For subsection (2) substitute—
In particular the Commission must—
give Monitor any information the Commission has about the
provision of health care which the Commission or Monitor
considers would assist Monitor in the exercise of its functions,
make arrangements with Monitor to ensure that—
a person applying to be both registered under Chapter 2
and for a licence under the Health and Social Care Act
2012 may do so by way of a single application form, and
such a person is granted a registration under Chapter 2
and a licence under that Act by way of a single
seek to secure that the conditions on a registration under
Chapter 2 in a case within paragraph (b) are consistent with the
conditions included in the person’s licence under that Act.”
for “Independent Regulator” substitute “Monitor”, and
for “an NHS foundation trust” substitute “a person who holds a licence
under the Health and Social Care Act 2012”.
After that subsection insert—
In this section, a reference to a licence under the Health and Social Care
Act 2012 is a reference to a licence under Chapter 3 of Part 3 of that Act.”
In the heading of that section, for “Independent Regulator of NHS Foundation
Trusts” substitute “Monitor”.
Other duties to co-operate
Monitor and each relevant body must co-operate with each other in the
exercise of their respective functions.
The Care Quality Commission and each relevant body must co-operate with
each other in the exercise of their respective functions.
The relevant bodies are—
the National Health Service Commissioning Board,
the National Institute for Health and Care Excellence,
the Health and Social Care Information Centre, and
Special Health Authorities which have functions that are exercisable in
The Secretary of State may by order amend subsection (3) so as to add to the
list of relevant bodies a body that has functions relating to health.
Where Monitor or the Care Quality Commission regulates an activity of a
relevant body, the duty imposed by subsection (1) or (as the case may be)
subsection (2) does not apply to—
the exercise by Monitor or by the Commission of its function of
regulating that activity;
the exercise by the relevant body of any function in so far as it involves
carrying on that activity.
A reference in this section to regulating an activity includes a reference to—
authorising the carrying on of the activity, imposing restrictions on the
carrying on of the activity, and exercising functions in relation to such
authorisations or restrictions;
enforcing the performance of an obligation imposed (whether or not by
provision made by or under an enactment) with respect to the carrying
issuing guidance on the carrying on of the activity, the authorisation of
the activity, restrictions on the activity, or the performance of obligation
imposed with respect to the carrying on of the activity.
For the purposes of this section and section 291, the functions of a Special
Health Authority include such functions as it is directed to exercise under
section 7 of the National Health Service Act 2006 (directions by Secretary of
References in this section and section 291 to functions are references to
functions so far as exercisable in relation to England.
Breaches of duties to co-operate
If the Secretary of State is of the opinion that bodies subject to a relevant co-
operation duty have breached or are breaching the duty, or are at significant
risk of breaching the duty, the Secretary of State may give a written notice of
the Secretary of State’s opinion to each body.
The relevant co-operation duties are—
the duty under section 288 (co-operation by Monitor with the Care
the duties under section 290(1) and (2),
the duty under section 70 of the Health and Social Care Act 2008 (co-
operation by the Care Quality Commission with Monitor),
any duties imposed by an enactment on relevant bodies to co-operate
with each other in the exercise of their respective functions.
The Secretary of State must publish each notice given under subsection (1) in
such form as the Secretary of State considers appropriate.
Subsection (5) applies if, having given a notice under subsection (1), the
Secretary of State is satisfied that—
the bodies concerned have breached or are continuing to breach the
duty or, the risk of a breach having materialised, are breaching the
the breach is having a detrimental effect on the performance of the
health service (or, where the effect of the breach on the performance of
the health service is both beneficial and detrimental, its overall effect is
The Secretary of State may by order prohibit each body from exercising
specified functions, or from exercising specified functions in a specified
manner, unless the other body concerned agrees in writing that the body may
The power to make an order under subsection (5)—
may be exercised so as to specify different functions in relation to each
may not be exercised so as to prevent a body from complying with a
requirement imposed by or under an enactment or by a court or
In default of agreement as to the exercise of a function specified in an order
under subsection (5), a body may exercise the function in accordance with
provision determined by arbitration.
An order under subsection (5) must specify the period for which a prohibition
imposed by it has effect; and the period specified for that purpose may not
exceed one year beginning with the day on which the order comes into force.
But if the Secretary of State is satisfied that the breach is continuing to have a
detrimental effect (or an effect that overall is detrimental) on the performance
of the health service, the Secretary of State may by order extend by one year the
period for which the prohibition for the time being has effect.
In this section, “the health service” means the comprehensive health service
continued under section 1(1) of the National Health Service Act 2006.
The Care Quality Commission
Requirement for Secretary of State to approve remuneration policy etc.
In paragraph 5 of Schedule 1 to the Health and Social Care Act 2008 (employees
of the Care Quality Commission), at the end insert—
Before making a determination as to remuneration, pensions,
allowances or gratuities for the purposes of sub-paragraph (3) or (4),
the Commission must obtain the approval of the Secretary of State to
its policy on that matter.”
Conduct of reviews etc. by Care Quality Commission
Part 1 of the Health and Social Care Act 2008 (the Care Quality Commission) is
In section 48 (special reviews and investigations)—
in subsection (1) after “may” insert “, with the approval of the Secretary
after subsection (1) insert—
The Commission may conduct an investigation under this
section without the approval of the Secretary of State where the
Commission considers there to be a risk to the health, safety or
welfare of persons receiving health or social care.”
In section 54 (studies as to economy, efficiency etc.), in each of subsections (1)
and (3) after “may” insert “, with the approval of the Secretary of State,”.
In section 57 (reviews of data, studies and research), in subsection (1) after
“may” insert “, with the approval of the Secretary of State,”.
Failure to discharge functions
In section 82 of the Health and Social Care Act 2008 (failure by Commission to
discharge functions), in subsection (1), at the end insert “,
and that the failure is significant.”
After subsection (2) of that section insert—
But the Secretary of State may not give a direction under subsection (1)
in relation to the performance of functions in a particular case.”
After subsection (3) of that section insert—
Where the Secretary of State exercises a power under subsection (1) or
(3), the Secretary of State must publish the reasons for doing so.
For the purposes of this section a failure to discharge a function
properly includes a failure to discharge it consistently with what the
Secretary of State considers to be the interests of the health service in
England or (as the case may be) with what otherwise appears to the
Secretary of State to be the purpose for which it is conferred; and “the
health service” has the same meaning as in the National Health Service
In section 161 of that Act (orders, regulations and directions: general
provisions), in subsection (3), before “any power of the Secretary of State to
give directions” insert “(subject to section 82(2A))”.
In section 165 of that Act (directions), at the beginning of subsection (2) insert
“Subject to subsection (3),”.
After that subsection insert—
A direction under section 82 must be given by regulations or by an
Arrangements with devolved authorities etc.
Arrangements between the Board and Northern Ireland Ministers
The National Health Service Commissioning Board may make arrangements
with a Northern Ireland Minister for the Board to commission services for the
purposes of the Northern Ireland health service.
Arrangements under this section may be on such terms and conditions as may
be agreed between the parties to the arrangements.
Those terms and conditions may include provision with respect to the making
of payments to the National Health Service Commissioning Board in respect of
the cost to it of giving effect to the arrangements.
“commission” means arrange for the provision of,
“Northern Ireland health service” means any of the health services under
any enactment which extends to Northern Ireland and which
corresponds to section 1(1) of the National Health Service Act 2006
(and, for that purpose, “enactment” includes subordinate legislation
(within the meaning of the Interpretation Act 1978) and Northern
Ireland legislation), and
“Northern Ireland Minister” includes the First Minister, the deputy First
Minister and a Northern Ireland department.