Increasing the independence of the Care Quality Commission

88 Chief Inspectors

After paragraph 3 of Schedule 1 to the Health and Social Care Act 2008 insert—

“Chief Inspectors

3A (1) 5The non-executive members must—

(a) appoint an executive member to be the Chief Inspector of
Hospitals,

(b) appoint an executive member to be the Chief Inspector of
Adult Social Care, and

(c) 10appoint an executive member to be the Chief Inspector of
General Practice.

(2) Each of those executive members is to exercise such functions of the
Commission on its behalf as it determines.

(3) When exercising functions under sub-paragraph (2), an executive
15member must have regard to the importance of safeguarding and
promoting the Commission’s independence from the Secretary of
State.”

89 Independence of the Care Quality Commission

(1) Part 1 of the Health and Social Care Act 2008 (the Care Quality Commission) is
20amended as follows.

(2) In section 48 (special reviews or investigations), omit subsection (7) (Secretary
of State’s power to make regulations as to procedure for representations before
publication of report).

(3) In section 54 (studies as to economy, efficiency etc), in subsections (1) and (3),
25omit “, with the approval of the Secretary of State,”.

(4) After subsection (2) of that section, insert—

“(2A) The Commission may not exercise the power under subsection (1)(a),
so far as it relates to the activity mentioned in subsection (2)(d), without
the approval of the Secretary of State.”

(5) 30In section 55 (publication of results of studies under section 54), omit
subsection (2) (Secretary of State’s power to make regulations as to procedure
for representations before publication of report).

(6) In section 57 (reviews of data, studies and research), in subsection (1), omit “,
with the approval of the Secretary of State,”.

(7) 35In section 61 (inspections carried out for registration purposes), omit—

(a) subsection (1) (Secretary of State’s power to make regulations
specifying frequency etc. of inspections), and

(b) subsection (4) (Secretary of State’s power to make regulations as to
procedure for representations before publication of report).

(8) 40In section 83 (annual reports), omit subsection (3) (Secretary of State’s power
to direct preparation of separate reports).

(9) In paragraph 5 of Schedule 4 (inspection programmes etc.), omit—

(a) in sub-paragraph (1) (preparation of programme etc.), “, or at such
times as the Secretary of State may specify by order,”, and

(b) sub-paragraph (3) (Secretary of State’s power to specify form of
5programme etc.).

(10) In consequence of subsections (3) and (6), omit section 293(3) and (4) of the
Health and Social Care Act 2012.

Performance ratings

90 Reviews and performance assessments

(1) 10Chapter 3 of Part 1 of the Health and Social Care Act 2008 (the Care Quality
Commission: quality of health and social care) is amended as follows.

(2) For section 46 (periodic reviews of health and social care provision)
substitute—

“46 Reviews and performance assessments

(1) 15The Commission must, in respect of such regulated activities and such
registered service providers as may be prescribed—

(a) conduct reviews of the carrying on of the regulated activities by
the service providers,

(b) assess the performance of the service providers following each
20such review, and

(c) publish a report of its assessment.

(2) Regulations under subsection (1) may prescribe—

(a) all regulated activities or regulated activities of a particular
description;

(b) 25all registered service providers or particular registered service
providers;

(c) the whole of a regulated activity or a particular aspect of it.

(3) The assessment of the performance of a registered service provider is to
be by reference to whatever indicators of quality the Commission
30devises.

(4) The Commission must prepare a statement—

(a) setting out the frequency with which reviews under this section
are to be conducted and the period to which they are to relate,
and

(b) 35describing the method that it proposes to use in assessing and
evaluating the performance of a registered service provider
under this section.

(5) The Commission may—

(a) use different indicators for different cases,

(b) 40make different provision about frequency and period of
reviews for different cases, and

(c) describe different methods for different cases.

(6) The Commission must publish—

(a) any indicators it devises for the purpose of subsection (3), and

(b) the statement it prepares for the purpose of subsection (4).

(7) Before doing so, the Commission—

(a) must consult the Secretary of State and such other persons, or
5other persons of such a description, as may be prescribed, and

(b) may also consult any other persons it considers appropriate.

(8) The Commission may from time to time revise—

(a) any indicators it devises for the purpose of subsection (3), and

(b) the statement it prepares for the purpose of subsection (4);

10and, if it does so, it must publish the indicators and statement as
revised.

(9) Subsection (7) applies to revised indicators and a revised statement, so
far as the Commission considers the revisions in question to be
significant.

(10) 15In this section “registered service provider” means a person registered
under Chapter 2 as a service provider.

(11) Consultation undertaken before the commencement of this section is as
effective for the purposes of subsection (7) as consultation undertaken
after that commencement.”

(3) 20Sections 47 (frequency and period of reviews under section 46) and 49 (power
to extend periodic review function) are repealed.

(4) In section 48 (special reviews and investigations), in subsection (1)—

(a) omit “, with the approval of the Secretary of State,”, and

(b) at the end insert “; but the Commission may not conduct a review or
25investigation under subsection (2)(ba) or (bb) without the approval of
the Secretary of State.”

(5) Omit subsection (1A) of that section.

(6) In subsection (2) of that section, for “a periodic review” substitute “a review
under section 46”.

(7) 30In that subsection, after paragraph (ba) (but before the following “or”) insert—

“(bb) the exercise of the functions of English local authorities in
arranging for the provision of adult social services,”.

(8) After subsection (3) of that section insert—

“(3A) A review or investigation under subsection (2)(b), in so far as it involves
35a review or investigation into the arrangements made for the provision
of the adult social services in question, is to be treated as a review under
subsection (2)(bb) (and the requirement for approval under subsection
(1) is accordingly to apply).”

(9) In consequence of the preceding provisions of this section—

(a) 40in section 50(1) of the Health and Social Care Act 2008 (failings by
English local authorities), omit “or 49”;

(b) in section 51(1) of that Act (failings by Welsh NHS bodies), omit “or 49”;

(c) in section 70(3)(a) of that Act (provision by Commission to Monitor of
material relevant to review under section 46 or 49), omit “or 49”;

(d) in section 72(a) of that Act (provision by Commission to Comptroller
and Auditor General of material relevant to review under section 46 or
49), omit “or 49”;

(e) in section 293 of the Health and Social Care Act 2012, omit subsections
5(1) and (2);

(f) in Schedule 5 to that Act (amendments in consequence of Part 1 of that
Act), omit paragraphs 157, 159, 163 and 164.

False or misleading information

91 Offence

(1) 10A care provider of a specified description commits an offence if—

(a) it supplies, publishes or otherwise makes available information of a
specified description,

(b) the supply, publication or making available by other means of
information of that description is required under an enactment or other
15legal obligation, and

(c) the information is false or misleading in a material respect.

(2) But it is a defence for a care provider to prove that it took all reasonable steps
and exercised all due diligence to prevent the provision of false or misleading
information as mentioned in subsection (1).

(3) 20“Care provider” means—

(a) a public body which provides health services or adult social care in
England,

(b) a person who provides health services or adult social care in England
pursuant to arrangements made with a public body exercising
25functions in connection with the provision of such services or care, or

(c) a person who provides health services or adult social care in England
all or part of the cost of which is paid for by means of a direct payment
under section 12A of the National Health Service Act 2006 or under Part
1 of this Act.

(4) 30“Health services” means services which must or may be provided as part of the
health service.

(5) “Adult social care”—

(a) includes all forms of personal care and other practical assistance for
individuals who, by reason of age, illness, disability, pregnancy,
35childbirth, dependence on alcohol or drugs, or any other similar
circumstances, are in need of such care or other assistance, but

(b) does not include anything provided by an establishment or agency for
which Her Majesty’s Chief Inspector of Education, Children’s Services
and Skills is the registration authority under section 5 of the Care
40Standards Act 2000.

(6) “Specified” means specified in regulations.

(7) If a care provider commits an offence under either of the provisions mentioned
in subsection (8) in respect of the provision of information, the provision of that
information by that provider does not also constitute an offence under
45subsection (1).

(8) The provisions referred to in subsection (7) are—

(a) section 44 of the Competition Act 1998 (provision of false or misleading
information) as applied by section 72 of the Health and Social Care Act
2012 (functions of the OFT under Part 1 of the Competition Act 1998 to
5be concurrent functions of Monitor), and

(b) section 117 of the Enterprise Act 2002 (provision of false or misleading
information) as applied by section 73 of the Health and Social Care Act
2012 (functions of the OFT under Part 4 of the Enterprise Act 2002 to be
concurrent functions of Monitor).

(9) 10If a care provider commits an offence under subsection (1) in respect of the
provision of information, the provision of that information by that provider
does not also constitute an offence under section 64 of the Health and Social
Care Act 2008 (failure to comply with request to provide information).

92 Penalties

(1) 15A person who is guilty of an offence under section 91 is liable—

(a) on summary conviction, to a fine;

(b) on conviction on indictment, to imprisonment for not more than two
years or a fine (or both).

(2) A court before which a care provider is convicted of an offence under section
2091 may (whether instead of or as well as imposing a fine under subsection (1))
make either or both of the following orders—

(a) a remedial order,

(b) a publicity order.

(3) A “remedial order” is an order requiring the care provider to take specified
25steps to remedy one or more of the following—

(a) the conduct specified in section 91(1),

(b) any matter that appears to the court to have resulted from the conduct,

(c) any deficiency, as regards the management of information, in the care
provider’s policies, systems or practices of which the conduct appears
30to the court to be an indication.

(4) A “publicity order” is an order requiring the care provider to publicise in a
specified manner—

(a) the fact that it has been convicted of an offence under section 91,

(b) specified particulars of the offence,

(c) 35the amount of any fine imposed, and

(d) the terms of any remedial order made.

(5) A remedial order may be made only on an application by the prosecution
specifying the terms of the proposed order; and any such order must be on
such terms (whether those proposed or others) as the court considers
40appropriate having regard to any representations made, and any evidence
adduced, in relation to that matter by the prosecution or on behalf of the care
provider.

(6) A remedial order must specify a period within which the steps referred to in
subsection (3) are to be taken.

(7) 45A publicity order must specify a period within which the requirements
referred to in subsection (4) are to be complied with.

(8) A care provider that fails to comply with a remedial order or a publicity order
commits an offence and is liable on conviction on indictment to a fine.

93 Offences by bodies

(1) Subsection (2) applies where an offence under section 91(1) is committed by a
5body corporate and it is proved that the offence is committed by, or with the
consent or connivance of, or is attributable to neglect on the part of—

(a) a director, manager or secretary of the body, or

(b) a person purporting to act in such a capacity.

(2) The director, manager, secretary or person purporting to act as such (as well as
10the body) is guilty of the offence and liable to be proceeded against and
punished accordingly (but section 92(2) does not apply).

(3) The reference in subsection (2) to a director, manager or secretary of a body
corporate includes a reference—

(a) to any other similar officer of the body, and

(b) 15where the body is a local authority, to a member of the authority.

(4) Proceedings for an offence under section 91(1) alleged to have been committed
by an unincorporated association are to be brought in the name of the
association (and not in that of any of the members); and rules of court relating
to the service of documents have effect as if the unincorporated association
20were a body corporate.

(5) In proceedings for an offence under section 91(1) brought against an
unincorporated association, section 33 of the Criminal Justice Act 1925 and
Schedule 3 to the Magistrates’ Courts Act 1980 apply as they apply in relation
to a body corporate.

(6) 25A fine imposed on an unincorporated association on its conviction for an
offence under section 91(1) is to be paid out of the funds of the association.

(7) Subsection (8) applies if an offence under section 91(1) is proved—

(a) to have been committed by, or with the consent or connivance of, an
officer of the association or a member of its governing body, or

(b) 30to be attributable to neglect on the part of such an officer or member.

(8) The officer or member (as well as the association) is guilty of the offence and
liable to be proceeded against accordingly (but section 92(2) does not apply).

Regulated activities

94 Training for persons working in regulated activity

35In section 20 of the Health and Social Care Act 2008 (regulation of regulated
activities), after subsection (4) insert—

“(4A) Regulations made under this section by virtue of subsection (3)(d) may
in particular include provision for a specified person to set the
standards which persons undergoing the training in question must
40attain.”

Part 3 Health

CHAPTER 1 Health Education England

Establishment

95 5Health Education England

(1) There is to be a body corporate called Health Education England (referred to in
this Act as “HEE”).

(2) Schedule 5 (which includes provision about HEE’s constitution, the exercise of
its functions and its financial and reporting duties) has effect.

(3) 10The Special Health Authority called Health Education England is abolished;
and, in consequence of that, the following are revoked—

(a) the Health Education England (Establishment and Constitution) Order
2012 (S.I. 2012/1273S.I. 2012/1273), and

(b) the Health Education England Regulations (S.I. 2012/1290S.I. 2012/1290).

(4) 15The Secretary of State may by order provide for the transfer of property, rights
and liabilities from that Special Health Authority to HEE; for further provision
about an order under this section, see section 117.

National functions

96 Planning education and training for health care workers etc.

(1) 20HEE must perform on behalf of the Secretary of State the duty under section
1F(1) of the National Health Service Act 2006 (planning and delivery of
education and training), so far as that duty applies to the functions of the
Secretary of State under—

(a) section 63(1) and (5) of the Health Services and Public Health Act 1968
25(instruction for officers of hospital authorities etc.),

(b) section 258(1) of the National Health Service Act 2006 (university
clinical teaching and research), and

(c) such other of the enactments listed in section 1F(3) of that Act as
regulations may specify.

(2) 30Regulations may—

(a) provide for the duty under section 1F(1) of the National Health Service
Act 2006 to apply to such other functions of the Secretary of State as are
specified; and

(b) impose on HEE a duty to perform the duty as it applies as a result of
35provision made under paragraph (a).

(3) Regulations may provide that the duty under subsection (1) or a duty imposed
under subsection (2) may only be performed, or may not be performed, in
relation to persons of a specified description.

(4) In each of the following provisions of the National Health Service Act 2006,
after “the Secretary of State” insert “and Health Education England”—

(a) section 1F(2) (duty on providers of health services to support system of
education and training for health care workers);

(b) 5section 13M (duty on National Health Service Commissioning Board to
support that system);

(c) section 14Z (duty on clinical commissioning groups to support that
system).

(5) Regulations may give HEE further functions relating to education and training
10for health care workers.

(6) HEE may, with the consent of the Secretary of State, carry out other activities
relating to—

(a) education and training for health care workers;

(b) the provision of information and advice on careers in the health service.

(7) 15After section 63(6) of the Health Services and Public Health Act 1968 insert—

“(6A) The Secretary of State may make such other payments as the Secretary
of State considers appropriate to persons availing themselves of such
instruction in England.

(6B) The Secretary of State may make a payment under subsection (6)(b) or
20(6A) subject to such terms and conditions as the Secretary of State
decides; and the Secretary of State’s power to make such a payment
includes power to suspend or terminate the payment, or to require
repayment, in such circumstances as the Secretary of State decides.”

(8) The power of the Secretary of State under section 63(6) or (6A) of the Health
25Services and Public Health Act 1968 is exercisable concurrently with HEE; but,
in exercising the power, HEE must have regard to any guidance or other
information issued by the Secretary of State about its exercise.

(9) “Health care workers” means persons in relation to whom HEE’s duty under
section 1F(1) of the National Health Service Act 2006 is to be performed.

97 30Ensuring sufficient skilled health care workers for the health service

(1) HEE must exercise its functions with a view to ensuring that a sufficient
number of persons with the skills and training to work as health care workers
for the purposes of the health service is available to do so throughout England.

(2) Regulations may provide that the duty under subsection (1) may only be
35performed, or may not be performed, in relation to persons of a specified
description.

98 Quality improvement in education and training, etc.

(1) HEE must exercise its functions with a view to securing continuous
improvement—

(a) 40in the quality of education and training provided for health care
workers;

(b) in the quality of health services.

(2) HEE must, in exercising its functions, promote—

(a) research into matters relating to such of the activities listed in section
63(2) of the Health Services and Public Health Act 1968 (social care
services, primary care services and other health services) as are relevant
to HEE’s functions, and

(b) 5the use in those activities of evidence obtained from the research.

(3) In section 2(2) of the Health Act 2009 (bodies required to have regard to NHS
Constitution when exercising health service functions), after paragraph (g)
insert—

“(h) Health Education England.”

(4) 10HEE must exercise its functions with a view to securing that education and
training for health care workers is provided in a way which promotes the NHS
Constitution.

(5) “Health services” means health services provided as part of the health service.

(6) “NHS Constitution” has the meaning given by section 1(1) of the Health Act
152009.

99 Objectives, priorities and outcomes

(1) The Secretary of State must publish before the start of each financial year a
document which specifies the objectives and priorities that the Secretary of
State has set for HEE for that year in relation to the education and training to
20be provided for health care workers.

(2) The Secretary of State must also publish at intervals of not more than three
years a document (called the “Education Outcomes Framework”) which
specifies the outcomes that the Secretary of State has set for HEE to achieve
having regard to those objectives and priorities.

(3) 25The Secretary of State—

(a) may revise a document published under subsection (1) or (2), and

(b) if the Secretary of State does so, must publish it as revised.

(4) HEE must publish a document which—

(a) specifies the objectives and priorities that it has set, for the period
30specified in the document, for the planning and delivery of education
and training to health care workers,

(b) specifies the outcomes that HEE expects to achieve in that respect
during that period having regard to those objectives and priorities, and

(c) includes, or refers to a document which includes, guidance for LETBs
35(see section 102) on the exercise of the function under section 106(1).

(5) In performing the duty under subsection (4), HEE must have regard, in
particular, to its objectives in the longer term in relation to the planning and
delivery of education and training to health care workers.

(6) HEE must ensure that the objectives, priorities and outcomes specified for the
40purposes of subsection (4)(a) and (b) are consistent with those specified for the
purposes of subsections (1) and (2).

(7) A document under subsection (4) may specify different periods in relation to
different categories of health care worker.

(8) HEE must, before the end of 12 months beginning with the date on which a
document under subsection (4) is published—

(a) review the document, and,

(b) if HEE revises it, publish it as revised.

(9) 5HEE may perform the duty under subsection (4) by publishing two or more
documents which, taken together, comply with that subsection.

(10) HEE must seek to achieve the objectives and outcomes and to reflect the
priorities specified in any document—

(a) published by the Secretary of State under subsection (1), (2) or (3);

(b) 10published by HEE under subsection (4) or (8).

100 Sections 97 and 99: matters to which HEE must have regard

(1) In performing the duty under section 97(1) (ensuring sufficient skilled workers
for the health service) or the duty under section 99(4) (setting objectives,
priorities and outcomes for education and training), HEE must have regard to
15the following matters in particular—

(a) the likely future demand for health services and for persons with the
skills and training to work as health care workers for the purposes of
the health service,

(b) the sustainability of the supply of persons with the skills and training
20to work as such,

(c) the priorities that providers of health services have for the education
and training of persons wishing to work as such,

(d) the mandate published under section 13A of the National Health
Service Act 2006,

(e) 25the objectives of the Secretary of State in exercising public health
functions (as defined by section 1H of that Act),

(f) the priorities that the National Health Service Commissioning Board
has for the provision of health services,

(g) documents published by the Secretary of State under section 99(1), (2)
30or (3),

(h) the desirability of promoting the integration of health provision with
health-related provision and care and support provision,

(i) the desirability of enabling health care workers to switch between
different posts relating to health provision, health-related provision or
35care and support provision, and

(j) such other matters as regulations may specify.

(2) In subsection (1), “health provision”, “health-related provision” and “care and
support provision” each have the same meaning as in section 3.

101 Advice

(1) 40HEE must make arrangements for obtaining advice on the exercise of its
functions from persons who are involved in, or who HEE thinks otherwise
have an interest in, the provision of education and training for health care
workers.

(2) HEE must seek to ensure that it receives representations from the following, in
45particular, under the arrangements it makes under subsection (1)—

(a) persons who provide health services;