Health and Social Care Bill (HC Bill 221)

(a) the consortium consents to the variation, or

(b) the Board considers that the variation is necessary for the
purpose of discharging any of its duties under section 14A.

(4) Before varying the constitution of a commissioning consortium under
5subsection (1) or (2), the Board must consult—

(a) that consortium, and

(b) any other consortium that the Board thinks might be affected by
the variation.

(5) Regulations may—

(a) 10confer powers on the Board to vary the constitution of a
commissioning consortium;

(b) make provision as to the circumstances in which those powers
are exercisable and the procedure to be followed before they are
exercised.

15Mergers, dissolution etc.

14G Mergers

(1) Two or more commissioning consortia may apply to the Board for—

(a) those consortia to be dissolved, and

(b) another consortium to be established under this section.

(2) 20An application under this section must be accompanied by—

(a) a copy of the proposed constitution of the commissioning
consortium,

(b) the name of the person whom the consortium wishes the Board
to appoint as its accountable officer, and

(c) 25such other information as the Board may specify in a document
published for the purposes of this section.

(3) The applicants may, with the agreement of the Board, modify the
application or the proposed constitution at any time before the Board
determines the application.

(4) 30Sections 14C and 14D(1) apply in relation to an application under this
section as they apply in relation to an application under section 14B.

14H Dissolution

(1) A commissioning consortium may apply to the Board for the
consortium to be dissolved.

(2) 35Regulations may make provision—

(a) as to the circumstances in which the Board must or may grant,
or must or may refuse, applications under this section;

(b) as to factors which the Board must or may take into account in
determining whether to grant such applications;

(c) 40as to the procedure for the making and determination of such
applications.

Supplemental provision about variation, mergers etc.

14I Transfers in connection with variation, merger, dissolution etc.

(1) The Board may make a property transfer scheme or a staff transfer
scheme in connection with—

(a) 5the variation of the constitution of a commissioning consortium
under section 14E or 14F, or

(b) the dissolution of a commissioning consortium under section
14G or 14H.

(2) A property transfer scheme is a scheme for the transfer from the
10commissioning consortium of any property, rights or liabilities, other
than rights or liabilities under or in connection with a contract of
employment, to the Board or another commissioning consortium.

(3) A staff transfer scheme is a scheme for the transfer from the
commissioning consortium of any rights or liabilities under or in
15connection with a contract of employment to the Board or another
commissioning consortium.

(4) Part 3 of Schedule 1A makes further provision about property transfer
schemes and staff transfer schemes.

14J Publication of constitution of consortia

(1) 20A commissioning consortium must publish its constitution.

(2) If the constitution of a commissioning consortium is varied under
section 14E or 14F, the consortium must publish the constitution as so
varied.

14K Guidance about the establishment of commissioning consortia etc.

25The Board may publish guidance as to—

(a) the making of applications under section 14B for the
establishment of a commissioning consortium, including
guidance on the form, content or publication of the proposed
constitution;

(b) 30the making of applications under section 14E, 14G or 14H;

(c) the publication of the constitutions of commissioning consortia
under section 14J.

Governing bodies of consortia

14L Governing bodies of commissioning consortia

(1) 35A commissioning consortium must have a governing body.

(2) The main function of the governing body is to ensure that the
consortium has made appropriate arrangements for ensuring that it
complies with—

(a) its obligations under section 14P, and

(b) 40such generally accepted principles of good governance as are
relevant to it.

(3) The governing body also has—

(a) the function of determining the remuneration, fees and
allowances payable to the employees of the consortium or to
other persons providing services to it, and

(b) such other functions connected with the exercise of its main
5function as may be specified in the consortium’s constitution or
by regulations.

(4) Only the following may be members of the governing body—

(a) a member of the consortium who is an individual;

(b) an individual appointed by virtue of regulations under section
1014N(2);

(c) an individual of a description specified in the constitution of the
consortium.

(5) A commissioning consortium may pay members of the governing body
such remuneration and allowances as it considers appropriate.

(6) 15Regulations may make provision requiring a commissioning
consortium to obtain the approval of its governing body before
exercising any functions specified in the regulations.

(7) Regulations may make provision requiring governing bodies of
commissioning consortia to publish, in accordance with the
20regulations, prescribed information relating to determinations made
under subsection (3)(a).

(8) The Board may publish guidance for governing bodies on the exercise
of their functions under subsection (3)(a).

14M Audit and remuneration committees of governing bodies

(1) 25The governing body of a commissioning consortium must have an
audit committee and a remuneration committee.

(2) The audit committee has—

(a) such functions in relation to the financial duties of the
consortium as the governing body considers appropriate for the
30purpose of assisting it in discharging its function under section
14L(2), and

(b) such other functions connected with the governing body’s
function under section 14L(2) as may be specified in the
consortium’s constitution or by regulations.

(3) 35The remuneration committee has—

(a) the function of making recommendations to the governing
body as to the discharge of its function under section 14L(3)(a),
and

(b) such other functions connected with the governing body’s
40function under section 14L(2) as may be specified in the
consortium’s constitution or by regulations.

14N Regulations as to governing bodies of commissioning consortia

(1) Regulations may make provision specifying the minimum number of
members of governing bodies of commissioning consortia.

(2) 45Regulations may—

(a) provide that the members of governing bodies must include the
accountable officer of the consortium;

(b) provide that the members of governing bodies, or their audit or
remuneration committees, must include—

(i) 5individuals who are health care professionals of a
prescribed description;

(ii) individuals who are lay persons;

(iii) individuals of any other description which is
prescribed;

(c) 10in relation to any description of individuals mentioned in
regulations by virtue of paragraph (b), specify—

(i) the minimum number of individuals of that description
who must be appointed;

(ii) the maximum number of such individuals who may be
15appointed;

(d) provide that the descriptions specified for the purposes of
section 14L(4)(c) may not include prescribed descriptions.

(3) Regulations may make provision as to—

(a) qualification and disqualification for membership of governing
20bodies or their audit or remuneration committees;

(b) how members are to be appointed;

(c) the tenure of members (including the circumstances in which a
member ceases to hold office or may be removed or suspended
from office);

(d) 25eligibility for re-appointment.

(4) Regulations may make provision for the appointment of chairs and
deputy chairs of governing bodies or their audit or remuneration
committees, including provision as to—

(a) qualification and disqualification for appointment;

(b) 30tenure of office (including the circumstances in which the chair
or deputy chair ceases to hold office or may be removed or
suspended from office);

(c) eligibility for re-appointment.

(5) Regulations may—

(a) 35make provision as to the matters which must be included in the
constitutions of commissioning consortia under paragraph 7 of
Schedule 1A;

(b) make such other provision about the procedure of governing
bodies or their audit or remuneration committees as the
40Secretary of State considers appropriate, including provision
about the frequency of meetings.

(6) In this section—

• “health care professional” means an individual who is a member
  of a profession regulated by a body mentioned in section 25(3)
  45of the National Health Service Reform and Health Care
  Professions Act 2002;

• “lay person” means an individual who is not—

  (a)

  a member of the consortium,

  (b)

  a health care professional, or

  Health and Social Care BillPage 34

  (c)

  an individual of a prescribed description.”

(2) After Schedule 1 to the National Health Service Act 2006 insert the Schedule set
out in Schedule 2 to this Act.

23 Commissioning consortia: general duties etc.

5After section 14N of the National Health Service Act 2006 insert—

“General duties of consortia

14O Duty to promote NHS Constitution

(1) Each commissioning consortium must, in the exercise of its functions—

(a) act with a view to securing that health services are provided in
10a 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—

• “health services” means services provided as part of the health
  15service;

• “patients” and “staff” have the same meanings as in Chapter 1 of
  Part 1 of the Health Act 2009 (see section 3(7) of that Act).

14P Duty as to effectiveness, efficiency etc.

Each commissioning consortium must exercise its functions effectively,
20efficiently and economically.

14Q Duty as to improvement in quality of services

(1) Each commissioning consortium 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,
25diagnosis or treatment of illness.

(2) In discharging its duty under subsection (1), a commissioning
consortium must, in particular, act with a view to securing continuous
improvement in the outcomes that are achieved from the provision of
the services.

(3) 30The outcomes relevant for the purposes of subsection (2) include, in
particular, outcomes which show—

(a) the effectiveness of the services,

(b) the safety of the services, and

(c) the quality of the experience undergone by patients.

(4) 35In discharging its duty under subsection (1), a commissioning
consortium must have regard to any guidance published under section
14Z6.

14R Duty in relation to quality of primary medical services

Each commissioning consortium must assist and support the Board in
40discharging its duty under section 13E so far as relating to securing
continuous improvement in the quality of primary medical services.

14S Duties as to reducing inequalities

(1) Each commissioning consortium must, in the exercise of its functions,
have regard to the need to—

(a) reduce inequalities between patients with respect to their ability
5to access health services;

(b) reduce inequalities between patients with respect to the
outcomes achieved for them by the provision of health services.

(2) In this section, “health services” means services provided as part of the
health service.

14T 10 Duty to promote involvement of each patient

(1) Each commissioning consortium must, in the exercise of its functions,
promote the involvement of patients, and their carers and
representatives (if any), in decisions about the provision of health
services to the patients.

(2) 15The Board may publish guidance for commissioning consortia on the
discharge of their duties under this section.

(3) A commissioning consortium must have regard to any guidance
published by the Board under subsection (2).

(4) In this section, “health services” has the same meaning as in section 14S.

14U 20Duty as to patient choice

(1) Each commissioning consortium 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.

(2) In this section, “health services” has the same meaning as in section 14S.

14V 25Duty to obtain appropriate advice

(1) Each commissioning consortium 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) 30the protection or improvement of public health.

(2) The Board may publish guidance for commissioning consortia on the
discharge of their duties under subsection (1).

(3) A commissioning consortium must have regard to any guidance
published by the Board under subsection (2).

14W 35Duty to promote innovation

(1) Each commissioning consortium must, in the exercise of its functions,
promote innovation in the provision of health services (including
innovation in the arrangements made for their provision).

(2) In this section, “health services” means services provided as part of the
40health service.

14X Duty in respect of research

Each commissioning consortium must, in the exercise of its functions,
have regard to the need to promote—

(a) research on matters relevant to the health service, and

(b) 5the use in the health service of evidence obtained from research.

14Y Duty as to promoting integration

(1) Each commissioning consortium 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) 10improve 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
15outcomes achieved for them by the provision of those services.

(2) Each commissioning consortium 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) 20improve 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) 25reduce inequalities between persons with respect to the
outcomes achieved for them by the provision of those services.

(3) In this section—

• “health services” means services provided as part of the health
  service;

• 30“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
  35(within the meaning of the Local Authority Social Services Act
  1970).

Public involvement

14Z Public involvement and consultation by commissioning consortia

(1) This section applies in relation to any health services which are, or are
40to be, provided pursuant to arrangements made by a commissioning
consortium (“commissioning arrangements”).

(2) The consortium must make arrangements to secure that individuals to
whom the services are being or may be provided are involved (whether
by being consulted or provided with information or in other ways)—

(a) 45in the planning of the commissioning arrangements by the
consortium,

(b) in the development and consideration of proposals by the
consortium for changes in the commissioning arrangements
where the implementation of the proposals would have an
impact on the manner in which the services are delivered to the
5individuals or the range of health services available to them,
and

(c) in decisions of the consortium affecting the operation of the
commissioning arrangements where the implementation of the
decisions would (if made) have such an impact.

(3) 10The commissioning consortium must include in its constitution—

(a) a description of the arrangements made by it under subsection
(2), and

(b) a statement of the principles which it will follow in
implementing those arrangements.

(4) 15The Board may publish guidance for commissioning consortia on the
discharge of their functions under this section.

(5) A commissioning consortium must have regard to any guidance
published by the Board under subsection (4).

(6) The reference in subsection (2)(b) to the delivery of services is a
20reference to their delivery at the point when they are received by users.

(7) In this section, “health services” means any services that are (or are to
be) provided as part of the health service.

Arrangements with others

14Z1 Arrangements by consortia in respect of the exercise of functions

(1) 25Any two or more commissioning consortia may make arrangements
under this section.

(2) The arrangements may provide for—

(a) one of the commissioning consortia to exercise any of the
commissioning functions of another on its behalf, or

(b) 30all the commissioning consortia to exercise any of their
commissioning functions jointly.

(3) For the purposes of the arrangements a commissioning consortium
may—

(a) make payments to another commissioning consortium, or

(b) 35make the services of its employees or any other resources
available to another commissioning consortium.

(4) For the purposes of the arrangements, all the consortia may establish
and maintain a pooled fund.

(5) A pooled fund is a fund—

(a) 40which is made up of contributions by all the consortia, and

(b) out of which payments may be made towards expenditure
incurred in the discharge of any of the commissioning functions
in respect of which the arrangements are made.

(6) Arrangements made under this section do not affect the liability of a
commissioning consortium for the exercise of any of its functions.

(7) In this section, “commissioning functions” means the functions of
commissioning consortia in arranging for the provision of services as
5part of the health service (including the function of making a request to
the Board for the purposes of section 14Z7).

14Z2 Joint exercise of functions with Local Health Boards

(1) Regulations may provide for any prescribed functions of a
commissioning consortium to be exercised jointly with a Local Health
10Board.

(2) Regulations may provide for any functions that are (by virtue of
subsection (1)) exercisable jointly by a commissioning consortium and
a Local Health Board to be exercised by a joint committee of the
consortium and the Board.

(3) 15Arrangements made by virtue of this section do not affect the liability
of a commissioning consortium for the exercise of any of its functions.

Additional powers of consortia

14Z3 Raising additional income

(1) A commissioning consortium has power to do anything specified in
20section 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) A commissioning consortium may exercise a power conferred by
subsection (1) only to the extent that its exercise does not to any
25significant extent interfere with the performance by the consortium of
its functions.

14Z4 Power to make grants

(1) A commissioning consortium may make payments by way of grant or
loan to a voluntary organisation which provides or arranges for the
30provision of services which are similar to the services in respect of
which the consortium has functions.

(2) The payments may be made subject to such terms and conditions as the
consortium considers appropriate.

Board’s functions in relation to consortia

14Z5 35Responsibility for payments to providers

(1) The Board may publish a document specifying—

(a) circumstances in which a commissioning consortium is liable to
make a payment to a person in respect of services provided by
that person in pursuance of arrangements made by another
40consortium in the discharge of its commissioning functions, and

(b) how the amount of any such payment is to be determined.

(2) A commissioning consortium is required to make payments in
accordance with any document published under subsection (1).

(3) Where a commissioning consortium is required to make a payment by
virtue of subsection (2), no other consortium is liable to make it.

(4) 5Accordingly, any obligation of another consortium 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) 10The Board may publish guidance for commissioning consortia for the
purpose of assisting them in understanding and applying any
document published under subsection (1).

(7) In this section and section 14Z6, “commissioning functions” means the
functions of commissioning consortia in arranging for the provision of
15services as part of the health service.

14Z6 Guidance on commissioning by the Board

(1) The Board must publish guidance for commissioning consortia on the
discharge of their commissioning functions.

(2) Each commissioning consortium must have regard to guidance under
20this section.

(3) The Board must consult the Healthwatch England committee of the
Care Quality Commission—

(a) before it first publishes guidance under this section, and

(b) before it publishes any revised guidance containing changes
25that are, in the opinion of the Board, significant.

14Z7 Exercise of functions by the Board

(1) The Board may, at the request of a commissioning consortium, exercise
on behalf of the consortium—

(a) any of its functions under section 3 or 3A which are specified in
30the request, and

(b) any other functions of the consortium which are related to the
exercise of those functions.

(2) Regulations may provide that the power in subsection (1) does not
apply in relation to functions of a prescribed description.

(3) 35Arrangements under this section may be on such terms and conditions
(including terms as to payment) as may be agreed between the Board
and the consortium.

(4) Arrangements made under this section do not affect the liability of a
commissioning consortium for the exercise of any of its functions.

14Z8 40Power of Board to provide assistance or support

(1) The Board may provide assistance or support to a commissioning
consortium.

(2) The assistance that may be provided includes—