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

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516 provisions

Title and introductory text

National Health Service Act 2006 2006 c. 41 An Act to consolidate certain enactments relating to the health service. [8th November 2006] Be it enacted by the Queen's most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—

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

(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement— (a) in the physical and mental health of the people of England, and (b) in the prevention, diagnosis and treatment of physical and mental illness. (2) For that purpose, the Secretary of State must exercise the functions conferred by this Act so as to secure that services are provided in accordance with this Act. (3) The Secretary of State retains ministerial responsibility to Parliament for the provision of the health service in England. (4) The services provided as part of the health service in England must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.

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1A Duty as to improvement in quality of services

(1) The Secretary of State must exercise the functions of the Secretary of State in relation to the health service with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with— (a) the prevention, diagnosis or treatment of illness, or (b) the protection or improvement of public health. (2) In discharging the duty under subsection (1) the Secretary of State must, in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services. (3) The outcomes relevant for the purposes of subsection (2) include, in particular, outcomes which show— (a) the effectiveness of the services, (b) the safety of the services, and (c) the quality of the experience undergone by patients. (4) In discharging the duty under subsection (1), the Secretary of State must have regard to the quality standards prepared by NICE under section 234 of the Health and Social Care Act 2012.

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1B Duty as to the NHS Constitution

(1) In exercising functions in relation to the health service, the Secretary of State must have regard to the NHS Constitution. (2) In this Act, “NHS Constitution” has the same meaning as in Chapter 1 of Part 1 of the Health Act 2009 (see section 1 of that Act).

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1C Duty as to reducing inequalities

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

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1D Duty as to promoting autonomy

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

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1E Duty as to research

(1) In exercising functions in relation to the health service, the Secretary of State must facilitate or otherwise promote— (a) research on matters relevant to the health service, and (b) the use in the health service of evidence obtained from research. (2) The research that the Secretary must facilitate or otherwise promote under subsection (1)(a) includes research into cancers that in the opinion of the Secretary of State are rare cancers. (3) In discharging the duty under subsection (1)(a) in relation to those cancers, the Secretary of State must, in particular, ensure that there are such arrangements in place as the Secretary of State considers appropriate to— (a) enable potential participants in clinical trials to be identified and contacted, and (b) ensure that a person (to be known as “the National Specialty Lead for Rare Cancers”) is appointed with a job description that includes promoting and facilitating research into rare cancers by— (i) providing advice in relation to the design and planning of research, and (ii) facilitating collaboration between interested persons. (4) In this section “rare cancer” means a cancer that affects not more than 1 in 2000 people in the United Kingdom.

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1F Duty as to education and training

(1) The Secretary of State must exercise the functions of the Secretary of State under any relevant enactment so as to secure that there is an effective system for the planning and delivery of education and training to persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service in England. (2) Any arrangements made with a person under this Act for the provision of services as part of that health service must include arrangements for securing that the person co-operates with the Secretary of State and NHS England in the discharge of the duty under subsection (1) (or, where a Special Health Authority is discharging that duty by virtue of a direction under section 7, with the Special Health Authority). (3) In subsection (1), “relevant enactment” means— (a) section 63 of the Health Services and Public Health Act 1968, (b) this Act, (c) the Health and Social Care Act 2008, (d) the Health Act 2009, and (e) the Health and Social Care Act 2012.

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

(1) The Secretary of State must, within one year of the passing of the Health and Social Care Act 2012, lay a report before Parliament on the treatment of NHS health care providers as respects any matter, including taxation, which might affect their ability to provide health care services for the purposes of the NHS or the reward available to them for doing so. (2) The report must include recommendations as to how any differences in the treatment of NHS health care providers identified in the report could be addressed. (3) The Secretary of State must keep under review the treatment of NHS health care providers as respects any such matter as is mentioned in subsection (1). (4) In this section— (a) “NHS health care providers” means persons providing or intending to provide health care services for the purposes of the NHS, and (b) “health care services for the purposes of the NHS” has the same meaning as in Part 3 of the Health and Social Care Act 2012.

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

(1) The Secretary of State must, at least once every five years, publish a report describing the system in place for assessing and meeting the workforce needs of the health service in England. (2) NHS England ...must assist in the preparation of a report under this section, if requested to do so by the Secretary of State.

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1H NHS England and its general functions

(1) There is to be a body corporate known as NHS England. (2) NHS England is subject to the duty under section 1(1) concurrently with the Secretary of State except in relation to the part of the health service that is provided in pursuance of the public health functions of the Secretary of State or local authorities. (3) For the purpose of discharging that duty, NHS England— (a) has the function of arranging for the provision of services for the purposes of the health service in England in accordance with this Act, and (b) must exercise the functions conferred on it by this Act in relation to integrated care boards , NHS trusts established under section 25 and NHS foundation trusts so as to secure that services are provided for those purposes in accordance with this Act. (4) Schedule A1 makes further provision about NHS England. (5) In this Act— (a) any reference to the public health functions of the Secretary of State is a reference to the functions of the Secretary of State under sections 2A and 2B and paragraphs 7C, 8 and 12 of Schedule 1, and (b) any reference to the public health functions of local authorities is a reference to the functions of local authorities under sections 2B and 111 and paragraphs 1 to 7B and 13 of Schedule 1.

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1I General functions of integrated care boards

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

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2. General power

(1) The Secretary of State may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any function conferred on the Secretary of State by this Act. (2) NHS England or an integrated care board may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any of its functions.

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

(1) The Secretary of State must take such steps as the Secretary of State considers appropriate for the purpose of protecting the public in England from disease or other dangers to health. (2) The steps that may be taken under subsection (1) include— (a) the conduct of research or such other steps as the Secretary of State considers appropriate for advancing knowledge and understanding; (b) providing microbiological or other technical services (whether in laboratories or otherwise); (c) providing vaccination, immunisation or screening services; (d) providing other services or facilities for the prevention, diagnosis or treatment of illness; (e) providing training; (f) providing information and advice; (g) making available the services of any person or any facilities. (3) Subsection (4) applies in relation to any function under this section which relates to— (a) the protection of the public from ionising or non-ionising radiation, and (b) a matter in respect of which a relevant body has a function. (4) In exercising the function, the Secretary of State must— (a) consult the relevant body, and (b) have regard to its policies. (5) For the purposes of subsections (3) and (4), each of the following is a relevant body— (a) the Health and Safety Executive; (b) the Office for Nuclear Regulation.

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

(1) Each local authority must take such steps as it considers appropriate for improving the health of the people in its area. (2) The Secretary of State may take such steps as the Secretary of State considers appropriate for improving the health of the people of England. (3) The steps that may be taken under subsection (1) or (2) include— (a) providing information and advice; (b) providing services or facilities designed to promote healthy living (whether by helping individuals to address behaviour that is detrimental to health or in any other way); (c) providing services or facilities for the prevention, diagnosis or treatment of illness; (d) providing financial incentives to encourage individuals to adopt healthier lifestyles; (e) providing assistance (including financial assistance) to help individuals to minimise any risks to health arising from their accommodation or environment; (f) providing or participating in the provision of training for persons working or seeking to work in the field of health improvement; (g) making available the services of any person or any facilities. (4) The steps that may be taken under subsection (1) also include providing grants or loans (on such terms as the local authority considers appropriate). (5) In this section, “local authority” means— (a) a county council in England; (b) a district council in England, other than a council for a district in a county for which there is a county council; (c) a London borough council; (d) the Council of the Isles of Scilly; (e) the Common Council of the City of London.

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

(1) An integrated care board must arrange for the provision of the following to such extent as it considers necessary to meet the reasonable requirements of the people for whom it has responsibility— (a) hospital accommodation, (b) other accommodation for the purpose of any service provided under this Act, (c) medical services other than primary medical services (for primary medical services, see Part 4), (d) dental services other than primary dental services (for primary dental services, see Part 5), (e) ophthalmic services other than primary ophthalmic services (for primary ophthalmic services, see Part 6), (f) nursing and ambulance services, (g) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as the board considers are appropriate as part of the health service, (h) such other services or facilities for palliative care as the board considers are appropriate as part of the health service, (i) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as the board considers are appropriate as part of the health service, and (j) such other services or facilities as are required for the diagnosis and treatment of illness. (2) For the purposes of this section an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service or facility). (3) The duty imposed on an integrated care board by subsection (1) to arrange for the provision of services or facilities does not apply to the extent that— (a) NHS England has a duty to arrange for their provision; (b) another integrated care board has a duty to arrange for their provision by virtue of subsection (2)(b). (4) In exercising its functions under this section, an integrated care board must act consistently with— (a) the discharge by the Secretary of State and NHS England of their duty under section 1(1) (duty to promote a comprehensive health service), and (b) the objectives and requirements for the time being specified in the mandate published under section 13A.

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

(1) Each integrated care board may arrange for the provision of such services or facilities as it considers appropriate for the purposes of the health service that relate to securing improvement— (a) in the physical and mental health of the people for whom it has responsibility, or (b) in the prevention, diagnosis and treatment of illness in those people. (2) For the purposes of this section an integrated care board has responsibility for— (a) the group of people for whom it has core responsibility (see section 14Z31), and (b) such other people as may be prescribed (whether generally or in relation to a prescribed service or facility). (3) An integrated care board may not arrange for the provision of a service or facility under subsection (1) if NHS England has a duty to arrange for its provision by virtue of section 3B or 4. (4) In exercising its functions under this section, an integrated care board must act consistently with— (a) the discharge by the Secretary of State and NHS England of their duty under section 1(1) (duty to promote a comprehensive health service), and (b) the objectives and requirements for the time being specified in the mandate published under section 13A.

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

(1) Regulations may require NHS England to arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of— (a) dental services of a prescribed description; (b) services or facilities for members of the armed forces or their families; (c) services or facilities for persons who are detained in a prison or in other accommodation of a prescribed description; (d) such other services or facilities as may be prescribed. (2) A service or facility may be prescribed under subsection (1)(d) only if the Secretary of State considers that it would be appropriate for NHS England to arrange for the provision of that service or facility (whether by NHS England making arrangements itself or by giving directions under section 13YB or making arrangements under section 65Z5). (3) In deciding whether it would be so appropriate, the Secretary of State must have regard to— (a) the number of individuals who require the provision of the service or facility; (b) the cost of providing the service or facility; (c) the number of persons able to provide the service or facility; (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (4) Before deciding whether to make regulations under this section, the Secretary of State must— (a) obtain advice appropriate for that purpose, and (b) consult NHS England. (4A) If the Secretary of State refuses a request by NHS England to revoke provision made by regulations under subsection (1)(d) prescribing a service or facility, the Secretary of State must explain why to NHS England. (5) The reference in subsection (1)(b) to members of the armed forces is a reference to persons who are members of— (a) the regular forces within the meaning of the Armed Forces Act 2006, or (b) the reserve forces within the meaning of that Act.

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4 High security psychiatric services

(1) NHS England must arrange for the provision of hospital accommodation and services for persons who— (a) are liable to be detained under the Mental Health Act 1983 (c. 20), and (b) in the opinion of the Secretary of State require treatment under conditions of high security on account of their dangerous, violent or criminal propensities. (2) The hospital accommodation and services mentioned in subsection (1) are referred to in this section and paragraph 15 of Schedule 4 (NHS trusts) as “high security psychiatric services”. (3) High security psychiatric services may be provided — (a) only at hospital premises at which services are provided only for the persons mentioned in subsection (1), and (b) only by a person approved by the Secretary of State for the purposes of this subsection. (3A) The Secretary of State may— (a) give directions to a person who provides high security psychiatric services about the provision by that person of those services; (b) give directions to NHS England about the exercise of its functions in relation to high security psychiatric services. (4) “Hospital premises” means— (a) a hospital, or (b) any part of a hospital which is treated as a separate unit.

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5 Other services

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

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6 Performance of functions outside England

(1) Where the Secretary of State has a duty or power to provide anything under section 2A or 2B or Schedule 1, that thing may be provided outside England. (1A) Where an integrated care board or NHS England has a duty or power to arrange for the provision of anything under section 3, 3A, 3B or 4 or Schedule 1, it may arrange for that thing to be provided outside England. (2) The functions of the Secretary of State, NHS England and integrated care boards may be performed outside England and Wales, in so far as they relate to— (a) holidays for patients, (b) the transfer of patients to or from Scotland, Northern Ireland, the Isle of Man or the Channel Islands, or (c) the return of patients who have received treatment in England and Wales, to countries or territories outside the British Islands (including for this purpose the Republic of Ireland).

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

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6B Prior authorisation for the purposes of section 6A

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

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6BB Prior authorisation for the purposes of section 6BA

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

(1) Regulations may require a local authority to exercise any of the public health functions of the Secretary of State (so far as relating to the health of the public in the authority's area) by taking such steps as may be prescribed. (2) Regulations may require a local authority to exercise its public health functions by taking such steps as may be prescribed. (3) Where regulations under subsection (1) require a local authority to exercise any of the public health functions of the Secretary of State, the regulations may also authorise or require the local authority to exercise any prescribed functions of the Secretary of State that are exercisable in connection with those functions (including the powers conferred by section 12). (4) The making of regulations under subsection (1) does not prevent the Secretary of State from taking any step that a local authority is required to take under the regulations. (5) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a local authority of any of its functions under regulations under subsection (1) are enforceable by or against the local authority (and no other person). (6) In this section, “local authority” has the same meaning as in section 2B.

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6D Regulations relating to EU obligations

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

(1) Regulations must impose requirements (to be known as “standing rules”) in accordance with this section on NHS England and on integrated care boards. (1A) The regulations must make provision as to the arrangements that NHS England and integrated care boards must make, in exercising their commissioning functions, for enabling persons to whom specified treatments or other specified services are to be provided to make choices with respect to specified aspects of them. (1B) The regulations may make other provision for the purpose of securing that, in exercising their commissioning functions, NHS England and integrated care boards protect and promote the rights of persons to make choices in relation to treatments or other services, where those rights— (a) arise by virtue of regulations under subsection (1A), or (b) are described in the NHS Constitution. (2) The regulations may, in relation to the commissioning functions of NHS England or integrated care boards, make provision— (a) requiring NHS England or integrated care boards to arrange for specified treatments or other specified services to be provided or to be provided in a specified manner or within a specified period; (b) as to the arrangements that NHS England or integrated care boards must make for the purpose of making decisions as to— (i) the treatments or other services that are to be provided; (ii) the manner in which or period within which specified treatments or other specified services are to be provided; (iii) the persons to whom specified treatments or other specified services are to be provided; (c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) Regulations by virtue of paragraph (b) of subsection (2) may, in particular, make provision— (a) requiring NHS England or an integrated care board to take specified steps before making decisions as to the matters mentioned in that paragraph; (b) as to reviews of, or appeals from, such decisions. (4) The regulations may— (a) specify matters for which provision must be made in commissioning contracts entered into by NHS England or integrated care boards; (b) require NHS England to draft terms and conditions making provision for those matters; (c) require NHS England or integrated care boards to incorporate the terms and conditions drafted by virtue of paragraph (b) in commissioning contracts entered into by NHS England or (as the case may be) integrated care boards. (5) The regulations must— (a) require NHS England to draft such terms and conditions as NHS England considers are, or might be, appropriate for inclusion in commissioning contracts entered into by NHS England or integrated care boards (other than terms and conditions that NHS England is required to draft by virtue of subsection (4)(a)); (b) authorise NHS England to require integrated care boards to incorporate terms and conditions prepared by virtue of paragraph (a) in their commissioning contracts; (c) authorise NHS England to draft model commissioning contracts. (6) The regulations may require NHS England to consult prescribed persons before exercising any of its functions by virtue of subsection (4)(b) or (5). (7) The regulations may require NHS England or integrated care boards in the exercise of any of its or their functions— (a) to provide information of a specified description to specified persons in a specified manner; (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) to do such other things as the Secretary of State considers necessary for the purposes of the health service. (8) The regulations may not impose a requirement on only one integrated care board. (9) If regulations under this section are made so as to come into force on a day other than 1 April, the Secretary of State must— (a) publish a statement explaining the reasons for making the regulations so as to come into force on such a day, and (b) lay the statement before Parliament. (10) In this section— (a) “commissioning contracts”, in relation to NHS England or integrated care boards, means contracts entered into by NHS England or (as the case may be) integrated care boards in the exercise of its or their commissioning functions; (b) “commissioning functions”, in relation to NHS England or integrated care boards, means the functions of NHS England or (as the case may be) integrated care boards in arranging for the provision of services as part of the health service; (c) “specified” means specified in the regulations.

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

(1) NHS England may investigate whether an integrated care board has failed or is likely to fail to comply with a requirement imposed by regulations under section 6E(1A) or (1B) (a “patient choice requirement”). (2) NHS England may direct an integrated care board— (a) to put in place measures for the purpose of preventing failures to comply with patient choice requirements or mitigating the effect of such failures, or (b) where an investigation under subsection (1) has been carried out, to remedy a failure to comply with patient choice requirements. (3) Where an investigation under subsection (1) is being or has been carried out, NHS England may accept from the integrated care board an undertaking that it will take any action falling within subsection (2)(a) or (b) that is specified in the undertaking, within a period that is so specified. (4) Where NHS England accepts an undertaking under subsection (3), NHS England may not— (a) continue to carry out any ongoing investigation under subsection (1) so far as relating to matters to which the undertaking relates, or (b) give a direction under subsection (2) in relation to those matters, unless the integrated care board fails to comply with the undertaking. (5) If an integrated care board from which NHS England has accepted an undertaking under subsection (3) complies partially with the undertaking, NHS England must take the partial compliance into account in deciding whether to do something mentioned in subsection (4)(a) or (b). (6) Schedule 1ZA makes further provision about undertakings.

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6G Guidance relating to patient choice

(1) NHS England must publish guidance about how it intends to exercise powers conferred on it by section 6F and Schedule 1ZA. (2) Before publishing guidance under this section, NHS England must obtain the approval of the Secretary of State.

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7 Functions of Special Health Authorities

(1) The Secretary of State may direct a Special Health Authority to exercise any functions of the Secretary of State or any other person which relate to the health service in England and are specified in the direction. (1A) Subsection (1) does not apply to any function of the Secretary of State of making an order or regulations. (1B) Before exercising the power in subsection (1) in relation to a function of a person other than the Secretary of State, the Secretary of State must consult that person. (1C) Regulations may provide that a Special Health Authority specified in the regulations is to have such additional functions in relation to the health service in England as may be so specified. (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

(1) The Secretary of State may arrange for any of the public health functions of the Secretary of State to be exercised by one or more relevant bodies. (2) In this section “relevant body” means— (a) NHS England, (b) an integrated care board, (c) a local authority (within the meaning of section 2B), (d) a combined authority, or (da) a combined county authority, or (e) such other body as may be prescribed. (3) Arrangements under this section may be made on such terms as may be agreed between the parties including— (a) terms as to payment; (b) terms prohibiting or restricting a relevant body from making delegation arrangements in relation to a function that is exercisable by it by virtue of arrangements under this section. (4) In subsection (3)(b) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else. (5) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a relevant body of any function by virtue of this section are enforceable by or against that body (and no other person). (6) The reference in subsection (1) to the public health functions of the Secretary of State includes any functions of the Secretary of State exercisable in connection with those functions (including the powers conferred by section 12).

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7B Directions requiring NHS bodies to exercise public health functions

(1) The Secretary of State may by direction provide for any of the public health functions of the Secretary of State to be exercised by one or more relevant bodies. (2) In this section “relevant body” means— (a) NHS England, or (b) an integrated care board. (3) A direction under subsection (1) may include provision prohibiting or restricting the relevant body from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction. (4) In subsection (3) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else. (5) The Secretary of State may make payments to a relevant body in respect of the exercise by it of a function by virtue of a direction under subsection (1). (6) The Secretary of State may give directions to an integrated care board as to the exercise by it of any functions by virtue of this section. (7) For power to give directions to NHS England as to the exercise of functions, see section 13ZC. (8) As soon as reasonably practicable after giving a direction under subsection (1) or (6), the Secretary of State must publish it. (9) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by a relevant body of any function by virtue of this section are enforceable by or against it (and no other person). (10) The reference in subsection (1) to the public health functions of the Secretary of State includes any functions of the Secretary of State exercisable in connection with those functions (including the powers conferred by section 12).

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7C Power of direction: investigation functions

(1) The Secretary of State may direct— (a) NHS England, or (b) any other public body, to exercise any of the investigation functions which are specified in the direction. (2) A direction under subsection (1) may include provision prohibiting or restricting the body directed from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction. (3) In subsection (2) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else. (4) The Secretary of State may make payments to NHS England or any other body in respect of the exercise by it of a function by virtue of a direction under subsection (1). (5) The Secretary of State may give directions to any body on whom functions are conferred by virtue of subsection (1)(b) as to the exercise of those functions. (6) For power to give directions to NHS England as to the exercise of functions, see section 13ZC. (7) As soon as reasonably practicable after giving a direction under subsection (1) or (5), the Secretary of State must publish it. (8) Any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by NHS England or any other body of any function by virtue of this section are enforceable by or against it (and no other person). (9) In this section “the investigation functions” are functions which, immediately before the coming into force of section 36 of the Health and Care Act 2022, were exercised by the Special Health Authority called the National Health Service Trust Development Authority pursuant to— (a) the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) Directions 2016 made under sections 7 and 8 of the National Health Service Act 2006, or (b) the National Health Service Trust Development Authority (Healthcare Safety Investigation Branch) (Additional Investigatory Functions in respect of Maternity Cases) Directions 2018 made under sections 7 and 8 of the National Health Service Act 2006.

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

(1) The Secretary of State may, in connection with a direction under section 7C, make one or more transfer schemes. (2) A “transfer scheme” is a scheme for the transfer to NHS England or any other public body of any property, rights or liabilities relating to the discharge of functions pursuant to any directions made by the Secretary of State under the power conferred by section 7C. (3) The things that may be transferred under a transfer scheme include— (a) property, rights and liabilities that could not otherwise be transferred; (b) property acquired, and rights and liabilities arising, after the making of the scheme; (c) criminal liabilities. (4) A transfer scheme may— (a) create rights, or impose liabilities, in relation to property or rights transferred; (b) make provision about the continuing effect of things done by, or on behalf of or in relation to the transferor in respect of anything transferred; (c) make provision about the continuation of things (including legal proceedings) in the process of being done by, on behalf of or in relation to the transferor in respect of anything transferred; (d) make provision for references to the transferor in an instrument or other document in respect of anything transferred to be treated as references to the transferee; (e) make provision for the shared ownership or use of property; (f) make provision which is the same as or similar to the TUPE regulations; (g) make other consequential, supplementary, incidental or transitional provision. (5) A transfer scheme may provide— (a) for modifications by agreement; (b) for modifications to have effect from the date when the original scheme came into effect. (6) In subsection (4)(f), “the TUPE regulations” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246). (7) For the purposes of this section— (a) references to rights and liabilities include rights and liabilities relating to a contract of employment; (b) references to the transfer of property include the grant of a lease. (8) For the purposes of subsection (7)(a)— (a) an individual who holds employment in the civil service of the State is to be treated as employed by virtue of a contract of employment, and (b) the terms of the individual’s employment in the civil service are to be regarded as constituting the terms of the contract of employment.

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7E Transfer schemes under section 7D: taxation

(1) The Treasury may by regulations make provision varying the way in which a relevant tax has effect in relation to— (a) anything transferred under a scheme under section 7D, or (b) anything done for the purposes of, or in relation to, a transfer under such a scheme. (2) The provision which may be made under subsection (1)(a) includes in particular provision for— (a) a tax provision not to apply, or to apply with modifications, in relation to anything transferred; (b) anything transferred to be treated in a specified way for the purposes of a tax provision; (c) the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything transferred. (3) The provision which may be made under subsection (1)(b) includes in particular provision for— (a) a tax provision not to apply, or to apply with modifications, in relation to anything done for the purposes of or in relation to the transfer; (b) anything done for the purposes of, or in relation to, the transfer to have or not have a specified consequence or be treated in a specified way; (c) the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything done for the purposes of, or in relation to, the transfer. (4) In this section references to the transfer of property include the grant of a lease. (5) In this section— “relevant tax” means income tax, corporation tax, capital gains tax, value added tax, stamp duty or stamp duty reserve tax; “tax provision” means a provision of an enactment about a relevant tax.

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

(1) The Secretary of State may give directions to any of the bodies mentioned in subsection (2) about its exercise of any functions. (2) The bodies are— (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) NHS trusts, and (d) Special Health Authorities. (3) Nothing in provision made by or under this or any other Act affects the generality of subsection (1).

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9 NHS contracts

(1) In this Act, an NHS contract is an arrangement under which one health service body (“the commissioner”) arranges for the provision to it by another health service body (“the provider”) of goods or services which it reasonably requires for the purposes of its functions. (2) Section 139(6) (NHS contracts and the provision of local pharmaceutical services under pilot schemes) makes further provision about acting as commissioner for the purposes of subsection (1). (3) Paragraph 15 of Schedule 4 (NHS trusts and NHS contracts) makes further provision about an NHS trust acting as provider for the purposes of subsection (1). (4) “Health service body” means any of the following— (za) NHS England, (zb) an integrated care board, (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) an NHS trust, (d) a Special Health Authority, (e) a Local Health Board, (f) a Health Board constituted under section 2 of the National Health Service (Scotland) Act 1978 (c. 29), (fa) a Special Health Board constituted under that section, (g) the Regional Agency for Public Health and Social Well-being, (h) the Common Services Agency for the Scottish Health Service, (i) the Wales Centre for Health, (j) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (k) the Care Quality Commission, (ka) NICE, (kb) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (kc) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (kd) the Health Services Safety Investigations Body, (l) the Scottish Dental Practice Board, (m) the Secretary of State, (n) the Welsh Ministers, (na) the Scottish Ministers, (nb) Healthcare Improvement Scotland, (o) the Regional Business Services Organisation, (p) a special health and social services agency established under the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990 (S.I. 1990/247 (N.I.3)), (q) a Health and Social Care trust trust established under the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)), (r) the Department of Health, Social Services and Public Safety. (5) Whether or not an arrangement which constitutes an NHS contract would apart from this subsection be a contract in law, it must not be regarded for any purpose as giving rise to contractual rights or liabilities. (6) But if any dispute arises with respect to such an arrangement, either party may refer the matter to the Secretary of State for determination under this section. (7) If, in the course of negotiations intending to lead to an arrangement which will be an NHS contract, it appears to a health service body— (a) that the terms proposed by another health service body are unfair by reason that the other is seeking to take advantage of its position as the only, or the only practicable, provider of the goods or services concerned or by reason of any other unequal bargaining position as between the prospective parties to the proposed arrangement, or (b) that for any other reason arising out of the relative bargaining position of the prospective parties any of the terms of the proposed arrangement cannot be agreed, that health service body may refer the terms of the proposed arrangement to the Secretary of State for determination under this section. (8) Where a reference is made to the Secretary of State under subsection (6) or (7), he may determine the matter himself or appoint a person to consider and determine it in accordance with regulations. (9) “The appropriate person” means the Secretary of State or the person appointed under subsection (8). (10) By the determination of a reference under subsection (7) the appropriate person may specify terms to be included in the proposed arrangement and may direct that it be proceeded with. (11) A determination of a reference under subsection (6) may contain such directions (including directions as to payment) as the appropriate person considers appropriate to resolve the matter in dispute. (12) The appropriate person may by the determination in relation to an NHS contract vary the terms of the arrangement or bring it to an end (but this does not affect the generality of the power of determination under subsection (6)). (13) Where an arrangement is so varied or brought to an end— (a) subject to paragraph (b), the variation or termination must be treated as being effected by agreement between the parties, and (b) the directions included in the determination by virtue of subsection (11) may contain such provisions as the appropriate person considers appropriate in order to give effect to the variation or to bring the arrangement to an end.

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10 Provision for bodies in Northern Ireland

(1) Subsection (2) applies where the Regional Agency for Public Health and Social Well-being or a body mentioned in paragraph (o), (p), (q) or (r) of section 9(4) is a party or prospective party to an arrangement or proposed arrangement which— (a) falls within the definition of NHS contract in section 9(1), and (b) also falls within the definition of HSS contract in Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)). (2) Subsections (5) to (13) of section 9 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Secretary of State of references to the Secretary of State and the Department of Health, Social Services and Public Safety acting jointly.

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10A Provision for bodies in Scotland

(1) Subsection (2) applies where the Scottish Ministers are, or a body mentioned in paragraph (f), (fa), (h), (l) or (nb) of section 9(4) is, a party or prospective party to an arrangement or proposed arrangement which— (a) falls within the definition of NHS contract in section 9(1), and (b) also falls within the definition of NHS contract in section 17A of the National Health Service (Scotland) Act 1978. (2) Subsections (5) to (13) of section 9 apply in relation to the arrangement or proposed arrangement (except in so far as it relates to reserved matters within the meaning of the Scotland Act 1998) with the substitution for references to the Secretary of State of references to the Secretary of State and the Scottish Ministers acting jointly. (3) Subsection (4) applies (and subsection (2) does not apply) where a cross-border Special Health authority is a party or prospective party to an arrangement or proposed arrangement which— (a) falls within the definition of NHS contract in section 9(1), and (b) also falls within the definition of NHS contract in section 17A of the National Health Service (Scotland) Act 1978 and the definition of NHS contract in section 7(1) of the National Health Service (Wales) Act 2006. (4) Subsections (5) to (13) of section 9 apply in relation to that arrangement or proposed arrangement (except in so far as it relates to reserved matters within the meaning of the Scotland Act 1998) with the substitution for references to the Secretary of State— (a) where the cross-border Special Health Authority is exercising functions in relation to England only, of references to the Secretary of State and the Scottish Ministers acting jointly; and (b) where the Authority is exercising functions in relation to England and Wales, of references to the Secretary of State and the Welsh Ministers acting concurrently with each other and jointly with the Scottish Ministers. (5) In subsections (3) and (4), “cross-border Special Health Authority” means a Special Health Authority which is established under the National Health Service Act 2006 and the National Health Service (Wales) Act 2006 by virtue of— (a) paragraph 1(2) of Schedule 2 to the National Health Service (Consequential Provisions) Act 2006, or (b) the power under section 28 of the National Health Service Act 2006 and the power under section 22 of the National Health Service (Wales) Act 2006 being exercised together.

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