Part 1 Services, administration and accountability

Duties of the Secretary of State

1 Secretary of State’s duties as to the health service

5For section 1 of the National Health Service Act 2006 (Secretary of State‘s duty
to promote comprehensive health service) substitute—

“1 Secretary of State’s duty as to the health service

(1) It shall be the duty of the Secretary of State to promote in England a
comprehensive health service designed to secure improvement—

(a) 10in the physical and mental health of the people of England, and

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

and for that purpose to provide or secure the effective provision of
services in accordance with this Act.

(2) The services so provided must be free of charge except in so far as the
making and recovery of charges is expressly provided for, by or under
any enactment, whenever passed.

(3) The Secretary of State shall exercise the functions referred to in
5subsection(1) with a view to integrating the provision of health services
and of social care services in accordance with this Act.

(4) The comprehensive health service referred to in subsection (1) is for the
purposes of—

(a) Protocol (No 26) to the Treaty on European Union (Services of
10General Interest), a non-economic service of general interest;
and

(b) the World Trade Organization’s General Agreement on Trade
in Services, a service supplied in the exercise of governmental
authority as a service supplied neither on a commercial basis,
15nor in competition with one or more suppliers.”

2 Abolition of the duties of autonomy

Sections 1D and 13F of the National Health Service Act 2006 (duties as to
promoting autonomy) are repealed.

Duties as to certain services

3 20Secretary of State’s duty to provide certain services

(1) For section 3 of the National Health Service Act 2006 (Duties of clinical
commissioning groups as to commissioning certain health services)
substitute—

“3 Secretary of State’s duty to provide certain services

(1) 25The duty of the Secretary of State under section 1(1) to provide or
secure the effective provision of services includes—

(a) the duty of the Secretary of State imposed by subsection (2)
below,

(b) the functions in relation to high security psychiatric services in
30accordance with section 4 below;

(c) the functions in Part 4 (medical services), Part 5 (dental
services), Part 6 (Ophthalmic services) and Part 7
(Pharmaceutical services and local pharmaceutical services)
below;

(d) 35the functions in relation to other services in accordance with
section 5 below;

(e) the functions in relation to public health under section 6 below;
and

(f) the functions in relation to information services in accordance
40with section 7(2).

(2) It is the Secretary of State’s duty to provide throughout England, to
such extent as the Secretary of State considers necessary to meet all
reasonable requirements—

(a) hospital accommodation;

(b) other accommodation for the purpose of any service provided
under this Act;

(c) medical, dental, nursing, ambulance and mental health
services;

(d) 5such other facilities for the care of expectant and nursing
mothers and young children as the Secretary of State considers
are appropriate as part of the health service;

(e) such facilities for the prevention of illness, the care of persons
suffering from illness and the after-care of persons who have
10suffered from illness as the Secretary of State considers are
appropriate as part of the health service;

(f) such other services as are required for the diagnosis and
treatment of illness.

(3) The Secretary of State may provide or secure the provision of anything
15mentioned in subsection (2) above outside England.

(4) Subsection (2) does not affect the provisions of Parts 4 to 7 (which relate
to arrangements with practitioners for the provision of medical, dental,
ophthalmic and pharmaceutical services).”

(2) Section 3 (Duties of clinical commissioning groups as to commissioning certain
20health services) and section 3A (Power of clinical commissioning groups to
commission certain health services) of the National Health Service Act 2006 are
repealed.

4 High security psychiatric services

In section 4(1) of the National Health Service Act 2006, for the words “The
25Board must arrange for the provision of” substitute the words “The Secretary
of State‘s duty under section 1(1) includes a duty to provide and maintain”.

5 Other services

Schedule 1 to the National Health Service Act 2006 is repealed and substituted
by Schedule 1 to this Act.

6 30Public health functions

(1) The Secretary of State must throughout England—

(a) protect the public from disease or other dangers to health;

(b) improve the health of the people; and

(c) reduce health inequalities,

35as an integral part of the comprehensive health service referred to in section
1(1) of the National Health Service Act 2006.

(2) For the purposes of the duty under subsection 1(a) above, the Secretary of State
shall—

(a) conduct research or such other steps as the Secretary of State considers
40appropriate for advancing knowledge and understanding;

(b) provide microbiological or other technical services (whether in
laboratories or otherwise);

(c) provide vaccination, immunisation or screening services;

(d) provide other services or facilities for the prevention, diagnosis or
treatment of physical and mental illness;

(e) provide training;

(f) provide evidence-based information and advice;

(g) 5make available the services of any person or any facilities.

(3) For the purposes of the duty under subsection 1(b) above, the Secretary of State
shall—

(a) provide evidence-based information and advice;

(b) provide services or facilities designed to promote healthy living
10(whether by helping individuals to address behaviour that is
detrimental to health or in any other way);

(c) provide services or facilities for the prevention, diagnosis or treatment
of physical and mental illness;

(d) provide assistance (including financial assistance) to help individuals
15to minimise any risks to health arising from their accommodation or
environment;

(e) provide or participate in the provision of training for persons working
or seeking to work in the field of health improvement;

(f) make available the services of any person or any facilities;

(g) 20promote healthy schools, including the appointment of health
professionals designated as public health advisers to schools and to the
school population and the adoption of standards;

(h) promote healthy workplaces.

(4) For the purposes of the Secretary of State’s functions under this Act the
25Secretary of State shall establish and maintain systems for the collection,
monitoring, analysis and publication of information and data about the
planning and provision of community, primary care and acute services and
about inequalities in—

(a) access to health services;

(b) 30outcomes achieved by the provision of health services;

(c) social factors (including employment, housing and family
circumstances) which may affect health;

(d) lifestyle factors (including diet, exercise, use of tobacco, consumption of
alcohol, and misuse of drugs or solvents) which may affect health,

35and in exercising the Secretary of State’s other functions under this Act the
Secretary of State shall have regard to such information and data, and to the
need to reduce such inequalities.

(5) The Secretary of State shall make regulations requiring any other body or
person performing functions under enactments specified in those regulations
40to have regard to such information and data and to the need to reduce such
inequalities.

(6) Regulations under this section shall provide for the Secretary of State to
delegate the duties under section 6(1) and Schedule 1 to a Special Health
Authority to be known as Public Health England; to NHS England; and, in
45relation to their area, to a local authority or Health Board under a public health
scheme referred to in section 9(5)(b)(ii) below.

Administration

7 Distribution of functions

(1) The Secretary of State shall establish by orders under section 28 of the National
Health Service Act 2006 Special Health Authorities to be known as—

(a) 5the National Health Service England Authority, with Regional
Committees, in accordance with and having the functions delegated to
it and referred to in section 8 below;

(b) Public Health England, having the functions delegated to it in
accordance with regulations under section 6 above;

(c) 10the Health and Social Care Information Centre, in accordance with and
having the functions delegated to it in accordance with regulations,
including the collection, analysis, use and dissemination of information
and the issuing of administrative identification numbers.

(2) Part 9 (Health and Social Care Services: Information) of the Health and Social
15Care Information Act 2012 shall be repealed upon the making of an order in
relation to subsection 7(1)(c).

8 NHS England and Regional Committees

(1) Subject to section 24(3) below, the National Health Service Commissioning
Board is abolished.

(2) 20The Special Health Authority known as The National Health Service England
Authority (referred to in this Act as “NHS England”) established pursuant to
section 7(1)(a) above shall have a number of Regional Committees covering the
whole of England.

(3) The Secretary of State shall make regulations in relation to the establishment of
25NHS England and its Regional Committees, including their membership,
appointments, pay and allowances, staff, committees and sub-committees.

(4) NHS England shall exercise on behalf of the Secretary of State—

(a) the duty in section 1(1), and, to the extent relevant, the Secretary of
State’s duty under section 3(2), of the National Health Service Act 2006,
30by providing or securing effective provision of the services or facilities
referred to in subsection (5) below in accordance with regulations made
by the Secretary of State;

(b) the functions in Parts 4 to 7 of the National Health Service Act 2006 for
the provision of medical, dental, ophthalmic and pharmaceutical
35services, provided that the power to make arrangements for primary
medical services with any person under section 83(2) shall not extend
to entering into contracts with commercial companies;

(c) the functions under section 6 in relation to public health and under
Schedule 1 in accordance with regulations made by the Secretary of
40State.

(5) The services or facilities referred to in subsection (4)(a) are—

(a) dental services of a prescribed description;

(b) services or facilities for members of the armed forces or their families;

(c) services or facilities for persons who are detained in a prison or in other
45accommodation of a prescribed description;

(d) such other services or facilities as may be prescribed that—

(i) support Health Boards and other Special Health Authorities in
discharging their functions, or

(ii) are more appropriate for NHS England to provide or secure
effective provision of rather than the Secretary of State or
5Health Boards.

(6) In deciding for the purposes of subsection (5)(d)(ii) whether it would be
appropriate, the Secretary of State must have regard to—

(a) the number of individuals who require the provision of the service or
facility;

(b) 10the cost of providing the service or facility;

(c) the number of persons able to provide the service or facility; and

(d) the financial implications of NHS England providing or securing
effective provision of the service rather than any of the other persons or
bodies mentioned in that subsection.

(7) 15Before deciding whether to make regulations under subsection (4)(a), the
Secretary of State must—

(a) obtain advice appropriate for that purpose, and

(b) consult NHS England.

(8) The reference in subsection (5)(b) to members of the armed forces is a reference
20to persons who are members of—

(a) the regular forces within the meaning of the Armed Forces Act 2006, or

(b) the reserve forces within the meaning of that Act.

(9) The Secretary of State may also make regulations containing directions to NHS
England relating to its functions under this section in accordance with section
2512 below.

(10) NHS England shall perform its functions through its Regional Committees,
save to the extent that regulations provide otherwise.

(11) The Secretary of State may make regulations under subsection (10) where the
Secretary of State considers that it is more appropriate for a service or facility
30to be provided, or for its effective provision to be secured, on a national basis
rather than on regional bases.

(12) NHS England shall in relation to its functions under this section also have the
additional functions set out in Schedule 3.

(13) In this Act, “health service body” means any of the following—

(a) 35NHS England, including one or more of its Regional Committees,

(b) a Health Board,

(c) a Special Health Authority,

(d) a Local Health Board,

(e) a Health Board constituted under section 2 of the National Health
40Service (Scotland) Act 1978 (c. 29)1978 (c. 29),

(f) a Special Health Authority constituted under that section,

(g) a Health and Social Services Board constituted under the Health and
Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265S.I. 1972/1265
(N.I.14)),

(h) 45the Common Services Agency for the Scottish Health Service,

(i) the Wales Centre for Health,

(j) the Care Quality Commission,

(k) NICE,

(l) the Health and Social Care Information Centre,

(m) the Scottish Dental Practice Board,

(n) the Secretary of State,

(o) 5the Welsh Ministers,

(p) the Scottish Ministers,

(q) Healthcare Improvement Scotland,

(r) the Northern Ireland Central Services Agency for the Health and Social
Services established under the Health and Personal Social Services
10(Northern Ireland) Order 1972,

(s) a special health and social services agency established under the Health
and Personal Social Services (Special Agencies) (Northern Ireland)
Order 1990 (S.I. 1990/247 (N.I.3)S.I. 1990/247 (N.I.3)),

(t) a Health and Social Services trust established under the Health and
15Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194S.I. 1991/194
(N.I.1)),

(u) the Department of Health, Social Services and Public Safety.

(14) An arrangement made by NHS England under this section shall not be
regarded as giving rise to contractual rights or liabilities and the Public
20Contracts Regulations 2006 shall not apply to it.

9 Health Boards

(1) There shall be Health Boards for areas of England established in accordance
with subsections (2) to (4) and Schedule 2 below.

(2) One or more local authorities, including elected mayors, may prepare and
25submit to the Secretary of State a draft scheme for the approval of the Secretary
of State in accordance with regulations for—

(a) establishing a Health Board for the area of the authority or authorities,
including its membership;

(b) transferring functions to and for the transparent performance of
30services by the Health Board; and

(c) management within the Health Board.

(3) It shall be the duty of the National Health Service Commissioning Board, and
of clinical commissioning groups, NHS trusts and NHS foundation trusts in
the area of such authority or authorities to cooperate with and assist them in
35preparing the draft scheme.

(4) Regulations shall—

(a) provide that any other person in such an area, including patients,
clinicians and other staff employed in providing health services,
voluntary organisations, trade unions and holding a post in a
40university that is related to health, may participate in preparing the
draft scheme;

(b) set out the procedure for preparation, submission and approval of the
draft scheme, including provisions relating to non-submission and re-
submission, and may require the draft scheme to include proposals for
45a constitution for the Health Board;

(c) confer on the Secretary of State a power to adopt a scheme in default of
submission or re-submission, or where the power under section 9(2) is
not exercised;

(d) impose a duty on the Secretary of State to approve or adopt such
schemes no later than 1 January 2018.

(5) A Health Board shall have the following functions—

(a) the duty to exercise on behalf of the Secretary of State the duty in
5section 1(1) of the National Health Service Act 2006 by exercising the
functions of the Secretary of State under the following provisions of
that Act—

(i) section 3(2)(a) and (b), with respect to the provision of hospital
and other accommodation for the purposes of any service
10provided under the Act;

(ii) section 3(2)(c), with respect to the provision of medical, dental,
nursing, ambulance and mental health services;

(iii) section 3(2)(d), with respect to the provision of facilities for the
care of expectant and nursing mothers and young children;

(iv) 15section 3(2)(e), with respect to the provision of facilities for the
prevention of illness and the aftercare of persons who have
suffered from illness;

(v) section 3(2)(f), with respect to the provision of such other
services as are required for the diagnosis and treatment of
20illness;

(vi) Schedule 1 of this Act, with respect to the other services referred
to therein, and

(vii) Schedule 3 of this Act, with respect to the additional functions
set out therein,

25and for those purposes to assess needs, plan services to meet those needs, set
clinical standards, match funding to delivery, capture information to support
the various stages of the cycle, and ensure accountability;

(b) the duty to prepare jointly with the local authority or authorities for its
area in accordance with regulations—

(i) 30a public health scheme for the purposes of exercising the
functions of the Secretary of State under section 6(1) above, in
consultation with Public Health England and NHS England;
and

(ii) an integration scheme for the purposes of integrating the
35provision of health services and of social care services, and of
more closely integrating health-related services;

(6) The Secretary of State may also make regulations containing directions to
Health Boards relating to their functions under this section in accordance with
and subject to section 12.

(7) 40“Health service body” has the same meaning as in section 8(13) above.

(8) An arrangement made by a Health Board under this section shall not be
regarded as giving rise to contractual rights or liabilities and the Public
Contracts Regulations 2006 shall not apply to it.

(9) In exercising its functions, a Health Board shall consult with and have regard
45to the views of the local Community Health Council established under section
17.

10 Administration of medical, dental, ophthalmic and pharmaceutical services

It is the duty of each Health Board—

(a) to administer the arrangements made under Parts 4 to 7 of the National
Health Service Act 2006 for the provision of medical, dental,
ophthalmic and pharmaceutical services for the area of the Board, and

(b) to perform such other administrative functions relating to those
5services as may be prescribed in regulations made by the Secretary of
State.

11 Special Health Authorities

(1) If the Secretary of State considers that a special body should be established for
the purpose of performing any functions which the Secretary of State may
10direct the body to perform on behalf of the Secretary of State, or on behalf of
NHS England (including on behalf of one or more of its Regional Committees)
or of a Health Board the Secretary of State may by order establish a body for
that purpose in accordance with section 28 (Special Health Authorities) of the
National Health Service Act 2006.

(2) 15An order under subsection (1) shall be accompanied by a statement explaining
how bureaucracy will be reduced as a consequence of such an order.

(3) Section 28A of the National Health Service Act 2006 is repealed.

12 Directions

(1) Subject to subsections (3) and (6), the Secretary of State may direct any of the
20bodies mentioned in subsection (2) to exercise any functions relating to the
health service which are specified in the directions, and may also give
directions to any such body about its exercise of any functions or about its
provision of services under arrangements referred to in subsection (2)(f).

(2) These bodies are—

(a) 25NHS England, including any or all of its Regional Committees,

(b) a Health Board,

(c) a Special Health Authority,

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

(e) the Health and Social Care Information Centre, and

(f) 30any other body or person providing services in pursuance of prescribed
arrangements.

(3) In exercising the power under subsection (1), the Secretary of State must have
regard to the desirability, so far as consistent with the interests of the health
service and relevant to the exercise of the power in all circumstances—

(a) 35of protecting and promoting the health of patients and the public,

(b) of any bodies mentioned in subsection (2) being free, in exercising its
functions or providing services in accordance with its duties and
powers, to do so in the manner that it considers best calculated to
promote the comprehensive service referred to in section 1 (1) of the
40National Health Service Act 2006, and

(c) of ensuring co-operation between the bodies mentioned in subsection
(2) in the exercise of their functions or provision of services.

(4) If, in having regard to the desirability of the matters referred to in subsection
(3) the Secretary of State considers that there is a conflict between those matters
45and the discharge of duties under section 1 of the National Health Service Act
2006, the Secretary of State must give priority to the duties under that section.