) a summary of all responses to the draft report which were received by the administrator in the period beginning with the publication of the draft report and ending with the last day of the consultation period. (3) After receiving the administrator's final report, NHS England must publish it and lay it before Parliament. (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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65J Power to extend time

(1) This section applies to— (a) the duty of a trust special administrator to provide a draft report within the period specified in section 65F(1) or (1A); (b) the duty of a trust special administrator to consult in the consultation period specified under section 65G(2); (c) the duty of a trust special administrator to provide a final report within the period specified in section 65I(1) or (1A). (2) If NHS England thinks it is not reasonable in the circumstances for the administrator to be required to carry out the duty within the specified period, NHS England may by order extend the period. (3) If an order is made extending the period mentioned in subsection (1)(a) or (c) the trust special administrator must publish a notice stating the new date on which the period will expire. (4) If an order is made extending the period mentioned in subsection (1)(b) the trust special administrator must— (a) publish a notice stating the new date on which the period will expire, and (b) publish a statement setting out the means by which the administrator will seek responses to the draft report during the extended consultation period. (5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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65K. Decision of NHS England or Secretary of State in case of NHS trust

(1) Within the period of 20 working days beginning with the day on which NHS England receives a final report under section 65I relating to an NHS trust, NHS England must decide what (if any) action to take in relation to the trust. (2) Within the period of 20 working days beginning with the day on which the Secretary of State receives a final report under section 65I relating to an NHS trust, the Secretary of State must decide what (if any) action to take in relation to the trust. (3) NHS England and the Secretary of State must consult one another before taking the decision under subsection (1) or (2). (4) After taking a decision under subsection (1) or (2) NHS England or the Secretary of State (as the case may be) must, as soon as reasonably practicable— (a) publish a notice of the decision and of the reasons for it; (b) lay a copy of the notice before Parliament.

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65KA NHS England’s decision in case of NHS foundation trust

(1) Within the period of 20 working days beginning with the day on which NHS England receives a final report under section 65I relating to an NHS foundation trust, NHS England must decide whether it is satisfied— (a) that the action recommended in the final report would achieve the objective set out in section 65DA, and (b) that the trust special administrator has carried out the administration duties. (2) In subsection (1)(b), “administration duties” means the duties imposed on the administrator by— (a) this Chapter, (b) a direction under this Chapter, or (c) the administrator's terms of appointment. (3) If NHS England is satisfied as mentioned in subsection (1), it must as soon as reasonably practicable provide to the Secretary of State— (a) the final report, and (b) the report provided to NHS England by the Care Quality Commission under section 65D(3). (4) If NHS England is not satisfied as mentioned in subsection (1), it must as soon as reasonably practicable give a notice of that decision to the administrator. (5) Where NHS England gives a notice under subsection (4), sections 65F to 65J apply in relation to the trust to such extent, and with such modifications, as NHS England may specify in the notice. (6) NHS England must as soon as reasonably practicable after giving a notice under subsection (4)— (a) publish the notice; (b) lay a copy of it before Parliament.

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65KB Secretary of State's response to NHS England’s decision

(1) Within the period of 30 working days beginning with the day on which the Secretary of State receives the reports referred to in section 65KA(3), the Secretary of State must decide whether the Secretary of State is satisfied— (a) that the persons to which the NHS foundation trust in question provides services under this Act have discharged their functions for the purposes of this Chapter, (b) that the trust special administrator has carried out the administration duties (within the meaning of section 65KA(1)(b)), (c) that NHS England has discharged its functions for the purposes of this Chapter, (ca) that the Care Quality Commission has discharged its functions for the purposes of this Chapter, (d) that the action recommended in the final report would secure the continued provision of the services provided by the trust to which the objective set out in section 65DA applies, (e) that the recommended action would secure the provision of services that are of sufficient safety and quality to be provided under this Act, and (f) that the recommended action would provide good value for money. (2) If the Secretary of State is not satisfied as mentioned in subsection (1), the Secretary of State must as soon as reasonably practicable— (a) give the trust special administrator a notice of the decision and of the reasons for it; (b) give a copy of the notice to NHS England and the Care Quality Commission; (c) publish the notice; (d) lay a copy of it before Parliament.

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65KC Action following Secretary of State's rejection of final report

(1) Within the period of 20 working days beginning with the day on which the trust special administrator receives a notice under section 65KB(2), the administrator must provide to NHS England the final report varied so far as the administrator considers necessary to secure that the Secretary of State is satisfied as mentioned in section 65KB(1). (2) Where the administrator provides to NHS England a final report under subsection (1), section 65KA applies in relation to the report as it applies in relation to a final report under section 65I; and for that purpose, that section has effect as if— (a) in subsection (1), for “20 working days” there were substituted “10 working days”, and (b) subsection (3)(b) were omitted. (3) If the Secretary of State thinks that, in the circumstances, it is not reasonable for the administrator to be required to carry out the duty under subsection (1) within the period mentioned in that subsection, the Secretary of State may by order extend the period. (4) If an order is made under subsection (3), the administrator must— (a) publish a notice stating the date on which the period will expire, and (b) where the administrator is proposing to carry out consultation in response to the notice under section 65KB(2), publish a statement setting out the means by which the administrator will consult during the extended period.

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65KD Secretary of State's response to re-submitted final report

(1) Within the period of 30 working days beginning with the day on which the Secretary of State receives a final report under section 65KA(3) as applied by section 65KC(2), the Secretary of State must decide whether the Secretary of State is, in relation to the report, satisfied as to the matters in section 65KB(1)(a) to (f). (2) If the Secretary of State is not satisfied as mentioned in subsection (1), the Secretary of State must as soon as reasonably practicable— (a) publish a notice of the decision and the reasons for it; (b) lay a copy of the notice before Parliament. (3) Where the Secretary of State publishes a notice under subsection (2)(a), subsections (5), (6) and (8A) apply. (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) If the notice states that an integrated care board has failed to discharge a function— (a) the board is to be treated for the purposes of this Act as having failed to discharge the function, (b) the Secretary of State may exercise the functions of NHS England under section 14Z61(2), (3)(a) and (5)(a), and (c) NHS England may not exercise any of its functions under section 14Z61. (6) Where, by virtue of subsection (5)(b), the Secretary of State exercises the function of NHS England under section 14Z61(3)(a), the integrated care board to which the direction is given must cooperate with the Secretary of State. (7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (8A) If the notice states that the Care Quality Commission has failed to discharge a function— (a) the Care Quality Commission is to be treated for the purposes of this Act as having failed to discharge the function, and (b) the failure is to be treated for those purposes as significant (and section 82 of the Health and Social Care Act 2008 applies accordingly). (9) Within the period of 60 working days beginning with the day on which the Secretary of State publishes a notice under subsection (2)(a), the Secretary of State must decide what action to take in relation to the trust. (10) The Secretary of State must as soon as reasonably practicable— (a) publish a notice of the decision and the reasons for it; (b) lay a copy of the notice before Parliament.

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65L Trusts coming out of administration

(1) Subsection (2) applies, in relation to an NHS trust, if NHS England and the Secretary of State both decide under section 65K not to dissolve the trust. (2) NHS England must make an order specifying a date when the following come to an end— (a) the appointment of the trust special administrator, and (b) the suspension of the chair and directors of the trust. (2A) Subsection (2B) applies, in relation to an NHS foundation trust, if— (a) the Secretary of State decides under section 65KD(9) not to dissolve the trust, or (b) the Secretary of State decides under section 65KB(1) or 65KD(1) that the Secretary of State is satisfied of the matters mentioned there, and the action recommended in the final report is to do something other than dissolve the trust. (2B) NHS England must make an order specifying a date when the following come to an end— (a) the appointment of the trust special administrator, and (b) the suspension of the governors, chair and directors of the trust. (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (6) Subsection (7) applies in the case of an NHS foundation trust. (7) If it appears to NHS England to be necessary in order to comply with Schedule 7, NHS England may by order— (a) terminate the office of any governor or of any executive or non-executive director of the trust; (b) appoint a person to be a governor or an executive or non-executive director of the trust.

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65LA Trusts to be dissolved

(1) This section applies if— (a) the Secretary of State is satisfied as mentioned in section 65KB(1) or 65KD(1), and (b) the action recommended in the final report is to dissolve the NHS foundation trust in question. (2) This section also applies if the Secretary of State decides under section 65KD(9) to dissolve the NHS foundation trust in question. (3) NHS England may make an order— (a) dissolving the trust, and (b) transferring, or providing for the transfer of, the property and liabilities of the trust — (i) to an NHS body; (ii) to the Secretary of State; (iii) between more than one NHS body or between one or more NHS bodies and the Secretary of State. (4) An order under subsection (3) may include provision for the transfer of employees of the trust. (5) The liabilities that may be transferred to an NHS body by virtue of subsection (3)(b) include criminal liabilities.

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65M Replacement of trust special administrator

(1) If a trust special administrator ceases to hold office for any reason before an order is made under section 65L(2) or (2B) or the trust is dissolved, NHS England must— (a) appoint another person as the trust special administrator, and (b) publish the name of the person appointed. (2) Where a person is appointed under subsection (1) in relation to a trust, anything done by or in relation to a previous trust special administrator has effect as if done by or in relation to that person, unless NHS England directs otherwise. (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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65N Guidance

(1) NHS England must publish guidance for trust special administrators. (1A) It must, in so far as it applies to NHS trusts, include guidance about— (a) seeking the support of commissioners for an administrator's recommendation; (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) It must include guidance about the publication of notices under sections 65H and 65J. (2A) It must include guidance about the publication of— (a) notices under section 65KC(4)(a); (b) statements under section 65KC(4)(b). (3) It must include guidance about the preparation of draft reports, as to— (a) persons to be consulted; (b) factors to be taken into account; (c) relevant publications. (3A) Before publishing guidance under this section, NHS England must consult the Care Quality Commission. (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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65O Interpretation of this Chapter

(1) In this Chapter— “trust special administrator” means a person appointed under section 65B(8)(a) , section 65D(2) or section 65M(1)(a); “working day” means any day which is not Saturday, Sunday, Christmas Day, Good Friday or a day which is a bank holiday in England and Wales under the Banking and Financial Dealings Act 1971. (2) The references in this Chapter to taking action in relation to an NHS trust include a reference to taking action, including in relation to another NHS trust or an NHS foundation trust, which is necessary for and consequential on action taken in relation to that NHS trust. (3) The references in this Chapter to taking action in relation to an NHS foundation trust include a reference to taking action, including in relation to another NHS foundation trust or an NHS trust, which is necessary for and consequential on action taken in relation to that NHS foundation trust.

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65Z4 Consolidated accounts for NHS trusts and NHS foundation trusts

(1) NHS England must, in respect of each financial year, prepare a set of accounts that consolidates the annual accounts of— (a) all NHS trusts established under section 25, and (b) all NHS foundation trusts. (2) The Secretary of State may give NHS England directions as to— (a) the content and form of the consolidated accounts, and (b) the methods and principles to be applied in preparing them. (3) NHS England must, within such period as the Secretary of State may direct, send a copy of the consolidated accounts to— (a) the Secretary of State, and (b) the Comptroller and Auditor General. (4) The accounts must be accompanied by such reports or other information as the Secretary of State may direct. (5) The Comptroller and Auditor General must— (a) examine, certify and report on the consolidated accounts, and (b) send a copy of the report to the Secretary of State and NHS England. (6) NHS England must lay before Parliament a copy of— (a) the consolidated accounts, and (b) the Comptroller and Auditor General’s report on them.

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65Z5 Joint working and delegation arrangements

(1) A relevant body may arrange for any functions exercisable by it to be exercised by or jointly with any one or more of the following— (a) a relevant body; (b) a local authority (within the meaning of section 2B); (c) a combined authority. (d) a combined county authority. (2) In this section “relevant body” means— (a) NHS England, (b) an integrated care board, (c) an NHS trust established under section 25, (d) an NHS foundation trust, or (e) such other body as may be prescribed. (3) Regulations may— (a) provide that the power in subsection (1) does not apply, or applies only to a prescribed extent, in relation to prescribed functions; (b) impose conditions on the exercise of the power. (4) Arrangements under this section may be made on such terms as may be agreed between the parties, including— (a) terms as to payment; (b) terms prohibiting or restricting a body from making delegation arrangements in relation to a function that is exercisable by it by virtue of arrangements under this section. (5) In subsection (4)(b) “delegation arrangements” means arrangements made by a body for the exercise of a function by someone else. (6) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a body of any function by virtue of this section are enforceable by or against that body (and no other person).

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65Z6 Joint committees and pooled funds

(1) This section applies where a function is exercisable jointly (by virtue of section 65Z5 or otherwise) by a relevant body and any one or more of the following— (a) a relevant body; (b) a local authority (within the meaning of section 2B); (c) a combined authority; (d) a combined county authority. (2) The bodies by whom the function is exercisable jointly may— (a) arrange for the function to be exercised by a joint committee of theirs; (b) arrange for one or more of the bodies, or a joint committee of the bodies, to establish and maintain a pooled fund. (3) A pooled fund is a fund— (a) which is made up of payments received in accordance with the arrangements from relevant bodies that are party to the arrangements, and (b) out of which payments may be made in accordance with the arrangements towards expenditure incurred in the exercise of functions in relation to which the arrangements are made. (4) Arrangements under this section may be made on such terms as may be agreed between the parties, including terms as to payment. (5) In this section “relevant body” has the meaning given by section 65Z5(2).

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65Z7 Joint working and delegation: guidance by NHS England

(1) NHS England may publish guidance for relevant bodies about the exercise of their powers under sections 65Z5 and 65Z6. (2) A relevant body must have regard to any guidance published under this section. (3) In this section “relevant body” has the meaning given by section 65Z5(2).

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66 Intervention orders

(1) This section applies to NHS bodies other than NHS foundation trusts. (2) If the Secretary of State— (a) considers that a body to which this section applies is not performing one or more of its functions adequately or at all, or that there are significant failings in the way the body is being run, and (b) is satisfied that it is appropriate for him to intervene under this section, he may make an order under this section in respect of the body (an “intervention order”). (3) An intervention order may make any provision authorised by section 67 (including any combination of such provisions).

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67 Effect of intervention orders

(1) In this section— (a) “member” means a member of a ... ... Special Health Authority or Local Health Board, or a member of the board of directors of an NHS trust, (b) “employee member” means a member of a ... ... Special Health Authority or Local Health Board, who is an officer of the body, or an executive director of an NHS trust. (2) An intervention order may provide for the removal from office of— (a) all the members, or (b) those specified in the order, and for their replacement with individuals specified in or determined in accordance with the order (who need not be the same in number as the removed individuals). (3) An intervention order may provide for the suspension (either wholly, or in respect only of powers and duties specified in or determined in accordance with the order) of— (a) all the members, or (b) those specified in the order, and for the powers of the suspended members to be exercised, and their duties performed, during their suspension by individuals specified in or determined in accordance with the order (who need not be the same in number as the suspended individuals). (4) The powers and duties referred to in subsection (3) are, in the case of an employee member, only those which he has in his capacity as a member. (5) An intervention order may contain directions to the body to which it relates to secure that a function of the body specified in the directions— (a) is performed, to the extent specified in the directions, on behalf of the body and at its expense, by such person as is specified in the directions, and (b) is so performed in such a way as to achieve such objectives as are so specified, and the directions may require that any contract or other arrangement made by the body with that person contains such terms and conditions as may be so specified. (6) If the person referred to in subsection (5)(a) is a body to which section 66 applies, the functions of that body include the performance of the functions specified in the directions under subsection (5). (7) Subsection (8) applies in relation to any provision in this Act, or in any order or regulations made, or directions given, under this Act, relating to— (a) the membership of the body to which an intervention order relates (or in the case of an NHS trust to the membership of its board of directors), or (b) the procedure of the body. (8) The intervention order may provide in relation to any provision specified in the order— (a) that it does not apply in relation to the body while the order remains in force, or (b) that it applies in relation to the body, while the order remains in force, with modifications specified in the order. (9) An intervention order may contain such supplementary directions to the body to which it relates as the Secretary of State considers appropriate for the purpose of giving full effect to the order.

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68 Default powers

(1) This section applies to NHS bodies other than NHS foundation trusts. (2) If the Secretary of State considers that a body to which this section applies— (a) has failed to carry out any functions conferred or imposed on it by or under this Act, or (b) has in carrying out those functions failed to comply with any regulations or directions relating to those functions, he may after such inquiry as he considers appropriate make an order declaring it to be in default. (3) The members of the body in default must immediately vacate their office, and the order— (a) must provide for the appointment, in accordance with the provisions of this Act, of new members of the body, and (b) may contain such provisions as seem to the Secretary of State expedient for authorising any person to act in the place of the body pending the appointment of new members. (4) An order under this section may contain such supplementary and incidental provisions as appear to the Secretary of State to be necessary or expedient, including— (a) provision for the transfer to the Secretary of State of property and liabilities of the body in default, and (b) where any such order is varied or revoked by a subsequent order, provision in the subsequent order for the transfer to the body in default of any property or liabilities acquired or incurred by the Secretary of State in discharging any of the functions transferred to him.

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68A Reconfiguration of NHS services

Schedule 10A confers intervention powers on the Secretary of State in relation to the reconfiguration of NHS services.

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69 Protection from personal liability

(1) Section 265 of the Public Health Act 1875 (c. 55) (which relates to the protection of members and officers of certain authorities) has effect as if there were included in the authorities referred to in that section a reference to an NHS body. (2) Any reference in that section to the Public Health Act 1875 has effect as if it included a reference to this Act and the National Health Service (Wales) Act 2006 (c. 42).

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69A Transfer schemes: NHS trusts and NHS foundation trusts

(1) NHS England may make one or more schemes for the transfer of property, rights and liabilities from a relevant NHS body to another relevant NHS body on an application made to it under this section. (2) The application must— (a) be made jointly by the relevant NHS bodies, and (b) state the property, rights or liabilities to be transferred. (3) NHS England may grant an application under this section only if it is satisfied that such steps as are necessary to prepare for the transfer have been taken. (4) 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. (5) 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 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. (6) 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. (7) 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. (8) In this section— “relevant NHS body” means— an NHS trust established under section 25; an NHS foundation trust; “the TUPE regulations” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).

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70 Transfer of residual liabilities of certain health service bodies

(1) If ...... an NHS trust or a Special Health Authority ceases to exist, the Secretary of State must exercise his functions so as to secure that all of the body's liabilities (other than any criminal liabilities) are dealt with. (2) A liability is dealt with by being transferred to an NHS body, the Secretary of State or the Welsh Ministers.

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71 Schemes for meeting losses and liabilities etc of certain health service bodies

(1) The Secretary of State may by regulations made with the consent of the Treasury establish a scheme whereby any of the bodies or other persons specified in subsection (2) may make provision to meet— (a) expenses arising from any loss of or damage to their property, and (b) liabilities to third parties for loss, damage or injury arising out of the carrying out of the functions of the bodies or other persons concerned. (2) The bodies and other persons referred to in subsection (1) are— (za) NHS England, (zb) integrated care boards, (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) NHS trusts, (d) Special Health Authorities, (da) NICE, (db) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (dc) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (e) NHS foundation trusts, (f) the Care Quality Commission , and (fa) the Health Research Authority; (fb) the Health Services Safety Investigations Body, (g) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (ga) the Commissioner for Patient Safety, (h) the Secretary of State, (ha) a company formed under section 223 and wholly or partly owned by the Secretary of State or NHS England, (hb) a subsidiary of a company which is formed under that section and wholly owned by the Secretary of State, and (i) a body or other person (other than a body or other person within any of paragraphs (za) to (hb) ) providing, or arranging the provision of, health services whose provision is the subject of arrangements with a body or other person within any of paragraphs (za) to (h) , but a scheme under this section may limit the class or description of bodies which , or other persons who, are eligible to participate in it. (2A) In subsection (1)(b) “functions”— (a) in relation to the Secretary of State, means the Secretary of State's functions in connection with the health service; (ab) in relation to a company within paragraph (ha) or (hb) of subsection (2), means the company's activities in providing facilities or services to any person or body; (b) in relation to a body or other person within paragraph (i) of subsection (2), means the body's or person's functions of providing, or arranging the provision of, health services whose provision is the subject of arrangements with a body or other person within any of paragraphs (za) to (h) of that subsection. (3) A scheme under this section may, in particular— (a) provide for the scheme to be administered by the Secretary of State or NHS England or by a ... ...NHS trust, Special Health Authority or NHS foundation trust specified in the scheme, (b) require any body which , or other person who, participates in the scheme to make payments in accordance with the scheme, and (c) provide for the making of payments for the purposes of the scheme by the Secretary of State (whether or not a participator in the scheme and, if a participator, whether or not required to make payments as a participator) . (4) If the Secretary of State so directs, a body which is eligible to participate in a scheme must do so. (5) The Secretary of State may make a direction under subsection (4) in respect of a body only if the body is within any of paragraphs (c), (d) and (f) of subsection (2). (6) Where a scheme provides for the scheme to be administered by the Secretary of State, NHS England or a ... ... NHS trust, Special Health Authority or NHS foundation trust must carry out such functions in connection with the administration of the scheme by the Secretary of State as he may direct. (7) Subsections (4) and (6) do not affect any other power of direction of the Secretary of State. (8) A person or body administering a scheme under this section does not require permission under any provision of the Financial Services and Markets Act 2000 (c. 8) as respects activities carried out under the scheme. (9) In subsection (2)(i), the reference to a person providing health services does not include a person providing health services under a contract of employment. (10) In this section “ health services ” means services provided as part of the health service.

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72 Co-operation between NHS bodies

(1) It is the duty of NHS bodies to co-operate with each other in exercising their functions. (1A) The Secretary of State may publish guidance on the discharge of the duty under subsection (1) in relation to England. (1B) An NHS body other than a Welsh NHS body must have regard to any guidance published under subsection (1A). (2) For the purposes of this section, NICE is an NHS body. (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) In this section “Welsh NHS body” means— (a) an NHS trust established under the National Health Service (Wales) Act 2006, (b) a Special Health Authority established under that Act, or (c) a Local Health Board.

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