Law

National Health Service (Wales) Act 2006

United Kingdom · statute

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In force since 2026-03-28, 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: 243 provisions
  1. Title and introductory text
  2. 1 Welsh Ministers' duty to promote health service
  3. 1A Welsh Ministers' duty to secure quality in health services
  4. 2 Welsh Ministers' general power
  5. 3 Welsh Ministers' duty as to provision of certain services
  6. 4 High security psychiatric services
  7. 5 Other services
  8. 6 Performance of functions outside Wales
  9. 6A Reimbursement of cost of services provided in another EEA state
  10. 6B Prior authorisation for the purposes of section 6A
  11. 6BA Reimbursement of cost of services provided in another EEA state where expenditure incurred on or after 25 October 2013
  12. 6BB Prior authorisation for the purposes of section 6BA
  13. 7 NHS contracts
  14. 8 Provision for bodies in Northern Ireland
  15. 8A Provision for bodies in Scotland
  16. 9 Arrangements to be treated as NHS contracts
  17. 10 Welsh Ministers' arrangements with other bodies
  18. 10A Procurement of services etc. as part of the NHS in Wales
  19. 10B Direct payments for health care
  20. 10C Regulations about direct payments
  21. 10D Arrangements with other bodies relating to direct payments
  22. 11 Local Health Boards
  23. 12 Functions of Local Health Boards
  24. 12A Local Health Boards' duty to secure quality in health services
  25. 13 Exercise of Local Health Board functions
  26. 14 Section 50 arrangements and section 64 arrangements
  27. 15 Administration and management of services
  28. 16 Advice for Local Health Boards
  29. 17 Plans for improving health etc
  30. 18 NHS trusts
  31. 19 Welsh Ministers' directions to NHS trusts
  32. 20 General duty of NHS trusts
  33. 20A Duty of NHS trusts to secure quality in health services
  34. 21 Financial provisions relating to NHS trusts
  35. 22 Special Health Authorities
  36. 23 Welsh Ministers' directions to Special Health Authorities
  37. 24 Exercise of health service functions by Special Health Authorities
  38. 24A Duty of Special Health Authorities to secure quality in health services
  39. 25 Exercise of Special Health Authority functions
  40. 25A Duty to have regard to providing sufficient nurses
  41. 25B Duty to calculate and take steps to maintain nurse staffing levels
  42. 25C Nurse staffing levels: method of calculation
  43. 25D Nurse staffing levels: guidance
  44. 25E Nurse staffing levels: reports
  45. 26 Intervention orders
  46. 27 Effect of intervention orders
  47. 28 Default powers
  48. 29 Transfer of residual liabilities
  49. 30 Schemes for meeting losses and liabilities etc of certain health service bodies
  50. 31 Directions and regulations under this Part
  51. 32 Supply of goods and services by local authorities
  52. 33 Arrangements between NHS bodies and local authorities
  53. 34 Power of local authorities to make payments
  54. 35 Care Trusts
  55. 36 Directed partnership arrangements
  56. 37 Further provisions about directions and directed partnership arrangements
  57. 38 Supply of goods and services by the Welsh Ministers
  58. 39 Conditions of supply under section 38
  59. 40 Health and well-being strategies in Wales
  60. 41 Primary medical services
  61. 42 General medical services contracts: introductory
  62. 43 Requirement to provide certain primary medical services
  63. 44 Persons eligible to enter into GMS contracts
  64. 45 GMS contracts: payments
  65. 46 GMS contracts: prescription of drugs, etc
  66. 47 GMS contracts: other required terms
  67. 48 GMS contracts: disputes and enforcement
  68. 49 Persons performing primary medical services
  69. 50 Arrangements by Local Health Boards for the provision of primary medical services
  70. 51 Persons with whom agreements may be made under section 50
  71. 52 Regulations about section 50 arrangements
  72. 53 Assistance and support: primary medical services
  73. 54 Local Medical Committees
  74. 55 Use of accommodation: provision of primary medical services
  75. 56 Primary dental services
  76. 57 General dental services contracts: introductory
  77. 58 Requirement to provide certain primary dental services
  78. 59 Persons eligible to enter into GDS contracts
  79. 60 GDS contracts: payments
  80. 61 GDS contracts: other required terms
  81. 62 GDS contracts: disputes and enforcement
  82. 63 Persons performing primary dental services
  83. 64 Arrangements by Local Health Boards for the provision of primary dental services
  84. 65 Persons with whom agreements may be made under section 64
  85. 66 Regulations about section 64 arrangements
  86. 67 Dental public health
  87. 68 Assistance and support: primary dental services
  88. 69 Local Dental Committees
  89. 70 Use of accommodation: provision of primary dental services
  90. 71 Arrangements for general ophthalmic services
  91. 72 Regulations as to general ophthalmic services
  92. 73 Medical practitioners with qualifications prescribed under section 71
  93. 74 Exercise of choice of practitioner
  94. 75 Inadequate provision of ophthalmic services
  95. 76 Remuneration for persons providing general ophthalmic services
  96. 77 Section 76: supplementary
  97. 78 Local Optical Committees
  98. 79 Use of accommodation: provision of general ophthalmic services
  99. 80 Arrangements for pharmaceutical services
  100. 81 Arrangements for additional pharmaceutical services
  101. 82 Terms and conditions, etc
  102. 82A Pharmaceutical needs assessments
  103. 83 Regulations as to pharmaceutical services
  104. 84 Regulations under section 83: appeals, etc
  105. 85 Power to charge
  106. 86 Persons authorised to provide pharmaceutical services
  107. 87 Inadequate provision of pharmaceutical services
  108. 88 Remuneration for persons providing pharmaceutical services
  109. 89 Section 88: supplementary
  110. 90 Local Pharmaceutical Committees
  111. 91 Use of accommodation: provision of pharmaceutical services
  112. 92 Pilot schemes
  113. 93 Making pilot schemes
  114. 94 Designation of priority neighbourhoods or premises
  115. 95 Reviews of pilot schemes
  116. 96 Variation and termination of pilot schemes
  117. 97 NHS contracts and the provision of piloted services
  118. 98 Funding of preparatory work
  119. 99 Application of this Act
  120. 100 Premises from which piloted services may be provided
  121. 101 Control of entry regulations
  122. 102 Local pharmaceutical services schemes
  123. 103 Application of enactments
  124. 104 Conditional inclusion in ophthalmic and pharmaceutical lists
  125. 105 Supplementary lists
  126. 106 Further provision about regulations under section 105
  127. 107 Disqualification of practitioners
  128. 108 Contingent removal
  129. 109 Fraud and unsuitability cases: supplementary
  130. 110 Suspension
  131. 111 Suspension pending appeal
  132. 112 Effect of suspension
  133. 113 Review of decisions
  134. 114 Appeals
  135. 115 National disqualification
  136. 116 Notification of decisions
  137. 117 Withdrawal from lists
  138. 118 Regulations about decisions under this Chapter
  139. 119 Corresponding provisions in Scotland and Northern Ireland
  140. 120 Indemnity cover
  141. 121 Charges for drugs, medicines or appliances, or pharmaceutical services
  142. 122 Exemptions from general charging
  143. 123 Pre-payment certificates
  144. 124 Charges in respect of non-residents
  145. 125 Dental charging
  146. 126 Exemptions from dental charging
  147. 127 Charges, recovery of payments and penalties
  148. 128 Charges for optical appliances
  149. 129 Payments in respect of optical appliances
  150. 130 Remission and repayment of charges
  151. 131 Payment of travelling expenses
  152. 132 Sections 130 and 131: supplementary
  153. 133 Charges for more expensive supplies
  154. 134 Charges for repairs and replacements in certain cases
  155. 135 Charges for designated services or facilities
  156. 136 Sums otherwise payable to those providing services
  157. 137 Hospital accommodation on part payment
  158. 138 Expenses payable by employed patients
  159. 139 Recovery of charges
  160. 140 Recovery of charges and payments in relation to goods and services
  161. 141 Penalties relating to charges
  162. 142 Offences relating to charges
  163. 143 Compulsory disclosure of documents
  164. 144 Persons and bodies about which provision is made by this Part
  165. 145 Notice requiring production of documents
  166. 146 Production of documents
  167. 147 Delegation of functions
  168. 148 Code of practice relating to delegated functions
  169. 149 Disclosure of information
  170. 150 Protection of personal information disclosed for purposes of proceedings
  171. 151 Manner in which disclosure notice may be served
  172. 152 Offences in connection with production of documents
  173. 153 Offences relating to disclosure or use of information
  174. 154 Offences by bodies corporate etc
  175. 155 Offences committed by partnerships and other unincorporated associations
  176. 156 Penalties for offences under this Part: transitional modification
  177. 157 Orders and regulations under this Part
  178. 158 Interpretation of this Part
  179. 159 Acquisition, use and maintenance of property
  180. 160 Special trustees for a university or teaching hospital
  181. 161 Transfers of trust property
  182. 162 Transfer of functions and property to or from special trustees
  183. 163 Trustees and property under section 169
  184. 164 Application of trust property: further provisions
  185. 165 Trusts: supplementary provisions
  186. 166 Transferred property free of trusts
  187. 167 Trust property previously held for general hospital purposes
  188. 168 Voluntary hospitals
  189. 169 Power to raise money
  190. 170 Public-private partnerships
  191. 171 Means of meeting expenditure of Special Health Authorities out of public funds
  192. 172 Financial duties of Special Health Authorities
  193. 173 Resource limits for Special Health Authorities
  194. 174 Public funding of Local Health Boards
  195. 175 Financial duties of Local Health Boards
  196. 176 Resource limits for Local Health Boards
  197. 177 Further provision about the expenditure of Local Health Boards
  198. 178 Accounts and audit
  199. 179 Allowances for members of certain bodies
  200. 180 Special arrangement as to payment of remuneration
  201. 181 Payments for certain medical examinations
  202. 182 Community Health Councils
  203. 183 Public involvement and consultation
  204. 184 Functions of overview and scrutiny committees
  205. 185 Joint overview and scrutiny committees etc
  206. 186 Overview and scrutiny committees: exempt information
  207. 187 Independent advocacy services
  208. 188 Joint working with the prison service
  209. 189 Welsh Ministers' standing advisory committees
  210. 190 Advisory committees for Wales
  211. 191 Emergency powers
  212. 192 Local social service authorities
  213. 193 Supplies not readily obtainable
  214. 194 Power of Local Health Boards to make payments towards expenditure on community services
  215. 195 Payments in respect of voluntary organisations under section 194
  216. 196 Power of Welsh Ministers to make payments towards expenditure on community services in Wales
  217. 197 University clinical teaching and research
  218. 198 Permission for use of facilities in private practice
  219. 199 Persons displaced by health service development
  220. 200 Special notices of births and deaths
  221. 201 Provision of information by Registrar General
  222. 202 Territorial limit of exercise of functions
  223. 203 Orders, regulations and directions
  224. 204 Further provision about orders and directions under this Act
  225. 205 Supplementary regulatory powers
  226. 206 Interpretation
  227. 207 Index of defined expressions
  228. 208 Commencement
  229. 209 Short title, extent and application
  230. SCHEDULE 1 Further provision about the Welsh Ministers and services under this Act
  231. SCHEDULE 2 Local Health Boards
  232. SCHEDULE 3 NHS trusts established under section 18
  233. SCHEDULE 4 Financial provision about NHS trusts established under section 18
  234. SCHEDULE 5 Special Health Authorities established under section 22
  235. SCHEDULE 6 Pilot schemes
  236. SCHEDULE 7 LPS schemes
  237. SCHEDULE 8 Further provision about the expenditure of Local Health Boards
  238. SCHEDULE 9 Accounts and audit
  239. SCHEDULE 10 Further provision about Community Health Councils
  240. SCHEDULE 11 Exempt information relating to health services
  241. SCHEDULE 12 Section 33 arrangements: transfer of staff
  242. SCHEDULE 13 Further provision about standing advisory committees
  243. SCHEDULE 14 Further provision about advisory committees for Wales

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243 provisions

Title and introductory text

National Health Service (Wales) Act 2006 2006 c. 42 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 Welsh Ministers' duty to promote health service

(1) The Welsh Ministers must continue the promotion in Wales of a comprehensive health service designed to secure improvement— (a) in the physical and mental health of the people of Wales, and (b) in the prevention, diagnosis and treatment of illness. (2) The Welsh Ministers must for that purpose provide or secure the provision of services in accordance with this Act. (3) The services so provided 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 Welsh Ministers' duty to secure quality in health services

(1) The Welsh Ministers must exercise their functions in relation to the health service with a view to securing improvement in the quality of health services. (2) For the purposes of this section— “health services” means any services provided or secured in accordance with this Act; “quality” includes, but is not limited to, quality in terms of— the effectiveness of health services, the safety of health services, and the experience of individuals to whom health services are provided. (3) The Welsh Ministers must publish an annual report on the steps they have taken to comply with the duty in subsection (1). (4) The report must include an assessment of the extent of any improvement in outcomes achieved by virtue of those steps. (5) The Welsh Ministers must lay a copy of the report before the National Assembly for Wales.

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2 Welsh Ministers' general power

(1) The Welsh Ministers may— (a) provide such services as they consider appropriate for the purpose of discharging any duty imposed on them by this Act, and (b) do anything else which is calculated to facilitate, or is conducive or incidental to, the discharge of such a duty. (2) Subsection (1) does not affect— (a) the powers of the Welsh Ministers apart from this section, (b) Part 6 and Chapter 1 of Part 7 (ophthalmic and pharmaceutical services).

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3 Welsh Ministers' duty as to provision of certain services

(1) The Welsh Ministers must provide throughout Wales, to such extent as they consider necessary to meet all reasonable requirements— (a) hospital accommodation, (b) other accommodation for the purpose of any service provided under this Act, (c) medical, dental, ophthalmic, nursing and ambulance services, (d) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as they consider are appropriate as part of the health service, (e) 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 they consider are appropriate as part of the health service, (f) such other services or facilities as are required for the diagnosis and treatment of illness. (2) For the purposes of the duty in subsection (1), services provided under— (a) section 41(2) (primary medical services) or 56(2) (primary dental services), or (b) a general medical services contract or a general dental services contract, must be regarded as provided by the Welsh Ministers. (3) This section does not affect Part 6 and Chapter 1 of Part 7 (ophthalmic and pharmaceutical services).

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4 High security psychiatric services

(1) The Welsh Ministers' duty under section 1 includes a duty to provide 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 Welsh Ministers 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 3 as “high security psychiatric services”. (3) High security psychiatric services may be provided only at hospital premises at which services are provided only for the persons mentioned in subsection (1). (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 Welsh Ministers and services under this Act.

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6 Performance of functions outside Wales

(1) The Welsh Ministers may provide or secure the provision of anything mentioned in section 3(1) outside Wales. (2) The Welsh Ministers' functions 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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7 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 97(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 3 (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— (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (ba) NHS England, (bb) an integrated care board, (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) the National Institute for Health and Care Excellence, (kb) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 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 to 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 Welsh Ministers 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 Welsh Ministers for determination under this section. (8) Where a reference is made to the Welsh Ministers under subsection (6) or (7), they may determine the matter themselves or appoint a person to consider and determine it in accordance with regulations. (9) “The appropriate person” means the Welsh Ministers 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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8 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 7(4) is a party or prospective party to an arrangement or proposed arrangement which— (a) falls within the definition of NHS contract in section 7(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 7 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Welsh Ministers of references to the Welsh Ministers and the Department of Health, Social Services and Public Safety acting jointly.

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8A 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 7(4) is, a party or prospective party to an arrangement or proposed arrangement which— (a) falls within the definition of NHS contract in section 7(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 7 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Welsh Ministers— (a) in so far as the arrangement or proposed arrangement relates to reserved matters within the meaning of the Scotland Act 1998, of references to the Welsh Ministers and the Secretary of State acting jointly, and (b) for all other purposes, of references to the Welsh Ministers 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 7(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 9(1) of the National Health Service Act 2006. (4) Subsections (5) to (13) of section 7 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 Welsh Ministers— (a) where the cross-border Special Health Authority is exercising functions in relation to Wales only, of references to the Welsh Ministers and the Scottish Ministers acting jointly, and (b) where the Authority is exercising functions in relation to England and Wales, of references to the Welsh Ministers and the Secretary of State 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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9 Arrangements to be treated as NHS contracts

(1) This section applies to any arrangement under which a Local Health Board or such other health service body as may be prescribed arranges for the provision to it— (a) by a contractor under a general ophthalmic services contract, (b) by a person on an ophthalmic list, (c) by a person on a pharmaceutical list, or (d) by a person who has entered into a pharmaceutical care services contract under section 17Q of the National Health Service (Scotland) Act 1978 (c. 29), of the goods or services mentioned in subsection (2). (2) The goods or services are those that the body reasonably requires for the purposes of its functions, other than functions under— (a) Part 6 (general ophthalmic services), (b) Chapter 1 or 2 of Part 7 (pharmaceutical services and local pharmaceutical services under pilot schemes), or (c) section 115 of, or Chapter 1 or 2 of Part 7 of, the National Health Service Act 2006 (c. 41) (primary ophthalmic services and pharmaceutical services and local pharmaceutical services under pilot schemes). (3) Any such arrangement is to be treated as an NHS contract for the purposes of section 7 (other than subsections (7) and (10)). (4) In this section— “general ophthalmic services contract” and “contractor” under such a contract have the meanings given by section 117 of the National Health Service Act 2006, “health service body” means a body which is a health service body for the purposes of section 7, “ophthalmic list” includes a list published in accordance with regulations made under— section 26(2)(a) of the National Health Service (Scotland) Act 1978 (c. 29), or Article 62(2)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)), and “pharmaceutical list” includes a list published in accordance with regulations made under— section 129(2)(a) of the National Health Service Act 2006, or Article 63(2A)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972. (5) The reference to a list published in accordance with regulations made under paragraph (a) of section 26(2) of the National Health Service (Scotland) Act 1978 is a reference to the first part of the list (referred to in sub-paragraph (i) of that paragraph) which is published in accordance with regulations under that paragraph.

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10 Welsh Ministers' arrangements with other bodies

(1) The Welsh Ministers may arrange with any person or body to provide, or assist in providing, any service under this Act. (2) Arrangements may be made under subsection (1) with voluntary organisations. (3) The Welsh Ministers may make available any facilities provided by them for any service under this Act— (a) to any person or body carrying out any arrangements under subsection (1), or (b) to any voluntary organisation eligible for assistance under section 64 or section 65 of the Health Services and Public Health Act 1968 (c. 46). (4) Where facilities are made available under subsection (3) the Welsh Ministers may make available the services of any person employed in connection with the facilities by— (a) the Welsh Ministers, (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) a Special Health Authority, or (d) a Local Health Board. (5) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Welsh Ministers. (6) Goods or materials may be made available either temporarily or permanently. (7) Any power to supply goods or materials under this section includes— (a) a power to purchase and store them, and (b) a power to arrange with third parties for the supply of goods or materials by those third parties.

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10A Procurement of services etc. as part of the NHS in Wales

(1) The Welsh Ministers may, by regulations, make provision in relation to the processes to be followed and objectives to be pursued by relevant authorities in the procurement of— (a) services provided as part of the health service in Wales (“health services”), and (b) goods or other services that are connected to those health services. (2) Regulations under subsection (1) must include provision specifying steps to be taken when following a competitive tendering process. (3) Regulations under subsection (1) must, in relation to the procurement of the services or goods to which they apply, make provision for the purposes of— (a) ensuring transparency; (b) ensuring fairness; (c) ensuring that compliance can be verified; (d) managing conflicts of interest. (4) Before making regulations under subsection (1), the Welsh Ministers must carry out such consultation as they consider appropriate and publish a summary of the responses they receive. (5) Explanatory material accompanying regulations made under subsection (1) must set out how the regulations make provision for the purposes of subsection (3). (6) The Welsh Ministers must publish such guidance as they consider appropriate about compliance with the regulations. (7) A relevant authority must have regard to guidance published under this section. (8) The Welsh Ministers must— (a) review the operation of the regulations, and (b) publish the conclusions of the review before the end of the period of 5 years beginning with the day on which the regulations come into force. (9) In this section “relevant authority” means— (a) a county council or county borough council in Wales; (b) a local health board established under section 11; (c) a National Health Service trust established under section 18; (d) a special health authority established under section 22.

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10B Direct payments for health care

(1) The Welsh Ministers may, for the purpose of securing the provision to a patient of anything to which subsection (3) applies, make payments to the patient or to a person nominated by the patient. (2) Subsection (1) is subject to any provision made by regulations under section 10C. (3) This subsection applies to— (a) anything that the Welsh Ministers may or must provide under section 2(1) or 3(1); (b) anything for which the Welsh Ministers must arrange under paragraph 8 of Schedule 1; (c) any vehicles that the Welsh Ministers may provide under paragraph 9 of Schedule 1; (d) anything the Welsh Ministers may provide under paragraph 10 of Schedule 1 (including anything for which a grant may be made under paragraph 10(3) of Schedule 1). (4) Payments may not be made under subsection (1) unless the patient consents to the making of the payments, subject to any provision made by regulations under section 10C in respect of a patient who lacks capacity or is a child. (5) Where the Welsh Ministers make payments under subsection (1), they must, having regard to the purposes for which the payments are made, make arrangements for the provision to the patient, payee or their representative of such information, advice or other support, as the Welsh Ministers consider appropriate. (6) Regulations may provide that a Local Health Board may, for the purpose of securing the provision to a patient of after-care services that a Local Health Board must provide under section 117 of the Mental Health Act 1983 (c. 20), make payments to the patient or to a person nominated by the patient. (7) Regulations under subsection (6) must— (a) provide that payments under the regulations cannot be made unless the patient consents to the making of the payments, subject to any provision made by regulations under section 10C in respect of a patient who lacks capacity or is a child; (b) make provision in respect of information, advice or other support to be provided by a Local Health Board to patients, payees or their representatives in connection with the payments. (8) In section 10C and section 10D, “direct payments” means payments made under subsection (1) or under regulations made under subsection (6). (9) In this section and section 10C— (a) “child” means a person who has not attained the age of 16; (b) references to a person lacking capacity are references to a person lacking capacity within the meaning of the Mental Capacity Act 2005 (c. 9).

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10C Regulations about direct payments

(1) Regulations may make provision about direct payments. (2) The regulations may, in particular, make provision about— (a) the circumstances in which, and descriptions of persons and services in respect of which, direct payments may, must or must not be made; (b) the circumstances in which direct payments may, must or must not be made to a person nominated by the patient; (c) the making of direct payments (and, in particular, as to persons to whom payments may or must be made) if the patient lacks capacity to consent to the making of the payments or is a child; (d) matters to which the Welsh Ministers or a Local Health Board may or must have regard when making a decision about direct payments; (e) conditions that the Welsh Ministers or a Local Health Board may, must or must not attach in relation to direct payments; (f) the steps that the Welsh Ministers or a Local Health Board may or must take before, or after, making a decision about direct payments; (g) the conditions that the patient or (if different) the payee may or must be required to comply with before, after, or at the time when a direct payment is made; (h) the amount of any direct payment or how it is to be calculated; (i) the circumstances in which the Welsh Ministers or a Local Health Board may or must stop making direct payments; (j) the circumstances in which the Welsh Ministers or a Local Health Board may or must require all or part of a direct payment to be repaid by the patient or (if different) the payee, or otherwise; (k) the monitoring of the making of direct payments, of their use by the patient or (if different) the payee, or of services which they are used to secure; (l) the review of decisions as to whether a direct payment should be made; (m) the arrangements to be made by the Welsh Ministers or Local Health Board for providing patients, payees or their representatives with information, advice or other support in connection with direct payments; (n) the extent to which such support is to be treated as a service in respect of which direct payments may be made. (3) If the regulations make provision about persons who lack capacity to consent to the making of direct payments, the regulations may also make provision about the cases or circumstances where a person who has lacked that capacity but no longer does so (whether because of fluctuating capacity or regaining or gaining capacity). (4) The regulations may provide for a sum that must be repaid to the Welsh Ministers or Local Health Board (as the case may be) by virtue of a condition or other requirement imposed by or under the regulations to be recoverable as a debt due to the Welsh Ministers or Local Health Board (as the case may be). (5) The regulations may make provision— (a) for a service in respect of which a direct payment has been made under section 10B(1) to be regarded as provided or arranged for by the Welsh Ministers under an enactment mentioned in section 10B(3), only to such extent and subject to such conditions as the regulations may specify; (b) displacing functions or obligations of a Local Health Board with respect to the provision of after-care services under section 117 of the Mental Health Act 1983 (c. 20), only to such extent and subject to such conditions as the regulations may prescribe. (6) In this section, “service” includes anything in respect of which direct payments may be made.

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10D Arrangements with other bodies relating to direct payments

(1) The Welsh Ministers or a Local Health Board may arrange with any person or body to provide assistance in connection with direct payments. (2) Arrangements may be made under subsection (1) with voluntary organisations. (3) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Welsh Ministers or the Local Health Board.

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11 Local Health Boards

(1) The Welsh Ministers may establish bodies to be known as Local Health Boards. (2) Each Local Health Board is established by order made by the Welsh Ministers (referred to in this Act as an LHB order), and an order may establish more than one Local Health Board. (3) A Local Health Board is established for the area of Wales specified in its LHB order. (4) If any consultation requirements apply, they must be complied with before an LHB order is varied or revoked. (5) “Consultation requirements” means requirements about consultation contained in regulations. (6) Schedule 2 makes further provision about Local Health Boards.

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12 Functions of Local Health Boards

(1) The Welsh Ministers may direct a Local Health Board to exercise in relation to its area— (a) functions which were transferred to the National Assembly for Wales by the Health Authorities (Transfer of Functions, Staff, Property, Rights and Liabilities and Abolition) (Wales) Order 2003 (S.I. 2003/813 (W.98)), (b) such other of their functions relating to the health service as are specified in the direction. (2) The functions which may be specified in directions under subsection (1) include functions under enactments relating to mental health and care homes. (3) The Welsh Ministers may give directions to a Local Health Board about its exercise of any functions.

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12A Local Health Boards' duty to secure quality in health services

(1) Each Local Health Board must exercise its functions with a view to securing improvement in the quality of health services. (2) For the purposes of this section— “health services” means any services provided or secured in accordance with this Act; “quality” includes, but is not limited to, quality in terms of— the effectiveness of health services, the safety of health services, and the experience of individuals to whom health services are provided. (3) Each Local Health Board must publish an annual report on the steps it has taken to comply with the duty in subsection (1). (4) The report must include an assessment of the extent of any improvement in outcomes achieved by virtue of those steps. (5) The Welsh Ministers must issue guidance to Local Health Boards in relation to the requirements imposed by subsections (1) and (3). (6) The guidance must, in particular, include guidance about— (a) the evidence to be used in support of an assessment required by this section, and (b) the conduct of such an assessment. (7) Each Local Health Board must have regard to guidance issued under subsection (5).

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13 Exercise of Local Health Board functions

(1) This section applies to functions exercisable by a Local Health Board under or by virtue of this Act (including this section) or any prescribed provision of any other Act. (2) The Welsh Ministers may give directions providing for any functions to which this section applies to be exercised— (a) by another Local Health Board, (b) by a Special Health Authority, or (c) jointly with any one or more of the bodies mentioned in subsection (3). (3) The bodies are— (aa) NHS England, (ab) integrated care boards, (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) NHS trusts, and (c) other Local Health Boards. (4) Directions given by the Welsh Ministers may provide— (a) for any functions to which this section applies to be exercised, on behalf of the Local Health Board by whom they are exercisable, by a committee, sub-committee or officer of the Local Health Board, (b) for any functions which, under this section, are exercisable by a Special Health Authority to be exercised, on behalf of that Special Health Authority, by a committee, sub-committee or officer of the Special Health Authority, (c) for any functions which, under this section, are exercisable by a Local Health Board jointly with one or more other Local Health Boards (but not with any NHS trusts) to be exercised, on behalf of the Local Health Boards in question, by a joint committee or joint sub-committee. (5) Subsection (6) applies where, by virtue of subsection (2)(b), a Special Health Authority exercises functions of a Local Health Board in relation to a general dental services contract. (6) The Welsh Ministers may by order make provision for the transfer to the Special Health Authority of the rights and liabilities of the Local Health Board under the contract (and for their transfer back to the Local Health Board where the Special Health Authority ceases to exercise the functions).

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14 Section 50 arrangements and section 64 arrangements

(1) Each Local Health Board must, in accordance with regulations, perform such functions in relation to section 50 arrangements (primary medical services) and section 64 arrangements (primary dental services) as may be prescribed. (2) The regulations may, in particular— (a) prescribe functions in relation to training, (b) provide for appeals to the Welsh Ministers or a prescribed body in relation to prescribed functions.

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15 Administration and management of services

Each Local Health Board must, in accordance with regulations— (a) administer the arrangements made in pursuance of this Act for the provision for its area of primary medical services, primary dental services, general ophthalmic services and pharmaceutical services, and (b) perform such management and other functions relating to those services as may be prescribed.

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16 Advice for Local Health Boards

Each Local Health Board must make arrangements with a view to securing that it receives advice appropriate for enabling it effectively to exercise the functions exercisable by it from persons with professional expertise relating to the physical or mental health of individuals.

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17 Plans for improving health etc

(1) Each Local Health Board must, at such times as the Welsh Ministers may direct, prepare a plan which sets out a strategy for improving— (a) the health of the people for whom it is responsible, and (b) the provision of health care to such people. (2) Each Local Health Board must keep under review any plan prepared by it under this section. (3) Each of the bodies specified in subsection (4) must participate in the preparation or review by a Local Health Board of any plan under this section. (4) Those bodies are— (a) any local authority whose area falls wholly or partly within the area of the Local Health Board, and (b) any NHS trust which provides services at or from a hospital or other establishment or facility which falls within the area of the Local Health Board. (5) In preparing or reviewing any plan under this section, a Local Health Board— (a) must consult, or seek the participation of, such persons as the Welsh Ministers may direct, and (b) may consult, or seek the participation of, such other persons as it considers appropriate. (6) The Welsh Ministers may give directions as to— (a) the periods to be covered by plans under this section, (b) the action to be taken by Local Health Boards, NHS trusts and local authorities in connection with the preparation or review of plans under this section, (c) the matters to be taken into account in connection with the preparation or review of plans under this section, (d) the matters to be dealt with by plans under this section, (e) the form and content of plans under this section, (f) the publication of plans prepared or reviewed under this section, (g) the sharing of information between NHS England , integrated care boards, ... ... NHS trusts, Local Health Boards and local authorities in connection with the preparation or review of plans under this section or the preparation of joint local health and wellbeing strategies under section 116A of the Local Government and Public Involvement in Health Act 2007, (h) the provision by NHS England , integrated care boards, ... ... and Local Health Boards of reports or other information to the Welsh Ministers in connection with plans under this section or joint local health and wellbeing strategies under section 116A of the Local Government and Public Involvement in Health Act 2007. (7) In exercising its functions— (a) a Local Health Board must have regard to any plan prepared or reviewed by it, and (b) an NHS trust and a local authority must have regard to any plan in relation to which it has participated. (8) For the purposes of this section, the persons for whom a Local Health Board is responsible are— (a) the people in the area of the Local Health Board, and (b) such of the people outside the area as may be specified in directions given by the Welsh Ministers. (9) “Health care” means— (a) services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness, and (b) the promotion and protection of public health.

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18 NHS trusts

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

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19 Welsh Ministers' directions to NHS trusts

(1) The Welsh Ministers may give directions to an NHS trust about its exercise of any functions. (2) The Welsh Ministers may not give directions under this section in respect of matters concerning xenotransplantation, surrogacy agreements, embryology or human genetics. (3) Nothing in provision made by or under this or any other Act affects the generality of subsection (1).

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20 General duty of NHS trusts

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

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20A Duty of NHS trusts to secure quality in health services

(1) Each NHS trust must exercise its functions with a view to securing improvement in the quality of health services. (2) For the purposes of this section— “health services” means any services provided or secured in accordance with this Act; “quality” includes, but is not limited to, quality in terms of— the effectiveness of health services, the safety of health services, and the experience of individuals to whom health services are provided. (3) Each NHS trust must publish an annual report on the steps it has taken to comply with the duty in subsection (1). (4) The report must include an assessment of the extent of any improvement in outcomes achieved by virtue of those steps. (5) The Welsh Ministers must issue guidance to NHS trusts in relation to the requirements imposed by subsections (1) and (3). (6) The guidance must, in particular, include guidance about— (a) the evidence to be used in support of an assessment required by this section, and (b) the conduct of such an assessment. (7) Each NHS trust must have regard to guidance issued under subsection (5).

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21 Financial provisions relating to NHS trusts

Schedule 4 makes provision about the financing of NHS trusts.

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22 Special Health Authorities

(1) The Welsh Ministers may by order establish special bodies for the purpose of exercising any functions which may be conferred on them by or under this Act. (2) The Welsh Ministers may make such further provision relating to a body established under subsection (1) as they consider appropriate. (3) A body established under this section is called a Special Health Authority. (4) An order may, in particular, contain provisions as to— (a) the membership of the body established by the order, (b) the transfer to the body of officers, property and liabilities, and (c) the name of the body. (5) The liabilities which may be transferred by virtue of this section, section 203(10) and section 204(1) to an NHS body on the abolition of a Special Health Authority include criminal liabilities. (6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (7) The Welsh Ministers must, before they make an order under this section, consult with respect to the order such bodies as they may recognise as representing officers who in the opinion of the Welsh Ministers are likely to be transferred or affected by transfers in pursuance of the order. (8) Schedule 5 makes further provision about Special Health Authorities.

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23 Welsh Ministers' directions to Special Health Authorities

(1) The Welsh Ministers may give directions to a Special Health Authority about its exercise of any functions. (2) The Welsh Ministers may not give directions under this section in respect of matters concerning xenotransplantation, surrogacy agreements, embryology or human genetics. (3) Nothing in provision made by or under this or any other Act affects the generality of subsection (1).

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24 Exercise of health service functions by Special Health Authorities

(1) The Welsh Ministers may direct a Special Health Authority to exercise any of the functions of the Welsh Ministers relating to the health service which are specified in the directions. (2) Subsection (1) does not apply to the functions of the Welsh Ministers in relation to pilot schemes. (3) The functions which may be specified in directions include functions under enactments relating to mental health and care homes.

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24A Duty of Special Health Authorities to secure quality in health services

(1) Each Special Health Authority must exercise its functions with a view to securing improvement in the quality of health services. (2) For the purposes of this section— “health services” means any services provided or secured in accordance with this Act; “quality” includes, but is not limited to, quality in terms of— the effectiveness of health services, the safety of health services, and the experience of individuals to whom health services are provided. (3) Each Special Health Authority must publish an annual report on the steps it has taken to comply with the duty in subsection (1). (4) The report must include an assessment of the extent of any improvement in outcomes achieved by virtue of those steps. (5) The Welsh Ministers must issue guidance to Special Health Authorities in relation to the requirements imposed by subsections (1) and (3). (6) The guidance must, in particular, include guidance about— (a) the evidence to be used in support of an assessment required by this section, and (b) the conduct of such an assessment. (7) Each Special Health Authority must have regard to guidance issued under subsection (5). (8) This section does not apply in relation to a cross-border Special Health Authority (within the meaning of section 8A(5)).

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25 Exercise of Special Health Authority functions

(1) Regulations may provide for any functions which are exercisable by a Special Health Authority under section 24 to be exercised— (a) by another Special Health Authority, or (b) jointly with one or more other Special Health Authorities. (2) Regulations may provide— (a) for any functions which are exercisable by a Special Health Authority under section 24 or this section to be exercised on behalf of that Special Health Authority by a committee, sub-committee or officer of the Special Health Authority, (b) for any functions exercisable jointly under subsection (1)(b) to be exercised, on behalf of the Special Health Authorities in question, by a joint committee or joint sub-committee.

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25A Duty to have regard to providing sufficient nurses

(1) Subsection (2) applies where a Local Health Board is considering the extent of provision of nursing services for its area necessary to meet all reasonable requirements. (2) The Local Health Board must have regard to the importance of— (a) providing sufficient nurses to allow the nurses time to care for patients sensitively, and (b) where securing the provision of nursing services, ensuring that there are sufficient nurses to allow the nurses time to care for patients sensitively. (3) Where an NHS Trust in Wales provides nursing services it must provide those services to such extent as it considers necessary to meet all reasonable requirements; and subsection (4) applies where an NHS Trust in Wales is considering the extent of provision of nursing services. (4) The NHS Trust must have regard to the importance of— (a) providing sufficient nurses to allow the nurses time to care for patients sensitively, and (b) where securing the provision of nursing services, ensuring that there are sufficient nurses to allow the nurses time to care for patients sensitively. (5) For the purposes of having regard to the importance of providing sufficient nurses to allow the nurses time to care for patients sensitively, a Local Health Board or NHS Trust in Wales must (among other things) undertake workforce planning (including planning the recruitment, retention, education and training of nurses). (6) In this section, and in sections 25B to 25E, references to— (a) a nurse providing care for patients include the provision of care by a person other than a nurse acting under the supervision of, or discharging duties delegated to the person by, a nurse; (b) a “nurse” mean a registered nurse; (c) an “NHS Trust in Wales” mean an NHS trust all or most of whose hospitals, establishments and facilities are situated in Wales.

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