Legalize / United Kingdom / Public General Act

National Health Service Act 2006

Type Public General Act

Publication 2006-11-08

Last updated 2025-09-01

State In force

Department Statute Law Database

Source legislation.gov.uk

articles Not indexed

Reform history JSON API

(1) NHS England must pay in respect of each financial year to each integrated care board sums not exceeding the amount allotted for that year by NHS England to the board towards meeting the expenditure of the board which is attributable to the performance by it of its functions in that year.

(2) In determining the amount to be allotted to an integrated care board for any year, NHS England may take into account—

(a) the expenditure of the integrated care board during any previous financial year, and

(b) the amount that it proposes to hold, during the year to which the allotment relates, in any contingency fund established under section 223F.

(3) An amount is allotted to an integrated care board for a year under this section when the board is notified in writing by NHS England that the amount is allotted to it for that year.

(4) NHS England may make a new allotment under this section increasing or reducing an allotment previously so made.

(5) Where NHS England allots an amount to an integrated care board or makes a new allotment under subsection (4), it must notify the Secretary of State.

(6) NHS England may give directions to an integrated care board with respect to—

(a) the application of sums paid to it by virtue of a new allotment increasing an allotment previously so made, and

(b) the payment of sums by it to NHS England in respect of charges or other sums referable to the valuation or disposal of assets.

(7) Sums falling to be paid to integrated care boards under this section are payable subject to such conditions as to records, certificates or otherwise as NHS England may determine.

(8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

223H

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223K

(1) NHS England may, after the end of a financial year, make a payment to an integrated care board.

(2) For the purpose of determining whether to make a payment under subsection (1) and (if so) the amount of the payment, NHS England must take into account at least one of the following factors—

(a) the quality of relevant services provided during the financial year;

(b) any improvement in the quality of relevant services provided during that year (in comparison to the quality of relevant services provided during previous financial years);

(c) the outcomes identified during the financial year as having been achieved from the provision at any time of relevant services;

(d) any improvement in the outcomes identified during that financial year as having been so achieved (in comparison to the outcomes identified during previous financial years as having been so achieved).

(3) For that purpose, NHS England may also take into account either or both of the following factors—

(a) relevant inequalities identified during that year;

(b) any reduction in relevant inequalities identified during that year (in comparison to relevant inequalities identified during previous financial years).

(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(6) Regulations may make provision as to how payments under subsection (1) may be spent ....

(7) An integrated care board must publish an explanation of how the board has spent any payment made to it under subsection (1).

(8) In this section—

“relevant services” means services provided in pursuance of arrangements made by the integrated care board in the exercise of its functions by virtue of this Act;

“relevant inequalities” means inequalities between the persons for whose benefit relevant services are at any time provided with respect to—their ability to access the services, orthe outcomes achieved for them by their provision.

Permission for use of facilities in private practice

Staff

SCHEDULE 1A

PART 1 — Constitution of clinical commissioning groups

General

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Governing bodies of clinical commissioning groups

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Supplemental

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PART 2 — Further provision about clinical commissioning groups

Status

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Staff

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Accountable officer

12

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Remuneration etc for members of governing bodies

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Additional powers in respect of payment of allowances

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...

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Externally financed development agreements

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Accounts and audits

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Provision of financial information to Board

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Provision of information required by the Secretary of State

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Incidental powers

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Seal and evidence

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PART 3 — Transfer schemes

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Power to make provision about voting

30

(1) Regulations may amend this Chapter so as to add, vary or omit provision relating to voting by members of the council of governors of a public benefit corporation that is an NHS foundation trust, by its directors or by its members.

(2) The power under sub-paragraph (1) is exercisable only in relation to provision in this Chapter that was inserted, or otherwise provided for, by Part 4 of the Health and Social Care Act 2012.

1G

(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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Objective of trust special administration

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

Chapter 5A — Notices and penalties

150A

(1) The Secretary of State may by regulations provide that where a practitioner who provides pharmaceutical services under arrangements with NHS England breaches a term of those arrangements, NHS England may—

(a) by a notice require the practitioner to do, or not do, specified things or things of a specified description within a specified period, or

(b) in prescribed circumstances or for a prescribed period, withhold all or part of a payment due to the practitioner under the arrangements.

(2) Regulations under this section must include provision conferring on such persons as may be prescribed rights of appeal from decisions of NHS England made by virtue of this section.

(3) In this section—

“practitioner” means a person included in a pharmaceutical list, and

“specified” means specified in a notice under paragraph (a) of subsection (1).

Definitions

Interim Accounts

Seal and evidence

Role of NHS England in the health service in England

1H

(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.

Role of integrated care boards in the health service in England

1I

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.

Exercise of Secretary of State's public health functions

7A.

(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,

(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).

Miscellaneous

12E

(1) The Secretary of State must not exercise the functions mentioned in subsection (2) for the purpose of causing a variation in the proportion of services provided as part of the health service that is provided by persons of a particular description if that description is by reference to—

(a) whether the persons in question are in the public or (as the case may be) private sector, or

(b) some other aspect of their status.

(2) The functions mentioned in this subsection are the functions of the Secretary of State under—

(a) section 6E;

(b) section 12ZB;

Non-executive members: tenure

SCHEDULE A1

1

(1) NHS England is not to be regarded as a servant or agent of the Crown, or as enjoying any status, privilege or immunity of the Crown.

(2) NHS England’s property is not to be regarded as property of, or property held on behalf of, the Crown.

2

(1) NHS England is to consist of—

(a) a chair appointed by the Secretary of State,

(b) at least five other members so appointed, and

(2) In this Schedule—

(a) references to non-executive members of NHS England are references to the members appointed in accordance with sub-paragraph (1)(a) and (b), and

(b) references to executive members of NHS England are references to the other members.

(3) The number of executive members must be less than the number of non-executive members.

3

(1) The chief executive and the other executive members of the Board are to be appointed by the non-executive members.

(2) A person may not be appointed as chief executive without the consent of the Secretary of State.

(3) The chief executive and the other executive members are to be employees of the Board.

(4) The first chief executive of the Board is to be appointed by the Secretary of State.

4

(1) A person holds and vacates office as a non-executive member of NHS England in accordance with that person’s terms of appointment.

(2) A person may at any time resign from office as a non-executive member by giving notice to the Secretary of State.

(3) The Secretary of State may at any time remove a person from office as a non-executive member on any of the following grounds—

(a) incapacity,

(b) misbehaviour, or

(4) The Secretary of State may suspend a person from office as a non-executive member if it appears to the Secretary of State that there are or may be grounds to remove that person from office under sub-paragraph (3).

(5) A person may not be appointed as a non-executive member for a period of more than four years.

(6) A person who ceases to be a non-executive member is eligible for re-appointment.

5

(1) This paragraph applies where a person is suspended under paragraph 4(4).

(2) The Secretary of State must give notice of the decision to the person; and the suspension takes effect on receipt by the person of the notice.

(3) The notice may be—

(a) delivered in person (in which case the person is taken to receive it when it is delivered), or

(b) sent by first class post to the person’s last known address (in which case, the person is taken to receive it on the third day after the day on which it is posted).

(4) The initial period of suspension must not exceed six months.

(5) The Secretary of State may at any time review the suspension.

(6) The Secretary of State—

(a) must review the suspension if requested in writing by the person to do so, but

(b) need not review the suspension less than three months after the beginning of the initial period of suspension.

(7) Following a review during a period of suspension, the Secretary of State may—

(a) revoke the suspension, or

(b) suspend the person for another period of not more than six months from the expiry of the current period.

(8) The Secretary of State must revoke the suspension if the Secretary of State —

(a) decides that there are no grounds to remove the person from office under paragraph 4(3), or

(b) decides that there are grounds to do so but does not remove the person from office under that provision.

6

(1) Where a person is suspended from office as the chair under paragraph 4(4), the Secretary of State may appoint a non-executive member as interim chair to exercise the chair’s functions.

(2) Appointment as interim chair is for a term not exceeding the shorter of—

(a) the period ending with either—

(i) the appointment of a new chair, or

(ii) the revocation or expiry of the existing chair’s suspension, and

(b) the remainder of the interim chair’s term as a non-executive member.

(3) A person who ceases to be the interim chair is eligible for re-appointment.

7

(1) NHS England must pay to its non-executive members such remuneration as the Secretary of State may determine.

(2) NHS England must pay or make provision for the payment of such pensions, allowances or gratuities as the Secretary of State may determine to or in respect of any person who is or has been a non-executive member of NHS England.

(3) If a person ceases to be a non-executive member and the Secretary of State decides that there are exceptional circumstances which mean that the person should be compensated, NHS England must pay compensation to the person of such amount as the Secretary of State may, with the approval of the Treasury, determine.

8

NHS England may appoint such persons to be employees of NHS England as it considers appropriate.

9

(1) Employees of NHS England are to be paid such remuneration and allowances as NHS England may determine.

(2) Employees of NHS England are to be appointed on such other terms and conditions as NHS England may determine.

(3) NHS England may pay or make provision for the payment of such pensions, allowances or gratuities as it may determine to or in respect of any person who is or has been an employee of NHS England.

(4) Before making a determination as to remuneration, pensions, allowances or gratuities for the purposes of this paragraph, NHS England must obtain the approval of the Secretary of State to its policy on the matter.

10

(1) NHS England may appoint such committees and sub-committees as it considers appropriate.

(2) A committee or sub-committee may consist of or include persons who are not members or employees of NHS England.

(3) NHS England may pay such remuneration and allowances as it determines to any person who—

(a) is a member of a committee or a sub-committee, but

(b) is not an employee of NHS England,

whether or not that person is a non-executive member of NHS England.

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12

(1) NHS England may regulate its own procedure.

(2) The validity of any act of NHS England is not affected by any vacancy among the members or by any defect in the appointment of any member.

Exercise of functions

13

NHS England may arrange for the exercise of any of its functions on its behalf by—

(a) any non-executive member,

(b) any employee (including any executive member), or

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(1) NHS England must keep proper accounts and proper records in relation to the accounts.

(2) The Secretary of State may, with the approval of the Treasury, give directions to NHS England as to—

(a) the content and form of its accounts, and

(b) the methods and principles to be applied in the preparation of its accounts.

(3) In sub-paragraph (2) the reference to accounts includes a reference to NHS England’s consolidated annual accounts prepared under paragraph 16 and any interim accounts prepared by virtue of paragraph 17.

(4) The chief executive of NHS England is to be its accounting officer.

16

(1) The Board must prepare consolidated annual accounts in respect of each financial year.

(2) The consolidated annual accounts must contain—

(a) the Board’s annual accounts, and

(b) a consolidation of the Board’s annual accounts and the annual accounts of each clinical commissioning group.

(3) The Board must send copies of the consolidated annual accounts to—

(a) the Secretary of State, and

(b) the Comptroller and Auditor General,

within such period after the end of the financial year to which the accounts relate as the Secretary of State may direct.

(4) The Comptroller and Auditor General must—

(a) examine, certify and report on the consolidated annual accounts, and

(b) lay copies of the accounts and the report on them before Parliament.

(5) In this paragraph, “financial year” includes the period which begins with the day on which the Board is established and ends on the following 31 March.

Interim Accounts

17

(1) The Secretary of State may, with the approval of the Treasury, direct the Board to prepare accounts in respect of such period or periods as may be specified in the direction (“interim accounts”).

(2) The interim accounts in respect of any period must contain—

(a) the Board’s accounts in respect of that period, and

(b) a consolidation of the Board’s accounts in respect of that period and any accounts of clinical commissioning groups in respect of that period which are prepared by virtue of paragraph 17(3) of Schedule 1A.

(3) The Board must send copies of any interim accounts to—

(a) the Secretary of State, and

(b) if the Secretary of State so directs, the Comptroller and Auditor General,

within such period as the Secretary of State may direct.

(4) The Comptroller and Auditor General must—

(a) examine, certify and report on any interim accounts sent by virtue of sub-paragraph (3)(b),

(b) if the Secretary of State so directs, send a copy of the report on the accounts to the Secretary of State, and

Seal and evidence

18

(1) The application of NHS England’s seal must be authenticated by the signature of any member of NHS England or any other person who has been authorised (generally or specially) for that purpose.

(2) A document purporting to be duly executed under NHS England’s seal or to be signed on its behalf must be received in evidence and, unless the contrary is proved, taken to be so executed or signed.

1A

(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

(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.

1B

(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).

1C

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.

1D

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1E

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.

1F

(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,

(d) the Health Act 2009, and

(e) the Health and Social Care Act 2012.

Provision for protection or improvement of public health

2A

(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);

(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.

2B

(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);

(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;

(d) the Council of the Isles of Scilly;

(e) the Common Council of the City of London.

3A.

(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.

Directions to certain NHS bodies

10A

(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.

12ZA

(1) This section applies in relation to arrangements made by NHS England or an integrated care board in the exercise of functions under section 3, 3A, 3B or 4 or Schedule 1.

(2) The arrangements may be made with any person or body (including public authorities and voluntary organisations).

(2A) The arrangements may confer discretions on a person with whom they are made in relation to anything to be provided under the arrangements.

(3) If NHS England or an integrated care board arranges for the provision of facilities by a service provider, it may also make arrangements for those facilities to be made available to another service provider or to an eligible voluntary organisation.

(4) NHS England or an integrated care board may make available any of its facilities to—

(a) a service provider, or

(b) an eligible voluntary organisation.

(5) Where facilities are made available under subsection (4) any of the following persons may make available the services of any employee of that person who is employed in connection with the facilities—

(a) the Secretary of State,

(b) NHS England,

(d) a Special Health Authority, or

(e) a Local Health Board.

(6) Goods or materials may be made available under this section either temporarily or permanently.

(7) Any power to supply goods or materials under this section includes—

(a) a power to purchase or store them, and

(b) a power to arrange with third parties for the supply of goods or materials by those third parties.

(8) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments.

(9) In this section—

“eligible voluntary organisation” means a voluntary organisation eligible for assistance under section 64 or section 65 of the Health Services and Public Health Act 1968;

“service provider” means a person or body with whom NHS England or an integrated care board has made arrangements in the exercise of the functions mentioned in subsection (1).

42A

(1) The Secretary of State must publish guidance on the powers conferred by sections 40 and 42.

(2) The guidance on the power to make a loan under section 40(1) must in particular—

(a) explain that, in exercising the power, the Secretary of State will apply the principle that a loan should be made only where there is a reasonable expectation that it will be repaid in accordance with the terms on which it is made;

(b) include other criteria that the Secretary of State will apply when determining whether to exercise the power and, if so, the terms on which to make the loan.

(3) The guidance on that power must also explain—

(a) the process for applying for a loan under section 40(1);

(b) the consequences of failing to comply with terms on which a loan is made under that provision.

(4) The guidance on the power to decide terms under section 42(3) must, in particular, include the criteria that the Secretary of State will apply when deciding the terms.

(5) The guidance on that power must also explain the consequences of failing to comply with the terms decided.

(6) In preparing guidance under this section, the Secretary of State must have regard (among other things) to any generally accepted principles used by financial institutions to determine whether to make loans to bodies corporate and the terms on which to make loans to them.

(7) Before publishing the guidance, the Secretary of State must consult—

(a) the Treasury,

(b) NHS England, and

51A

(1) An NHS foundation trust may enter into a significant transaction only if more than half of the members of the council of governors of the trust voting approve entering into the transaction.

(2) “Significant transaction” means a transaction or arrangement of such description as may be specified in the trust's constitution.

(3) If an NHS foundation trust does not wish to specify any descriptions of transaction or arrangement for the purposes of subsection (2), the constitution of the trust must specify that it contains no such descriptions.

56A

(1) An application may be made jointly by—

(a) an NHS foundation trust (A), and

(b) another NHS foundation trust or an NHS trust established under section 25 (B),

to NHS England for the acquisition by A of B.

(2) An application under this section may be made only with the approval of more than half of the members of the council of governors of each applicant (that is an NHS foundation trust).

(3) The application must—

(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b) be accompanied by a copy of the proposed constitution of A, amended on the assumption that A acquires B.

(4) NHS England must grant the application if—

(a) it is satisfied that such steps as are necessary to prepare for the acquisition have been taken, and

(b) the Secretary of State approves the grant of the application,

and must otherwise refuse the application.

(4A) Where NHS England proposes to grant the application, it may by order make provision for the transfer of employees of B to A on the grant of the application.

(5) On the grant of the application, the proposed constitution has effect, but where a person who is specified as a director of A in the constitution has yet to be appointed as such, the directors of A may exercise that person's functions under the constitution.

56B

(1) An application may be made to NHS England by an NHS foundation trust for the dissolution of the trust and the establishment of two or more new NHS foundation trusts.

(2) An application under this section may be made only with the approval of more than half of the members of the council of governors of the applicant.

(3) The application must, by reference to each of the proposed new trusts—

(a) specify the property and liabilities proposed to be transferred to it;

(b) be accompanied by a copy of its proposed constitution.

(4) NHS England must grant the application if—

(a) it is satisfied that such steps as are necessary to prepare for the dissolution of the trust and the establishment of each of the proposed new trusts have been taken, and

(b) the Secretary of State approves the grant of the application,

and must otherwise refuse the application.

(5) On the grant of the application, the proposed constitution of each of the new trusts has effect but, in the case of each of the new trusts, the proposed directors may exercise the functions of the trust on its behalf until a board of directors is appointed in accordance with the constitution.

57A

(1) An application may be made by an NHS foundation trust to NHS England for dissolution.

(2) An application under this section may be made only with the approval of more than half of the members of the council of governors of the applicant.

(3) NHS England must grant the application if it is satisfied that—

(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b) such steps as are necessary to prepare for the dissolution have been taken.

(4) Where an application under this section is granted, NHS England must make an order—

(a) dissolving the trust in question, and

(b) transferring, or providing for the transfer of, the property and liabilities (including criminal liabilities) to another NHS foundation trust, an NHS trust established under section 25 or the Secretary of State.

(5) The order must include provision for the transfer of any employees of the NHS foundation trust that is dissolved.

65DA

(1) The objective of a trust special administration is to secure—

(a) the continued provision of such of the services provided for the purposes of the NHS by the NHS foundation trust that is subject to an order under section 65D(2), at such level, as the commissioners of those services determine, and

(aa) that the services whose continuous provision is secured as mentioned in paragraph (a) are of sufficient safety and quality to be provided under this Act,

(b) that it becomes unnecessary for the order to remain in force for that purpose.

(2) The commissioners may determine that the objective set out in subsection (1) is to apply to a service only if they are satisfied that the criterion in subsection (3) is met.

(3) The criterion is that ceasing to provide the service under this Act would, in the absence of alternative arrangements for its provision under this Act, be likely to—

(a) have a significant adverse impact on the health of persons in need of the service or significantly increase health inequalities, or

(b) cause a failure to prevent or ameliorate either a significant adverse impact on the health of such persons or a significant increase in health inequalities.

(4) In determining whether that criterion is met, the commissioners must (in so far as they would not otherwise be required to do so) have regard to—

(a) the current and future need for the provision of the service under this Act,

(b) whether ceasing to provide the service under this Act would significantly reduce equality between those for whom the commissioner arranges for the provision of services under this Act with respect to their ability to access services so provided, and

(5) NHS England may revise guidance under subsection (4)(c) and, if it does so, must publish the guidance as revised.

(5A) Before publishing guidance under subsection (4)(c), NHS England must consult the Care Quality Commission.

(6) Before publishing guidance under subsection (4)(c) or (5), NHS England must obtain the approval of—

(a) the Secretary of State;

(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(7) NHS England must make arrangements for facilitating agreement between commissioners in determining the services provided by the trust under this Act to which the objective set out in subsection (1) is to apply.

(8) Where commissioners fail to reach agreement in pursuance of arrangements under subsection (7), NHS England may make the determination (and the duty imposed by subsection (1)(a), so far as applying to the commissioners concerned, is to be regarded as discharged).

(9) In this section—

“commissioners” means the persons to which the trust provides services under this Act, and

“health inequalities” means the inequalities between persons with respect to the outcomes achieved for them by the provision of services that are provided as part of the health service.

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

Directed partnership arrangements

73B

(1) A local authority must, in the exercise of any functions mentioned in subsection (2), have regard to any document published by the Secretary of State for the purposes of this section.

(2) The functions mentioned in this subsection are—

(a) the exercise by the authority of its functions under section 2B, 111 or 249 or Schedule 1,

(b) the exercise by the authority of its functions by virtue of section 6C(1) or (3),

(ca) any public health functions of the Secretary of State exercisable by the authority in pursuance of arrangements made with another body by virtue of section 65Z5 or 75,

(d) the functions of the authority under section 325 of the Criminal Justice Act 2003, and

(e) such other functions relating to public health as may be prescribed.

(3) The Secretary of State may give guidance to local authorities as to the exercise of any functions mentioned in subsection (2).

(4) A document published under subsection (1), and guidance given under subsection (3), may include guidance as to the appointment of officers of the local authority to discharge any functions mentioned in subsection (2), and as to their terms and conditions, management and dismissal.

(5) The director of public health for a local authority must prepare an annual report on the health of the people in the area of the local authority.

(6) The local authority must publish the report.

(7) In this section, “local authority” has the same meaning as in section 2B.

165A

(1) NHS England must provide the Secretary of State with such information relating to the remuneration paid by NHS England to persons providing pharmaceutical services or local pharmaceutical services as the Secretary of State may require.

(2) The information must be provided in such form, and at such time or within such period, as the Secretary of State may require.

(3) Schedule 12A makes further provision about pharmaceutical remuneration.

223A.

(1) Section 223 applies in relation to an integrated care board as it applies in relation to NHS England.

(2) But the powers conferred by that section are exercisable by an integrated care board only for the purpose of securing improvement—

(a) in the physical and mental health of the group of people for whom it has core responsibility (see section 14Z31), or

(b) in the prevention, diagnosis and treatment of illness in such people.

Co-operation in relation to public health functions

247B

(1) This section applies to any body or other person that exercises functions similar to those of the Secretary of State under section 2A (whether or not in relation to the United Kingdom).

(2) The Secretary of State must co-operate with the body or other person in the exercise by it of those functions.

(3) If the Secretary of State acts under subsection (2) at the request of the body or other person, the Secretary of State may impose charges in respect of any costs incurred by the Secretary of State in doing so.

(4) The body or other person must co-operate with the Secretary of State in the exercise by the Secretary of State of functions under section 2A.

(5) If the body or other person acts under subsection (4) at the request of the Secretary of State, it may impose charges in respect of any costs incurred by it in doing so.

Duty to keep under review

247C

(1) The Secretary of State must keep under review the effectiveness of the exercise by the bodies mentioned in subsection (2) of functions in relation to the health service in England.

(2) The bodies mentioned in this subsection are—

(a) NHS England;

(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(d) the National Institute for Health and Care Excellence;

(e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(ea) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(eb) the Health Services Safety Investigations Body;

(f) Special Health Authorities.

(3) The Secretary of State may include in an annual report under section 247D the Secretary of State's views on the effectiveness of the exercise by the bodies mentioned in subsection (2) of functions in relation to the health service.

Annual report

247D

(1) The Secretary of State must publish an annual report on the performance of the health service in England.

(2) The report must include the Secretary of State's assessment of the effectiveness of the discharge of the duties under sections 1A and 1C.

(3) The Secretary of State must lay any report prepared under this section before Parliament.

252A

(1) NHS England and each integrated care board must take appropriate steps for securing that it is properly prepared for dealing with a relevant emergency.

(2) NHS England must take such steps as it considers appropriate for securing that each integrated care board is properly prepared for dealing with a relevant emergency.

(3) The steps taken by NHS England under subsection (2) must include monitoring compliance by each integrated care board with its duty under subsection (1).

(4) NHS England must take such steps as it considers appropriate for securing that each relevant service provider is properly prepared for dealing with a relevant emergency.

(5) The steps taken by NHS England under subsection (4) must include monitoring compliance by the service provider with any requirements imposed on it by its service arrangements for the purpose of securing that it is properly prepared for dealing with a relevant emergency.

(6) NHS England may take such steps as it considers appropriate for facilitating a co-ordinated response to an emergency by the integrated care boards and relevant service providers for which it is a relevant emergency.

(7) NHS England may arrange for any body or person to exercise any functions of NHS England under subsections (2) to (6).

(8) Where NHS England makes arrangements with another body or person under subsection (7) it may also arrange for that other body or person to exercise any functions that NHS England has, by virtue of being a Category 1 responder, under Part 1 of the Civil Contingencies Act 2004.

(9) A relevant service provider must appoint an individual to be responsible for—

(a) securing that the provider is properly prepared for dealing with a relevant emergency,

(b) securing that the provider complies with any requirements mentioned in subsection (5), and

(c) providing NHS England with such information as it may require for the purpose of discharging its functions under this section.

(10) In this section—

“relevant emergency”—in relation to NHS England or an integrated care board, means any emergency which might affect NHS England or the board (whether by increasing the need for the services that it may arrange or in any other way);in relation to a relevant service provider, means any emergency which might affect the provider (whether by increasing the need for the services that it may provide or in any other way);

“relevant service provider” means any body or person providing services in pursuance of service arrangements;

“service arrangements” means arrangements made by virtue of this Act for the provision of services.

Support functions of the Secretary of State

254A

(1) The Secretary of State may, for the purpose of assisting any person exercising functions in relation to the health service or providing services for its purposes—

(a) provide (or otherwise make available) to the person goods, materials or other facilities;

(b) facilitate the recruitment and management of the person's staff;

(d) do such other things to facilitate or support the carrying out of the person's functions or other activities as the Secretary of State considers appropriate;

(e) arrange for any other person to do anything mentioned in paragraphs (a) to (d) or to assist the Secretary of State in doing any such thing.

(2) The power conferred by subsection (1)(a) includes power to purchase goods and materials for the purpose of providing them or making them available.

(3) The Secretary of State may, in connection with anything done under subsection (1), make available the services of any person employed by the Secretary of State.

(4) The powers conferred by this section may be exercised on such terms, including terms as to the making of payments to or by the Secretary of State, as may be agreed.

(5) In this section, “the health service” does not include that part of the health service that is provided in pursuance of the public health functions of the Secretary of State or local authorities.

271A

(1) Services to which this section applies are to be treated as services of the Crown for the purposes of—

(a) Schedule 1 to the Registered Designs Act 1949 (provisions as to the use of registered designs for the services of the Crown etc.), and

(b) sections 55 to 59 of the Patents Act 1977 (use of patented inventions for the services of the Crown).

(2) This section applies to services provided in pursuance of—

(a) the functions of NHS England or an integrated care board under section 3, 3A, 3B or 4 or Schedule 1, or

(b) the public health functions of a local authority.

Supply of blood and other human tissues

7C

The Secretary of State must for the purposes of the health service make arrangements for—

(a) collecting, screening, analysing, processing and supplying blood or other tissues,

(b) preparing blood components and reagents, and

10A

The general duties of the council of governors are—

(a) to hold the non-executive directors individually and collectively to account for the performance of the board of directors, and

(b) to represent the interests of the members of the corporation as a whole and the interests of the public.

10B

A public benefit corporation must take steps to secure that the governors are equipped with the skills and knowledge they require in their capacity as such.

10C

For the purpose of obtaining information about the corporation's performance of its functions or the directors' performance of their duties (and deciding whether to propose a vote on the corporation's or directors' performance), the council of governors may require one or more of the directors to attend a meeting.

18A

The general duty of the board of directors, and of each director individually, is to act with a view to promoting the success of the corporation so as to maximise the benefits for the members of the corporation as a whole and for the public.

18B

(1) The duties that a director of a public benefit corporation has by virtue of being a director include in particular—

(a) a duty to avoid a situation in which the director has (or can have) a direct or indirect interest that conflicts (or possibly may conflict) with the interests of the corporation;

(b) a duty not to accept a benefit from a third party by reason of being a director or doing (or not doing) anything in that capacity.

(2) The duty referred to in sub-paragraph (1)(a) is not infringed if—

(a) the situation cannot reasonably be regarded as likely to give rise to a conflict of interest, or

(b) the matter has been authorised in accordance with the constitution.

(3) The duty referred to in sub-paragraph (1)(b) is not infringed if acceptance of the benefit cannot reasonably be regarded as likely to give rise to a conflict of interest.

(4) In sub-paragraph (1)(b), “third party” means a person other than—

(a) the corporation, or

(b) a person acting on its behalf.

18C

(1) If a director of a public benefit corporation has in any way a direct or indirect interest in a proposed transaction or arrangement with the corporation, the director must declare the nature and extent of that interest to the other directors.

(2) If a declaration under this paragraph proves to be, or becomes, inaccurate or incomplete, a further declaration must be made.

(3) Any declaration required by this paragraph must be made before the corporation enters into the transaction or arrangement.

(4) This paragraph does not require a declaration of an interest of which the director is not aware or where the director is not aware of the transaction or arrangement in question.

(5) A director need not declare an interest—

(a) if it cannot reasonably be regarded as likely to give rise to a conflict of interest;

(b) if, or to the extent that, the directors are already aware of it;

(i) by a meeting of the board of directors, or

(ii) by a committee of the directors appointed for the purpose under the constitution.

18D

(1) Before holding a meeting, the board of directors must send a copy of the agenda of the meeting to the council of governors.

(2) As soon as practicable after holding a meeting, the board of directors must send a copy of the minutes of the meeting to the council of governors.

18E

(1) The constitution must provide for meetings of the board of directors to be open to members of the public.

(2) But the constitution may provide for members of the public to be excluded from a meeting for special reasons.

Annual meeting of members

27A

(1) A public benefit corporation must hold an annual meeting of its members.

(2) The meeting must be open to members of the public.

(3) At least one member of the board of directors of the corporation must attend the meeting and present the following documents to the members at the meeting—

(a) the annual accounts,

(b) any report of the auditor on them,

(4) Where an amendment is made to the constitution in relation to the powers or duties of the council of governors of a public benefit corporation (or otherwise with respect to the role that the council has as part of the corporation)—

(a) at least one member of the council of governors must attend the next meeting to be held under this paragraph and present the amendment, and

(b) the corporation must give the members an opportunity to vote on whether they approve the amendment.

(5) If more than half of the members voting approve the amendment, the amendment continues to have effect; otherwise, it ceases to have effect and the corporation must take such steps as are necessary as a result.

Combined meetings of members and governors

28A

A public benefit corporation may hold a meeting which combines a meeting under paragraph 27A with a meeting under paragraph 28.

SCHEDULE 12A

Interpretation

1

In this Schedule—

(a) “drugs” includes medicines and listed appliances (within the meaning of section 126), and

(b) “pharmaceutical remuneration” means remuneration paid by NHS England to persons providing pharmaceutical services or local pharmaceutical services.

Pharmaceutical remuneration to be apportioned among integrated care boards

2

(1) NHS England must determine the elements of pharmaceutical remuneration in respect of which apportionments are to be made in relation to a financial year in accordance with this paragraph.

(2) In this Schedule, those elements of pharmaceutical remuneration are referred to as “designated elements”.

(3) NHS England must notify each integrated care board of a determination under sub-paragraph (1).

(4) NHS England must apportion the sums paid by it in respect of each designated element during the financial year among all integrated care boards, in such manner as NHS England thinks appropriate.

(5) In apportioning sums under sub-paragraph (4), NHS England may, in particular, take into account the financial consequences of orders for the provision of drugs that are attributable to the members of each integrated care board.

(6) Where an amount of pharmaceutical remuneration is apportioned to an integrated care board, NHS England—

(a) may deduct that amount from the sums that it would otherwise pay to the board under section 223G(1), and

(b) if it does so, must notify the board accordingly.

(7) The Secretary of State may direct NHS England that an element of pharmaceutical remuneration specified in the direction is not to be included in a determination under sub-paragraph (1).

(8) In determining the amount to be allotted to an integrated care board for the purposes of section 223G, NHS England must take into account the effect of this Schedule.

(9) For the purposes of sections 223GC and 223M (1)(b) and paragraph 22 of Schedule 1B, any amount of which an integrated care board is notified under sub-paragraph (6) is to be treated as expenditure of the group which is attributable to the performance by it of its functions in the year in question.

Other pharmaceutical remuneration

3

(1) This paragraph applies in relation to pharmaceutical remuneration paid in a financial year other than—

(a) designated elements of such remuneration, and

(b) remuneration of a prescribed description.

(2) NHS England may require a person to reimburse NHS England for any pharmaceutical remuneration to which this paragraph applies if the drugs or services to which the remuneration relates were—

(a) ordered by that person, or

(b) ordered in the course of the delivery of a service arranged by that person.

(3) Any sum payable to NHS England by virtue of sub-paragraph (2) may be recovered summarily as a civil debt (but this does not affect any other method of recovery).

Exercise of functions

4

NHS England may, with the consent of the Secretary of State—

(a) direct a Special Health Authority to exercise any functions of NHS England under this Schedule, or

(b) arrange for any other person to exercise any of those functions.

6BA

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

6BB

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

Conditions of supply under section 80

223GA

(1) Where the Secretary of State has given NHS England a direction under section 223B(6)(a) about sums paid to it in respect of a financial year, NHS England may direct an integrated care board that an amount (a “designated amount”) of the sums paid to the board under section 223G in respect of that year is to be used for purposes relating to service integration.

(2) The designated amount—

(a) is to be determined in such manner as NHS England considers appropriate, and

(b) must be specified in the direction under subsection (1).

(3) The conditions under section 223G(7) subject to which the payment of a designated amount is made must include a condition that the integrated care board transfers the amount into one or more funds (“pooled funds”) established under arrangements under section 75(2)(a) (“pooling arrangements”).

(4) The conditions may also include—

(a) conditions relating to the preparation and agreement by the integrated care board and each local authority and other integrated care board that is party to the pooling arrangements of a plan for how to use the designated amount (a “spending plan”);

(b) conditions relating to the approval of a spending plan by NHS England;

(d) conditions relating to the meeting of any performance objectives included in a spending plan or specified by NHS England.

(5) Where a condition subject to which the payment of a designated amount is made is not met, NHS England may—

(a) withhold the payment (in so far as it has not been made);

(b) recover the payment (in so far as it has been made);

(c) direct the integrated care board as to the use of the designated amount for purposes relating to service integration or for making payments under section 256.

(6) Where NHS England withholds or recovers a payment under subsection (5)(a) or (b)—

(a) it may use the amount for any purposes relating to service integration, and

(b) in so far as the exercise of the power under paragraph (a) involves making a payment to a different integrated care board or some other person, the making of the payment is subject to such conditions as NHS England may determine.

(7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(8) The power under subsection (5)(b) to recover a payment may be exercised in a financial year after the one in respect of which the payment was made.

(9) The payments that may be made out of a pooled fund into which a designated amount is transferred include payments to a local authority which is not party to the pooling arrangements in question in connection with the exercise of its functions under Part 1 of the Housing Grants, Construction and Regeneration Act 1996 (disabilities facilities grants).

(10) In exercising a power under this section, NHS England must have regard to the extent to which there is a need for the provision of each of the following—

(a) health services (see subsection (12)),

(b) health-related services (within the meaning given in section 14Z42), and

(11) A reference in this section to service integration is a reference to the integration of the provision of health services with the provision of health-related services or social care services, as referred to in sections 13N and 14Z42.

(12) “Health services” means services provided as part of the health service in England.

56AA

(1) On the grant of an application under section 56A—

(a) any order made by NHS England under section 56A(4A) takes effect,

(b) the property and liabilities of the acquired NHS foundation trust or NHS trust are transferred to the acquiring NHS foundation trust (other than rights and liabilities which may be dealt with by order under section 56A(4A)),

(d) where the acquired trust is an NHS trust, the NHS trust order establishing it is revoked.

(2) So far as may be necessary for the purposes of subsection (1)(b)—

(a) anything done before the grant of the application by or in relation to the acquired trust is to be treated (on and after the grant) as having been done by or in relation to the acquiring trust;

(b) any reference in a document to the acquired trust is to be read as a reference to the acquiring trust.

(3) Anything (including legal proceedings) that, immediately before the grant of the application, is in the process of being done by or in relation to the acquired trust may continue to be done afterwards by or in relation to the acquiring trust.

(4) In subsection (1)—

(a) “liabilities” includes criminal liabilities;

(b) “property” includes trust property.

13ZA

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

13ZB

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

14Z3A

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

264A

(1) References in this section to a UK producer are to a person who manufactures, distributes or supplies any UK health service products.

(2) Regulations may require any UK producer to—

(a) record and keep information which the Secretary of State may require for the purpose specified in subsection (3), and

(b) provide that information to the Secretary of State,

(subject to subsection (9)).

(3) The purpose is that of enabling or facilitating any of the following—

(a) the determination of the payments to be made to any persons who provide primary medical services under Part 4;

(b) the determination of the remuneration to be paid to any persons who provide pharmaceutical services under Part 7;

(i) adequate supplies of English health service products are available, and

(ii) the terms on which those products are available represent value for money;

(d) the determination of the payments to be made to any persons who provide primary medical services under Part 4 of the National Health Service (Wales) Act 2006;

(e) the determination of the remuneration to be paid to any persons who provide pharmaceutical services under Part 7 of that Act;

(f) the consideration by the Welsh Ministers of whether—

(i) adequate supplies of Welsh health service products are available, and

(ii) the terms on which those products are available represent value for money;

(g) the determination of the payments to be made to any persons who provide primary medical services under section 2C(1) of the National Health Service (Scotland) Act 1978 (“the 1978 Act”);

(h) the determination of the remuneration to be paid to any persons who provide pharmaceutical care services under section 2CA(1) of the 1978 Act;

(i) the consideration by the Scottish Ministers of whether—

(i) adequate supplies of Scottish health service products are available, and

(ii) the terms on which those products are available represent value for money;

(j) the determination of the remuneration to be paid to any persons who provide primary medical services or pharmaceutical services under Part 2 or 6 of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I. 14));

(k) the consideration by a Northern Ireland department of whether—

(i) adequate supplies of Northern Ireland health service products are available, and

(ii) the terms on which those products are available represent value for money;

(l) the exercise by the Secretary of State of any powers under sections 260 to 264 and 265;

(m) the operation of a voluntary scheme.

(4) The information which the Secretary of State may require from a UK producer by virtue of this section includes the following—

(a) the price charged or paid by the producer for UK health service products;

(b) the price charged or paid by the producer for delivery or other services in connection with the manufacturing, distribution or supply of UK health service products;

(c) the discounts or rebates or other payments given or received by the producer in connection with the manufacturing, distribution or supply of UK health service products;

(d) the revenue or profits accrued to the producer in connection with the manufacturing, distribution or supply of UK health service products (including, in relation to profits, the costs incurred by the producer in connection with the manufacturing, distribution or supply of the products);

(e) such information about medicinal products, other medical supplies or other related products as is necessary to verify whether they are UK health service products and, if so, which of the following they are—

(i) English health service products;

(ii) Welsh health service products;

(iii) Scottish health service products;

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