Health and Care Act 2022

(14Z32) (1) Each integrated care board must, in the exercise of its functions— (a) act with a view to securing that health services are provided in a way which promotes the NHS Constitution, and (b) promote awareness of the NHS Constitution among patients, staff and members of the public. (2) In this section, “patients” and “staff” have the same meaning as in Chapter 1 of Part 1 of the Health Act 2009 (see section 3(7) of that Act). (14Z33) Each integrated care board must exercise its functions effectively, efficiently and economically. (14Z34) (1) Each integrated care board must exercise its functions with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness. (2) In discharging its duty under subsection (1), an integrated care board must, in particular, act with a view to securing continuous improvement in the outcomes that are achieved from the provision of the services. (3) The outcomes relevant for the purposes of subsection (2) include, in particular, outcomes which show— (a) the effectiveness of the services, (b) the safety of the services, and (c) the quality of the experience undergone by patients. (14Z35) Each integrated care board must, in the exercise of its functions, have regard to the need to— (a) reduce inequalities between persons with respect to their ability to access health services, and (b) reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services (including the outcomes described in section 14Z34(3)). (14Z36) Each integrated care board must, in the exercise of its functions, promote the involvement of patients, and their carers and representatives (if any), in decisions which relate to— (a) the prevention or diagnosis of illness in the patients, or (b) their care or treatment. (14Z37) Each integrated care board must, in the exercise of its functions, act with a view to enabling patients to make choices with respect to aspects of health services provided to them. (14Z38) Each integrated care board must obtain advice appropriate for enabling it effectively to discharge its functions from persons who (taken together) have a broad range of professional expertise in— (a) the prevention, diagnosis or treatment of illness, and (b) the protection or improvement of public health. (14Z39) Each integrated care board must, in the exercise of its functions, promote innovation in the provision of health services (including innovation in the arrangements made for their provision). (14Z40) Each integrated care board must, in the exercise of its functions, 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. (14Z41) Each integrated care board must, in exercising its functions, have regard to the need to promote education and training for the persons mentioned in section 1F(1) so as to assist the Secretary of State and Health Education England in the discharge of the duty under that section. (14Z42) (1) Each integrated care board must exercise its functions with a view to securing that health services are provided in an integrated way where it considers that this would— (a) improve the quality of those services (including the outcomes that are achieved from their provision), (b) reduce inequalities between persons with respect to their ability to access those services, or (c) reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services. (2) Each integrated care board must exercise its functions with a view to securing that the provision of health services is integrated with the provision of health-related services or social care services where it considers that this would— (a) improve the quality of the health services (including the outcomes that are achieved from the provision of those services), (b) reduce inequalities between persons with respect to their ability to access those services, or (c) reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services. (3) In this section— - “health-related services” means services that may have an effect on the health of individuals but are not health services or social care services; - “social care services” means services that are provided in pursuance of the social services functions of local authorities (within the meaning of the Local Authority Social Services Act 1970 or for the purposes of the Social Services and Well-being (Wales) Act 2014). (4) For the purposes of this section, the provision of housing accommodation is a health-related service. (14Z43) (1) In making a decision about the exercise of its functions, an integrated care board must have regard to all likely effects of the decision in relation to— (a) the health and well-being of the people of England; (b) the quality of services provided to individuals— (i) by relevant bodies, or (ii) in pursuance of arrangements made by relevant bodies, for or in connection with the prevention, diagnosis or treatment of illness, as part of the health service in England; (c) efficiency and sustainability in relation to the use of resources by relevant bodies for the purposes of the health service in England. (2) In subsection (1)— (a) the reference to a decision does not include a reference to a decision about the services to be provided to a particular individual for or in connection with the prevention, diagnosis or treatment of illness; (b) the reference to effects of a decision in relation to the health and well-being of the people of England includes a reference to its effects in relation to inequalities between the people of England with respect to their health and well-being; (c) the reference to effects of a decision in relation to the quality of services provided to individuals includes a reference to its effects in relation to inequalities between individuals with respect to the benefits that they can obtain from those services. (3) In discharging the duty under this section, integrated care boards must have regard to guidance published by NHS England under section 13NB. (4) In this section “relevant bodies” means— (a) NHS England, (b) integrated care boards, (c) NHS trusts established under section 25, and (d) NHS foundation trusts. (14Z44) (1) Each integrated care board must, in the exercise of its functions, have regard to the need to— (a) contribute towards compliance with— (i) section 1 of the Climate Change Act 2008 (UK net zero emissions target), and (ii) section 5 of the Environment Act 2021 (environmental targets), and (b) adapt to any current or predicted impacts of climate change identified in the most recent report under section 56 of the Climate Change Act 2008. (2) In discharging the duty under this section, integrated care boards must have regard to guidance published by NHS England under section 13ND. (14Z45) (1) This section applies in relation to any health services which are, or are to be, provided pursuant to arrangements made by an integrated care board in the exercise of its functions (“commissioning arrangements”). (2) The integrated care board must make arrangements to secure that individuals to whom the services are being or may be provided, and their carers and representatives (if any), are involved (whether by being consulted or provided with information or in other ways)— (a) in the planning of the commissioning arrangements by the integrated care board, (b) in the development and consideration of proposals by the integrated care board for changes in the commissioning arrangements where the implementation of the proposals would have an impact on— (i) the manner in which the services are delivered to the individuals (at the point when the service is received by them), or (ii) the range of health services available to them, and (c) in decisions of the integrated care board affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact. (3) This section does not require an integrated care board to make arrangements in relation to matters to which a trust special administrator’s draft or final report under section 65F or 65I relates before— (a) in a case where the administrator’s report relates to an NHS trust, NHS England and the Secretary of State have made their decisions under section 65K(1) and (2), or (b) in a case where the administrator’s report relates to an NHS foundation trust, the Secretary of State is satisfied as mentioned in section 65KB(1) or 65KD(1) or makes a decision under section 65KD(9). (14Z46) (1) Regulations may provide for any prescribed functions of an integrated care board to be exercised jointly with a Local Health Board. (2) The regulations may permit or require any functions that are exercisable jointly by an integrated care board and a Local Health Board by virtue of the regulations to be exercised by a joint committee of those bodies. (3) Arrangements made by virtue of this section do not affect the liability of an integrated care board for the exercise of any of its functions. (14Z47) (1) An integrated care board has power to do anything specified in section 7(2)(a), (b) and (e) to (h) of the Health and Medicines Act 1988 (provision of goods etc) for the purpose of making additional income available for improving the health service. (2) An integrated care board may exercise a power conferred by subsection (1) only to the extent that its exercise does not to any significant extent interfere with the exercise by the board of its other functions. (14Z48) (1) An integrated care board may make payments— (a) by way of grant to any of its partner NHS trusts or NHS foundation trusts; (b) by way of grant or loan to a voluntary organisation which provides or arranges for the provision of services which are similar to the services in respect of which the integrated care board has functions. (2) The payments may be made subject to such terms as the integrated care board considers appropriate. (3) For the purposes of this Act an NHS trust or NHS foundation trust is a “partner” of an integrated care board if the trust— (a) provides services for the purposes of the health service within the integrated care board’s area, and (b) has the function, under the integrated care board’s constitution, of participating in the nomination of members as a result of falling within a description prescribed for the purposes paragraph 8(2)(a) of Schedule 1B. (14Z49) An integrated care board must— (a) keep under review the skills, knowledge and experience that it considers necessary for members of the board to possess (when taken together) in order for the board effectively to carry out its functions, and (b) if it considers that the board as constituted lacks the necessary skills, knowledge and experience, take such steps as it considers necessary to address or mitigate that shortcoming. (14Z50) (1) NHS England may publish a document specifying— (a) circumstances in which an integrated care board is liable to make a payment to a person in respect of services provided by that person in pursuance of arrangements made by another integrated care board in the discharge of commissioning functions, and (b) how the amount of any such payment is to be determined. (2) An integrated care board is required to make payments in accordance with any document published under subsection (1). (3) Where an integrated care board is required to make a payment by virtue of subsection (2), no other integrated care board is liable to make it. (4) Accordingly, any obligation of another integrated care board to make the payment ceases to have effect. (5) Any sums payable by virtue of subsection (2) may be recovered summarily as a civil debt (but this does not affect any other method of recovery). (6) NHS England may publish guidance for integrated care boards for the purpose of assisting them in understanding and applying any document published under subsection (1). (7) In this section “commissioning functions” means the functions of integrated care boards in arranging for the provision of services as part of the health service. (14Z51) (1) NHS England must publish guidance for integrated care boards on the discharge of their functions. (2) Each integrated care board must have regard to guidance under this section. (14Z52) (1) Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out how they propose to exercise their functions in the next five years. (2) The plan must, in particular— (a) describe the health services for which the integrated care board proposes to make arrangements in the exercise of its functions by virtue of this Act; (b) explain how the integrated care board proposes to discharge its duties under— (i) sections 14Z34 to 14Z45 (general duties of integrated care boards), and (ii) sections 223GB to 223N (financial duties); (c) set out any steps that the integrated care board proposes to take to implement any joint local health and wellbeing strategy to which it is required to have regard under section 116B(1) of the Local Government and Public Involvement in Health Act 2007; (d) set out any steps that the integrated care board proposes to take to address the particular needs of children and young persons under the age of 25; (e) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults). (3) The integrated care board and its partner NHS trusts and NHS foundation trusts must publish the plan. (4) The integrated care board and its partner NHS trusts and NHS foundation trusts must give a copy of the plan to— (a) the integrated care partnership for the board’s area, (b) each relevant Health and Wellbeing Board, and (c) NHS England. (5) NHS England may give a direction as to the date by which subsection (4) must be complied with. (6) An integrated care board and its partner NHS trusts and NHS foundation trusts must have regard to the plan under subsection (1). (7) In this Chapter “relevant Health and Wellbeing Board”, in relation to an integrated care board (or an integrated care board and its partner NHS trusts and NHS foundation trusts), means a Health and Wellbeing Board established by a local authority whose area coincides with, or includes the whole or any part of, the area of the integrated care board. (8) In this Act “financial year”, in relation to an integrated care board, means— (a) the period beginning with the date on which the integrated care board is established and ending with the 31 March following that date, and (b) each successive period of twelve months. (14Z53) (1) An integrated care board and its partner NHS trusts and NHS foundation trusts may revise a plan published under section 14Z52. (2) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in a way that they consider to be significant, section 14Z52(3) and (4) apply in relation to the revised plan as they applied in relation to the original plan. (3) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in any other way they must— (a) publish a document setting out the changes, and (b) give a copy of the document to— (i) the integrated care partnership for the board’s area, (ii) each relevant Health and Wellbeing Board, and (iii) NHS England. (14Z54) (1) This section applies where an integrated care board and its partner NHS trusts and NHS foundation trusts are— (a) preparing a plan under section 14Z52, or (b) revising a plan under section 14Z53 in a way that they consider to be significant. (2) The integrated care board and its partner NHS trusts and NHS foundation trusts must consult— (a) the group of people for whom the integrated care board has core responsibility, and (b) any other persons they consider it appropriate to consult. (3) The integrated care board and its partner NHS trusts and NHS foundation trusts must involve each relevant Health and Wellbeing Board in preparing or revising the plan. (4) The integrated care board and its partner NHS trusts and NHS foundation trusts must, in particular— (a) give each relevant Health and Wellbeing Board a draft of the plan or (as the case may be) the plan as revised, and (b) consult each relevant Health and Wellbeing Board on whether the draft takes proper account of each joint local health and wellbeing strategy published by it which relates to the period (or any part of the period) to which the plan relates. (5) Where a Health and Wellbeing Board is consulted under subsection (4)(b)— (a) it must respond with its opinion on the matter mentioned there; (b) it may also give that opinion to NHS England. (6) Where a Health and Wellbeing Board gives its opinion to NHS England under subsection (5)(b) it must inform the integrated care board and its partner NHS trusts and NHS foundation trusts that it has done so (unless it informed them, in advance, that it was planning to do so). (7) If an integrated care board and its partner NHS trusts and NHS foundation trusts revise or further revise a draft after it has been given to each relevant Health and Wellbeing Board under subsection (4), subsections (4) and (5) apply in relation to the revised draft as they applied in relation to the original draft. (8) An integrated care board and its partner NHS trusts and NHS foundation trusts must include in a plan published under section 14Z52(3)— (a) a summary of the views expressed by anyone consulted under subsection (2), (b) an explanation of how they took account of those views, and (c) a statement of the final opinion of each relevant Health and Wellbeing Board consulted in relation to the plan under subsection (4). (9) In this section, “joint local health and wellbeing strategy” means a strategy under section 116A of the Local Government and Public Involvement in Health Act 2007. (14Z55) (1) A relevant Health and Wellbeing Board— (a) may give NHS England its opinion on whether a plan published by an integrated care board and its partner NHS trusts and NHS foundation trusts under section 14Z52(3) takes proper account of each joint local health and wellbeing strategy published by the Health and Wellbeing Board which relates to the period (or any part of the period) to which the plan relates, and (b) if it does so, must give the integrated care board and its partner NHS trusts and NHS foundation trusts a copy of its opinion. (2) In this section, “joint local health and wellbeing strategy” has the same meaning as in section 14Z54(9). (14Z56) (1) Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out their planned capital resource use. (2) The plan must relate to such period as may be specified in a direction by the Secretary of State. (3) The Secretary of State must publish any direction under subsection (2). (4) The integrated care board and its partner NHS trusts and NHS foundation trusts must publish the plan. (5) The integrated care board and its partner NHS trusts and NHS foundation trusts must give a copy of the plan to— (a) the integrated care partnership for the board’s area, (b) each relevant Health and Wellbeing Board, and (c) NHS England. (6) NHS England may give a direction as to the date by which subsection (5) must be complied with. (7) NHS England may publish guidance about the discharge by an integrated care board and its partner NHS trusts and NHS foundation trusts of their functions under this section. (8) An integrated care board and its partner NHS trusts and NHS foundation trusts must have regard to any guidance published under subsection (7). (9) NHS England may give directions, in relation to a financial year— (a) specifying descriptions of resources which must, or must not, be treated as capital resources for the purposes of this section; (b) specifying uses of capital resources which must, or must not, be taken into account for the purposes of this section. (10) The reference in subsection (1) to the use of capital resources is a reference to its expenditure, consumption or reduction in value. (14Z57) (1) An integrated care board and its partner NHS trusts and NHS foundation trusts may revise a plan published under section 14Z56. (2) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in a way that they consider to be significant, section 14Z56(4) and (5) apply in relation to the revised plan as they applied in relation to the original plan. (3) If the integrated care board and its partner NHS trusts and NHS foundation trusts revise the plan in any other way, they must— (a) publish a document setting out the changes, and (b) give a copy of the document to— (i) the integrated care partnership for the board’s area, (ii) each relevant Health and Wellbeing Board, and (iii) NHS England. (14Z58) (1) An integrated care board must, in each financial year, prepare a report (an “annual report”) on how it has discharged its functions in the previous financial year. (2) An annual report must, in particular— (a) explain how the integrated care board has discharged its duties under sections 14Z34 to 14Z45 and 14Z49 (general duties of integrated care boards), (b) review the extent to which the board has exercised its functions in accordance with the plans published under— - section 14Z52 (forward plan), and - section 14Z56 (capital resource use plan), (c) review the extent to which the board has exercised its functions consistently with NHS England’s views set out in the latest statement published under section 13SA(1) (views about how functions relating to inequalities information should be exercised), and (d) review any steps that the board has taken to implement any joint local health and wellbeing strategy to which it was required to have regard under section 116B(1) of the Local Government and Public Involvement in Health Act 2007. (3) In undertaking the review required by subsection (2)(d), an integrated care board must consult each relevant Health and Wellbeing Board. (4) An annual report must include— (a) a statement of the amount of expenditure incurred by the integrated care board during the financial year in relation to mental health, (b) a calculation of the proportion of the expenditure incurred by the integrated care board during the financial year that relates to mental health, and (c) an explanation of the statement and calculation. (5) NHS England may give directions to integrated care boards as to the form and content of an annual report. (6) An integrated care board must— (a) give a copy of its annual report to NHS England before the date specified by NHS England in a direction, and (b) publish a copy of the annual report. (14Z59) (1) NHS England must conduct a performance assessment of each integrated care board in respect of each financial year. (2) A performance assessment is an assessment of how well the integrated care board has discharged its functions during that year. (3) The assessment must, in particular, include an assessment of how well the integrated care board has discharged its duties under— (a) section 14Z34 (improvement in quality of services), (b) section 14Z35 (reducing inequalities), (c) section 14Z38 (obtaining appropriate advice), (d) section 14Z40 (duty in respect of research), (e) section 14Z43 (duty to have regard to effect of decisions), (f) section 14Z45 (public involvement and consultation), (g) sections 223GB to 223N (financial duties), and (h) section 116B(1) of the Local Government and Public Involvement in Health Act 2007 (duty to have regard to assessments and strategies). (4) In conducting a performance assessment, NHS England must consult each relevant Health and Wellbeing Board as to its views on any steps that the board has taken to implement any joint local health and wellbeing strategy to which the board was required to have regard under section 116B(1) of that Act of 2007. (5) In conducting a performance assessment, NHS England must, in particular, have regard to— (a) any guidance published by the Secretary of State for the purposes of this section, and (b) any guidance published under section 14Z51. (6) NHS England must publish a report in respect of each financial year containing a summary of the results of each performance assessment conducted by NHS England in respect of that year. (14Z60) (1) NHS England may require an integrated care board to provide NHS England with information. (2) The information must be provided in such form, and at such time or within such period, as NHS England may require. (14Z61) (1) This section applies if NHS England is satisfied that— (a) an integrated care board is failing or has failed to discharge any of its functions, or (b) there is a significant risk that an integrated care board will fail to do so. (2) NHS England may direct the integrated care board to discharge such of those functions in such manner and within such period or periods as may be specified in the direction. (3) NHS England may direct— (a) the integrated care board, or (b) the chief executive of the integrated care board, to cease to perform any functions for such period or periods as may be specified in the direction. (4) NHS England may— (a) terminate the appointment of the integrated care board’s chief executive, and (b) direct the chair of the board as to which individual to appoint as a replacement and on what terms. (5) Where a direction is given under subsection (3)(a) NHS England may— (a) exercise, on behalf of the integrated care board, any of the functions that are the subject of the direction; (b) direct another integrated care board to perform any of those functions on behalf of the integrated care board, in such manner and within such period or periods as may be specified in the direction. (6) A direction under subsection (5)(b) may include provision prohibiting or restricting the integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction. (7) In subsection (6) “delegation arrangements” means arrangements made by a person for the exercise of a function by someone else. (8) Where a direction is given under subsection (3)(b) NHS England may— (a) exercise, on behalf of the chief executive, any of the functions that are the subject of the direction; (b) direct the chief executive of another integrated care board to perform any of those functions on behalf of the chief executive, in such manner and within such period or periods as may be specified in the direction. (9) For the purposes of this section— (a) a failure to discharge a function includes a failure to discharge it properly, and (b) a failure to discharge a function properly includes a failure to discharge it consistently with what NHS England considers to be the interests of the health service. (14Z62) (1) Before exercising the power conferred by section 14Z61(5)(b) or (8)(b) NHS England must consult the integrated care board to which it is proposing to give the direction or to whose chief executive it is proposing to give the direction. (2) Where a direction is given under section 14Z61(3)(b) to the chief executive of an integrated care board, that board must co-operate with any chief executive to whom a direction is given under subsection (8)(b). (14Z63) (1) An integrated care board may disclose information obtained by it in the exercise of its functions if— (a) the information has previously been lawfully disclosed to the public, (b) the disclosure is made under or pursuant to regulations under section 113 or 114 of the Health and Social Care (Community Health and Standards) Act 2003 (complaints about health care or social services), (c) the disclosure is made in accordance with any enactment or court order, (d) the disclosure is necessary or expedient for the purposes of protecting the welfare of any individual, (e) the disclosure is made to any person in circumstances where it is necessary or expedient for the person to have the information for the purpose of exercising functions of that person under any enactment, (f) the disclosure is made for the purpose of facilitating the exercise of any of the integrated care board’s functions, (g) the disclosure is made in connection with the investigation of a criminal offence (whether or not in the United Kingdom), or (h) the disclosure is made for the purpose of criminal proceedings (whether or not in the United Kingdom). (2) Subsection (1)(a) to (c) and (h) have effect notwithstanding any rule of common law which would otherwise prohibit or restrict the disclosure. (14Z64) In this Chapter— - “the health service” means the health service in England; - “health services” means services provided as part of the health service; - “integrated care partnership” has the meaning given by section 116ZA(1) of the Local Government and Public Involvement in Health Act 2007; - “relevant Health and Wellbeing Board”, in relation to an integrated care board, has the meaning given by section 14Z52(7).

• (3) In section 48 (power to obtain information from NHS foundation trust)—

• (a) after subsection (1) insert—

(1A) An integrated care board may require any of its partner NHS foundation trusts to provide it with any information that it requires.

;

• (b) for subsection (2) substitute—

(2) Information required under this section must be provided in such form, and at such time or within such period, as may be specified by the person imposing the requirement.

• (4) In Schedule 4 (NHS trusts: constitution etc), in paragraph 13—

• (a) the existing provision becomes sub-paragraph (1);

• (b) after that sub-paragraph insert—

(2) An integrated care board may require any of its partner NHS trusts to provide it with any information that it requires. (3) Information required under sub-paragraph (2) must be provided in such form, and at such time or within such period, as may be specified by the integrated care board.

Integrated care partnerships

Integrated care partnerships and strategies

26

• (1) The Local Government and Public Involvement in Health Act 2007 is amended in accordance with subsections (2) to (6).

• (2) In section 104 (interpretation: partner authorities), in subsection (2), for paragraph (ja) substitute—

(ja) an integrated care board;

.

• (3) In section 116 (health and social care: joint strategic needs assessments)—

• (a) in subsection (4), for paragraph (b) substitute—

(b) each of its partner integrated care boards,

;

• (b) after subsection (5) insert—

(5A) The responsible local authority must give a copy of each assessment of relevant needs prepared under this section to any integrated care partnership established under section 116ZA whose area coincides with or includes the whole or part of the area of the responsible local authority.

;

• (c) in subsections (6) and (7), for “clinical commissioning group”, in each place it occurs, substitute “integrated care board”;

• (d) in subsection (8), for “clinical commissioning groups” substitute “integrated care boards”;

• (e) in subsections (8A) and (9), for “clinical commissioning group”, in each place it occurs, substitute “integrated care board”.

• (4) After section 116 insert—

(116ZA) (1) An integrated care board and each responsible local authority whose area coincides with or falls wholly or partly within the board’s area must establish a joint committee for the board’s area (an “integrated care partnership”). (2) The integrated care partnership for an area is to consist of— (a) one member appointed by the integrated care board, (b) one member appointed by each of the responsible local authorities, and (c) any members appointed by the integrated care partnership. (3) An integrated care partnership may determine its own procedure (including quorum). (116ZB) (1) An integrated care partnership must prepare a strategy (an “integrated care strategy”) setting out how the assessed needs in relation to its area are to be met by the exercise of functions of— (a) the integrated care board for its area, (b) NHS England, or (c) the responsible local authorities whose areas coincide with or fall wholly or partly within its area. (2) In preparing a strategy under this section, an integrated care partnership must, in particular, consider the extent to which the needs could be met more effectively by the making of arrangements under section 75 of the National Health Service Act 2006 (rather than in any other way). (3) In preparing a strategy under this section, an integrated care partnership must have regard to— (a) the mandate published by the Secretary of State under section 13A of the National Health Service Act 2006, and (b) any guidance issued by the Secretary of State. (4) In preparing a strategy under this section, an integrated care partnership must— (a) involve the Local Healthwatch organisations whose areas coincide with or fall wholly or partly within its area, and (b) involve the people who live or work in that area. (5) An integrated care partnership may include in a strategy under this section a statement of its views on how arrangements for the provision of health-related services in its area could be more closely integrated with arrangements for the provision of health services and social care services in that area. (6) Each time that an integrated care partnership receives an assessment of relevant needs under section 116(5A) it must— (a) consider whether the current integrated care strategy should be revised, and (b) if so, prepare a revised integrated care strategy under subsection (1). (7) An integrated care partnership must— (a) publish each integrated care strategy, and (b) give a copy of each integrated care strategy to— (i) each responsible local authority whose area coincides with or falls wholly or partly within its area, and (ii) each partner integrated care board of those responsible local authorities. (8) In this section— (a) “assessed needs”, in relation to the area of an integrated care partnership, means the needs assessed under section 116 in relation to the areas of the responsible local authorities so far as those needs relate to the integrated care partnership’s area; (b) “partner integrated care board”, in relation to a responsible local authority, has the same meaning as in section 116; (c) “health services”, “health-related services” and “social care services” have the same meaning as in section 195 of the Health and Social Care Act 2012.

• (5) In section 116A (health and social care: joint health and wellbeing strategies)—

• (a) in the heading, after “joint” insert “local”;

• (b) for subsections (1) and (2) substitute—

(1) This section applies where a responsible local authority and each of its partner integrated care boards receive an integrated care strategy under section 116ZB(7)(b). (2) The responsible local authority and each of its partner integrated care boards must prepare a strategy (“a joint local health and wellbeing strategy”) setting out how the assessed needs in relation to the responsible local authority’s area are to be met by the exercise of functions of— (a) the responsible local authority, (b) its partner integrated care boards, or (c) NHS England. (2A) But the responsible local authority and its partner integrated care boards need not prepare a new joint local health and wellbeing strategy if, having considered the integrated care strategy, they consider that the existing joint local health and wellbeing strategy is sufficient.

;

• (c) in subsection (3)—

• (i) for “clinical commissioning groups” substitute “integrated care boards”;

• (ii) after “the extent to which the” insert “assessed”;

• (d) in subsection (4)—

• (i) for “clinical commissioning groups” substitute “integrated care boards”;

• (ii) before paragraph (a) insert—

(za) the integrated care strategy prepared under section 116ZB,

;

• (e) in subsections (5) and (7), for “clinical commissioning groups” substitute “integrated care boards”;

• (f) in subsection (8), for paragraph (a) (including the “and” at the end) substitute—

(a) “partner integrated care board”, in relation to a responsible local authority, has the same meaning as in section 116, (aa) “assessed needs”, in relation to the area of a local authority, means the needs assessed in relation to its area under section 116, and

.

• (6) For section 116B substitute—

(116B) (1) A responsible local authority and each of its partner integrated care boards must, in exercising any functions, have regard to the following so far as relevant— (a) any assessment of relevant needs prepared under section 116 in relation to the responsible local authority’s area, (b) any integrated care strategy prepared under section 116ZB in relation to an area that coincides with or includes the whole or part of the responsible local authority’s area, and (c) any joint local health and wellbeing strategy prepared under section 116A by the responsible local authority and its partner integrated care boards. (2) NHS England must, in exercising any functions in arranging for the provision of health services in relation to the area of a responsible local authority, have regard to the following so far as relevant— (a) any assessment of relevant needs prepared under section 116 in relation to that area, (b) any integrated care strategy prepared under section 116ZB in relation to an area that coincides with or includes the whole or part of that area, and (c) any joint local health and wellbeing strategy prepared under section 116A by the responsible local authority and its partner integrated care boards.

• (7) In the following provisions after “joint” insert “local”—

• (a) section 17(6)(g) and (h) of the National Health Service (Wales) Act 2006;

• (b) sections 26(7) and 27(4) of the Children and Families Act 2014.

Integrated care system: financial controls

NHS England’s financial responsibilities

27

For sections 223C to 223E of the National Health Service Act 2006 substitute—

(223C) (1) NHS England must exercise its functions with a view to ensuring that expenditure incurred by the following bodies in a financial year (taken together) does not exceed the aggregate of any sums received by them in the year— (a) NHS England; (b) integrated care boards. (2) The Secretary of State may by direction— (a) specify descriptions of expenditure that are, or are not, to be treated for the purposes of this section as expenditure incurred by a body, or expenditure incurred by it in a particular financial year; (b) specify descriptions of sums that are, or are not, to be treated for the purposes of this section as having been received by a body, or as having been received by it in a particular financial year; (c) provide for sums received by NHS England under section 223B in a year but not spent to be treated for the purposes of this section as expenditure incurred by it in a particular financial year; (d) provide for sums received by an integrated care board under section 223G in a year but not spent to be treated for the purposes of this section as expenditure incurred by it in a particular financial year. (3) For the purposes of this section any sum allotted to NHS England for a year under section 223B is to be treated as received by it in that year (subject to any direction under subsection (2)(b)). (223CA) The Secretary of State may by direction require NHS England to use banking facilities specified in the direction for any purposes so specified. (223D) (1) NHS England must exercise its functions with a view to ensuring that, in respect of each financial year— (a) total capital resource use does not exceed the limit specified in a direction by the Secretary of State; (b) total revenue resource use does not exceed the limit specified in a direction by the Secretary of State. (2) In subsection (1) “total capital resource use” and “total revenue resource use” means the use of capital resources or (as the case may be) revenue resources by relevant NHS bodies, other than use that consists of the transfer of resources between relevant NHS bodies. (3) In subsection (2) “relevant NHS bodies” means— (a) NHS England, (b) integrated care boards, (c) NHS trusts established under section 25, and (d) NHS foundation trusts. (4) A direction under subsection (1)(a) or (b) specifying a limit in relation to a financial year may be varied by a subsequent direction only if— (a) NHS England agrees to the change, (b) a parliamentary general election takes place, or (c) the Secretary of State considers that there are exceptional circumstances which make the variation necessary. (5) The Secretary of State must publish and lay before Parliament any directions under this section. (6) Any reference in this Chapter to the use of capital resources or revenue resources is a reference to their expenditure, consumption or reduction in value. (223E) (1) The Secretary of State may direct NHS England to ensure— (a) that relevant capital resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified; (b) that relevant revenue resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified. (2) In subsection (1) “relevant capital resource use” and “relevant revenue resource use” means the use of capital resources or (as the case may be) revenue resources by NHS England and integrated care boards. (3) The Secretary of State may direct NHS England to ensure that NHS England’s use of revenue resources in a financial year which is attributable to such matters relating to administration as are specified in the direction does not exceed an amount so specified.

Expansion of NHS England’s duties in respect of expenditure

28

In section 223C of the National Health Service Act 2006 (as substituted by section 27 of this Act), in subsection (1), after paragraph (b) insert—

(c) NHS trusts established under section 25; (d) NHS foundation trusts.

Financial responsibilities of integrated care boards and their partners

29

• (1) The National Health Service Act 2006 is amended as follows.

• (2) For the italic heading before section 223G substitute—

.

• (3) After section 223GA insert—

(223GB) (1) NHS England may give integrated care boards directions about their management or use of financial or other resources. (2) The directions that may be given include a direction imposing limits on expenditure or resource use by integrated care boards. (3) NHS England must publish any directions under this section. (223GC) (1) An integrated care board must exercise its functions with a view to ensuring that expenditure incurred by the board in a financial year does not exceed the sums received by it in that year. (2) NHS England may by direction— (a) specify descriptions of expenditure that are, or are not, to be treated for the purposes of this section as expenditure incurred by an integrated care board, or expenditure incurred by it in a particular financial year; (b) specify descriptions of sums that are, or are not, to be treated for the purposes of this section as having been received by an integrated care board, or as having been received by it in a particular financial year; (c) provide for sums received by an integrated care board under section 223G in a year but not spent to be treated for the purposes of this section as expenditure incurred by it in a particular financial year. (3) For the purposes of this section any sum allotted to an integrated care board for a year under section 223G is to be treated as received by it in that year (subject to any direction under subsection (2)(b)). (223GD) The Secretary of State may give integrated care boards directions requiring them to use specified banking facilities for any specified purposes.

• (4) Omit sections 223H to 223J (financial duties of clinical commissioning groups).

• (5) After section 223K insert—

(223L) (1) NHS England may set joint financial objectives for integrated care boards and their partner NHS trusts and NHS foundation trusts. (2) An integrated care board and its partner NHS trusts and NHS foundation trusts must seek to achieve any financial objectives set under this section. (3) Financial objectives under this section may apply to— (a) integrated care boards and their partner NHS trusts and NHS foundation trusts generally, (b) a particular integrated care board and its partner NHS trusts and NHS foundation trusts, or (c) an integrated care board of a particular description and its partner NHS trusts and NHS foundation trusts. (223M) (1) Each integrated care board and its partner NHS trusts and NHS foundation trusts must exercise their functions with a view to ensuring that, in respect of each financial year— (a) local capital resource use does not exceed the limit specified in a direction by NHS England; (b) local revenue resource use does not exceed the limit specified in a direction by NHS England. (2) In this section “local capital resource use” and “local revenue resource use” means the use of capital resources or (as the case may be) revenue resources by the integrated care board and its partner NHS trusts and NHS foundation trusts, other than use that consists of the transfer of resources between those bodies. (3) Where an NHS trust or NHS foundation trust is the partner of more than one integrated care board, its use of capital resources or revenue resources is to be apportioned for the purposes of this section to one or more of the integrated care boards in such manner as may be provided for in a direction by NHS England. (4) NHS England may by direction make provision for determining to which integrated care board, NHS trust or NHS foundation trust a use of capital resources or revenue resources is to be attributed for the purposes of this section. (223N) (1) NHS England may direct an integrated care board and its partner NHS trusts and NHS foundation trusts to exercise their functions with a view to— (a) ensuring that local capital resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified; (b) ensuring that local revenue resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified. (2) A direction under subsection (1) may— (a) specify descriptions of resources which must, or must not, be treated as local capital resources or local revenue resources for the purposes of the direction; (b) specify uses of local capital resources or local revenue resources which must, or must not, be taken into account for the purposes of the direction. (3) Any directions given under section 223M(3) or (4) apply for the purposes of this section as they apply for the purposes of section 223M. (4) In this section “local capital resource use” and “local revenue resource use” have the meaning given by section 223M(2). (223O) The Secretary of State may give directions, in relation to a financial year— (a) specifying descriptions of resources which must, or must not, be treated as capital resources or revenue resources for the purposes of section 223D, 223E or 223M; (b) specifying uses of capital resources or revenue resources which must, or must not, be taken into account for the purposes of section 223D, 223E or 223M.

Expansion of financial duties of integrated care boards and their partners

30

• (1) The National Health Service Act 2006 is amended as follows.

• (2) Omit section 223GC (inserted by section 29 of this Act).

• (3) After section 223L (inserted by section 29 of this Act) insert—

(223LA) (1) An integrated care board and its partner NHS trusts and NHS foundation trusts must exercise their functions with a view to ensuring that their expenditure in a financial year (taken together) does not exceed the aggregate of any sums received by them in the year. (2) Where an NHS trust or NHS foundation trust is the partner of more than one integrated care board its receipts and expenditure are to be apportioned for the purposes of this section to one or more of the integrated care boards in such manner as may be provided for in a direction by NHS England. (3) NHS England may by direction— (a) specify descriptions of expenditure that are, or are not, to be treated for the purposes of this section as expenditure incurred by a body, or expenditure incurred by it in a particular financial year; (b) specify descriptions of sums that are, or are not, to be treated for the purposes of this section as having been received by a body, or as having been received by it in a particular financial year; (c) provide for sums received by an integrated care board under section 223G in a year but not spent to be treated for the purposes of this section as expenditure by it in a particular financial year. (4) For the purposes of this section any sum allotted to an integrated care board for a year under section 223G is to be treated as received by it in that year (subject to any direction under subsection (3)(b)).

Integrated care system: reviews and further amendments

Care Quality Commission reviews etc of integrated care system

31

• (1) Chapter 3 of Part 1 of the Health and Social Care Act 2008 (quality of health and social care) is amended as follows.

• (2) After section 46A (inserted by section 163 of this Act) insert—

(46B) (1) The Commission must, in accordance with this section— (a) conduct reviews of— (i) the provision of relevant health care, and adult social care, within the area of each integrated care board, and (ii) the exercise of the functions of the following in relation to the provision of that care within the area of each integrated care board: the board; its partner local authorities; and registered service providers, (b) assess the functioning of the system for the provision of relevant health care, and adult social care, within the area of each integrated care board (taking into account, in particular, how those mentioned in paragraph (a)(ii) work together), and (c) publish a report of its assessment. (2) The Secretary of State— (a) must set, and may from time to time revise, objectives and priorities for the Commission in relation to assessments under this section, and (b) must inform the Commission of the objectives and priorities. (3) The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services. (4) The Commission— (a) must determine, and may from time to time revise, indicators of quality for the purposes of assessments under this section, and (b) must obtain the approval of the Secretary of State in relation to the indicators. (5) The Secretary of State may direct the Commission to revise the indicators under subsection (4). (6) Different objectives and priorities may be set, and different indicators of quality may be determined, for different cases. (7) The Commission— (a) must prepare, and may from time to time revise, a statement— (i) setting out the frequency with which reviews under this section are to be conducted and the period to which they are to relate, and (ii) describing the method that it proposes to use in assessing and evaluating the functioning of the system for the provision of relevant health care, and adult social care, within the area of an integrated care board, and (b) must obtain the approval of the Secretary of State in relation to the statement. (8) The statement may— (a) make different provision about frequency and period of reviews for different cases, and (b) describe different methods for different cases. (9) Before preparing or revising a statement under subsection (7) the Commission must consult— (a) NHS England, and (b) any other persons it considers appropriate. (10) The Secretary of State may direct the Commission to revise the statement under subsection (7). (11) The Commission must publish— (a) the objectives and priorities under subsection (2), (b) the indicators of quality under subsection (4), and (c) the statement under subsection (7). (12) For the purposes of this section— - “adult social care” means social care for individuals aged 18 or over; - “partner local authority”, in relation to an integrated care board, means any English local authority whose area coincides with, or includes the whole or any part of, the area of the integrated care board; - “registered service provider” means a person registered under Chapter 2 as a service provider; - “relevant health care” means— NHS care, or the promotion and protection of public health. (13) Regulations may amend the definition of “relevant health care” to include health care which is provided or commissioned by a public authority (but which does not amount to NHS care).

• (3) In section 48 (special reviews and investigations), in subsection (2), after “46A” (inserted by section 163 of this Act) insert “or 46B”.

• (4) In section 50 (failings by English local authorities), in subsection (1), after “46A” (inserted by section 163 of this Act) insert “or 46B”.

• (5) In section 162 (orders and regulations: parliamentary control), in subsection (3), after paragraph (c) insert—

(c) regulations under section 46B(13) (amendment of definition of relevant health care),

.

Integrated care system: further amendments

32

Schedule 4 contains minor and consequential amendments.

Merger of NHS bodies etc

Abolition of Monitor and transfer of functions to NHS England

33

• (1) Monitor is abolished.

• (2) Schedule 5 contains amendments to transfer Monitor’s functions to NHS England and related amendments.

Exercise by NHS England of new regulatory functions

34

• (1) The National Heath Service Act 2006 is amended as follows.

• (2) After section 13SA (inserted by section 11 of this Act) insert—

(13SB) (1) NHS England must make arrangements for— (a) minimising the risk of conflicts between the exercise of its regulatory functions and its other functions; (b) managing any conflicts that arise. (2) In this Act “regulatory functions”, in relation to NHS England, means— (a) its functions under the provisions listed in subsection (3), (b) its functions under Chapter 5A of Part 2 (trust special administrators) in relation to NHS foundation trusts, except for any functions that are conferred on it under section 65DA, 65F or 65G as a commissioner, and (c) any other functions of NHS England so far as exercisable in connection with functions within paragraph (a) or (b). (3) Those provisions are— (a) in Part 2 of this Act, Chapter 5 (NHS foundation trusts); (b) in Part 3 of the Health and Social Care Act 2012— (i) Chapter 3 (licensing); (ii) Chapter 4 (NHS payment scheme); (iii) Chapter 5 (health special administration); (iv) Chapter 6 (financial assistance in special administration cases).

• (3) In section 13U (annual report), after subsection (2) insert—

(2A) The annual report must include a statement explaining what NHS England has done, during the financial year, to comply with its duties under section 13SB.

• (4) In section 275 (interpretation), in subsection (1), at the appropriate place insert—

• “regulatory functions”, in relation to NHS England, has the meaning given by section 13SB,

.

Modification of standard licence conditions

35

• (1) Section 100 of the Health and Social Care Act 2012 (modification of standard conditions) is amended as follows.

• (2) After subsection (1) insert—

(1A) Before making modifications under subsection (1) that NHS England consider to be a major change, NHS England must— (a) carry out an assessment of the likely impact of the modifications, or (b) publish a statement setting out its reasons for concluding that such assessment is not needed.

• (3) In subsection (2), for “such modifications” substitute “modifications under subsection (1)”.

• (4) In subsection (4), after paragraph (b) insert—

(ba) set out any impact assessment carried out by NHS England under subsection (1A)(a),

.

Abolition of NHS Trust Development Authority

36

• (1) The Special Health Authority called the National Health Service Trust Development Authority is abolished.

• (2) The following are revoked—

• (a) the National Health Service Trust Development Authority (Establishment and Constitution) Order 2012 (S.I. 2012/901);

• (b) the National Health Service Trust Development Authority Regulations 2012 (S.I. 2012/922);

• (c) the National Health Service Trust Development Authority (Directions and Miscellaneous Amendments etc.) Regulations 2016 (S.I. 2016/214).

• (3) In section 9 of the Mental Health Units (Use of Force) Act 2018 (investigation of deaths or serious injuries), omit paragraph (d).

• (4) In section 15 of the Domestic Abuse Act 2021 (duty to co-operate with the Domestic Abuse Commissioner), in subsection (7), omit paragraph (e) of the definition of “NHS body in England”.

Merger of bodies: consequential amendment

37

In section 1H of the National Health Service Act 2006 (NHS England and its general functions), in subsection (3)(b), before “so as to secure” insert “, NHS trusts established under section 25 and NHS foundation trusts”.

Transfer schemes in connection with abolished bodies

38

• (1) The Secretary of State may make one or more schemes for the transfer of property, rights and liabilities from Monitor or the National Health Service Trust Development Authority to NHS England.

• (2) The things that may be transferred under a transfer scheme include—

• (a) property, rights and liabilities that could not otherwise be transferred;

• (b) property acquired, and rights and liabilities arising, after the making of the scheme;

• (c) criminal liabilities.

• (3) A transfer scheme may—

• (a) create rights, or impose liabilities, in relation to property or rights transferred;

• (b) make provision about the continuing effect of things done by the transferor in respect of anything transferred;

• (c) make provision about the continuation of things (including legal proceedings) in the process of being done by, on behalf of or in relation to the transferor in respect of anything transferred;

• (d) make provision for references to the transferor in an instrument or other document in respect of anything transferred to be treated as references to the transferee;

• (e) make provision which is the same as or similar to the TUPE regulations;

• (f) make other consequential, supplementary, incidental or transitional provision.

• (4) In subsection (3)(e), “the TUPE regulations” means the Transfer of Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).

• (5) In this section references to rights and liabilities include rights and liabilities relating to a contract of employment.

Transfer schemes under section 38: taxation

39

• (1) The Treasury may by regulations make provision varying the way in which a relevant tax has effect in relation to—

• (a) anything transferred under a scheme under section 38, or

• (b) anything done for the purposes of, or in relation to, a transfer under such a scheme.

• (2) The provision which may be made under subsection (1)(a) includes in particular provision for—

• (a) a tax provision not to apply, or to apply with modifications, in relation to anything transferred;

• (b) anything transferred to be treated in a specified way for the purposes of a tax provision;

• (c) the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything transferred.

• (3) The provision which may be made under subsection (1)(b) includes in particular provision for—

• (a) a tax provision not to apply, or to apply with modifications, in relation to anything done for the purposes of or in relation to the transfer;

• (b) anything done for the purposes of, or in relation to, the transfer to have or not have a specified consequence or be treated in a specified way;

• (c) the Secretary of State to be required or permitted to determine, or specify the method for determining, anything which needs to be determined for the purposes of any tax provision so far as relating to anything done for the purposes of, or in relation to, the transfer.

• (4) Regulations under this section are subject to annulment in pursuance of a resolution of the House of Commons.

• (5) In this section—

• “relevant tax” means income tax, corporation tax, capital gains tax, value added tax, stamp duty or stamp duty reserve tax;

• “tax provision” means a provision of an enactment about a relevant tax.

Secretary of State's functions

Duties in respect of research

40

In section 1E of the National Health Service Act 2006 (duty as to research), after “must” insert “facilitate or otherwise”.

Report on assessing and meeting workforce needs

41

After section 1G of the National Health Service Act 2006 (but before the italic heading after it) insert—

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

Arrangements for exercise of public health functions

42

For section 7A of the National Health Service Act 2006 substitute—

(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, (c) a local authority (within the meaning of section 2B), (d) a combined 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).

Power of direction: public health functions

43

• (1) The National Health Service Act 2006 is amended as follows.

• (2) After section 7A (inserted by section 42 of this Act) insert—

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

• (3) In section 73 (directions and regulations under Parts 1 and 2), in subsection (1), after paragraph (a) insert—

(aa) section 7B,

.

Power of direction: investigation functions

44

• (1) The National Health Service Act 2006 is amended as follows.

• (2) After section 7B (inserted by section 43 of this Act) insert—