Health and Social Care Bill

Session 2010 - 12
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Other Bills before Parliament

Health and Social Care Bill

Health and Social Care Bill
Part 1 — The health service in England
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14Z1
Duty as to promoting integration
(1)
Each clinical commissioning group 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
5
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.
10
(2)
Each clinical commissioning group 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
15
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
20
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;
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“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).
Public involvement
30
14Z2
Public involvement and consultation by clinical commissioning
groups
(1)
This section applies in relation to any health services which are, or are
to be, provided pursuant to arrangements made by a clinical
commissioning group in the exercise of its functions (“commissioning
35
arrangements”).
(2)
The clinical commissioning group 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)—
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(a)
in the planning of the commissioning arrangements by the
group,
(b)
in the development and consideration of proposals by the
group for changes in the commissioning arrangements where
the implementation of the proposals would have an impact on
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the manner in which the services are delivered to the
individuals or the range of health services available to them,
and

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(c)
in decisions of the group affecting the operation of the
commissioning arrangements where the implementation of the
decisions would (if made) have such an impact.
(3)
The clinical commissioning group must include in its constitution—
(a)
a description of the arrangements made by it under subsection
5
(2), and
(b)
a statement of the principles which it will follow in
implementing those arrangements.
(4)
The Board may publish guidance for clinical commissioning groups on
the discharge of their functions under this section.
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(5)
A clinical commissioning group 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
reference to their delivery at the point when they are received by users.
Arrangements with others
15
14Z3
Arrangements by clinical commissioning groups in respect of the
exercise of functions
(1)
Any two or more clinical commissioning groups may make
arrangements under this section.
(2)
The arrangements may provide for—
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(a)
one of the clinical commissioning groups to exercise any of the
commissioning functions of another on its behalf, or
(b)
all the clinical commissioning groups to exercise any of their
commissioning functions jointly.
(3)
For the purposes of the arrangements a clinical commissioning group
25
may—
(a)
make payments to another clinical commissioning group, or
(b)
make the services of its employees or any other resources
available to another clinical commissioning group.
(4)
For the purposes of the arrangements, all the clinical commissioning
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groups may establish and maintain a pooled fund.
(5)
A pooled fund is a fund—
(a)
which is made up of contributions by all the groups, and
(b)
out of which payments may be made towards expenditure
incurred in the discharge of any of the commissioning functions
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in respect of which the arrangements are made.
(6)
Arrangements made under this section do not affect the liability of a
clinical commissioning group for the exercise of any of its functions.
(7)
In this section, “commissioning functions” means the functions of
clinical commissioning groups in arranging for the provision of
40
services as part of the health service (including the function of making
a request to the Board for the purposes of section 14Z9).

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14Z4
Joint exercise of functions with Local Health Boards
(1)
Regulations may provide for any prescribed functions of a clinical
commissioning group to be exercised jointly with a Local Health Board.
(2)
Regulations may provide for any functions that are (by virtue of
subsection (1)) exercisable jointly by a clinical commissioning group
5
and a Local Health Board to be exercised by a joint committee of the
group and the Local Health Board.
(3)
Arrangements made by virtue of this section do not affect the liability
of a clinical commissioning group for the exercise of any of its
functions.
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Additional powers of clinical commissioning groups
14Z5
Raising additional income
(1)
A clinical commissioning group 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
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available for improving the health service.
(2)
A clinical commissioning group may exercise a power conferred by
subsection (1) only to the extent that its exercise does not to any
significant extent interfere with the performance by the group of its
functions.
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14Z6
Power to make grants
(1)
A clinical commissioning group may make payments 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 group has functions.
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(2)
The payments may be made subject to such terms and conditions as the
group considers appropriate.
Board’s functions in relation to clinical commissioning groups
14Z7
Responsibility for payments to providers
(1)
The Board may publish a document specifying—
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(a)
circumstances in which a clinical commissioning group is liable
to make a payment to a person in respect of services provided
by that person in pursuance of arrangements made by another
clinical commissioning group in the discharge of its
commissioning functions, and
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(b)
how the amount of any such payment is to be determined.
(2)
A clinical commissioning group is required to make payments in
accordance with any document published under subsection (1).
(3)
Where a clinical commissioning group is required to make a payment
by virtue of subsection (2), no other clinical commissioning group is
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liable to make it.

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(4)
Accordingly, any obligation of another clinical commissioning group 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).
5
(6)
The Board may publish guidance for clinical commissioning groups for
the purpose of assisting them in understanding and applying any
document published under subsection (1).
(7)
In this section and section 14Z8, “commissioning functions” means the
functions of clinical commissioning groups in arranging for the
10
provision of services as part of the health service.
14Z8
Guidance on commissioning by the Board
(1)
The Board must publish guidance for clinical commissioning groups on
the discharge of their commissioning functions.
(2)
Each clinical commissioning group must have regard to guidance
15
under this 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
20
that are, in the opinion of the Board, significant.
14Z9
Exercise of functions by the Board
(1)
The Board may, at the request of a clinical commissioning group,
exercise on behalf of the group—
(a)
any of its functions under section 3 or 3A which are specified in
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the request, and
(b)
any other functions of the group 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.
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(3)
Arrangements under this section may be on such terms and conditions
(including terms as to payment) as may be agreed between the Board
and the clinical commissioning group.
(4)
Arrangements made under this section do not affect the liability of a
clinical commissioning group for the exercise of any of its functions.
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14Z10
Power of Board to provide assistance or support
(1)
The Board may provide assistance or support to a clinical
commissioning group.
(2)
The assistance that may be provided includes—
(a)
financial assistance, and
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(b)
making the services of the Board’s employees or any other
resources of the Board available to the clinical commissioning
group.

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(3)
Assistance or support provided under this section may be provided on
such terms and conditions, including terms as to payment, as the Board
considers appropriate.
(4)
The Board may, in particular, impose restrictions on the use of any
financial or other assistance or support provided under this section.
5
(5)
A clinical commissioning group must comply with any restrictions
imposed under subsection (4).
Commissioning plans and reports
14Z11
Commissioning plan
(1)
Before the start of each relevant period, a clinical commissioning group
10
must prepare a plan setting out how it proposes to exercise its functions
in that period.
(2)
In subsection (1), “relevant period”, in relation to a clinical
commissioning group, means—
(a)
the period which —
15
(i)
begins on such day during the first financial year of the
group as the Board may direct, and
(ii)
ends at the end of that financial year, and
(b)
each subsequent financial year.
(3)
The plan must, in particular, explain how the group proposes to
20
discharge its duties under—
(a)
sections 14R and 14Z2, and
(b)
sections 223H to 223J.
(4)
The clinical commissioning group must publish the plan.
(5)
The clinical commissioning group must give a copy of the plan to the
25
Board before the date specified by the Board in a direction.
(6)
The clinical commissioning group must give a copy of the plan to each
relevant Health and Wellbeing Board.
(7)
The Board may publish guidance for clinical commissioning groups on
the discharge of their functions by virtue of this section and sections
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14Z12 and 14Z13.
(8)
A clinical commissioning group must have regard to any guidance
published by the Board under subsection (7).
(9)
In this Chapter, “relevant Health and Wellbeing Board”, in relation to a
clinical commissioning group, means a Health and Wellbeing Board
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established by a local authority whose area coincides with, or includes
the whole or any part of, the area of the group.
14Z12
Revision of commissioning plans
(1)
A clinical commissioning group may revise a plan published by it
under section 14Z11.
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(2)
If the clinical commissioning group revises the plan in a way which it
considers to be significant—

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(a)
the group must publish the revised plan, and
(b)
subsections (5) and (6) of section 14Z11 apply in relation to the
revised plan as they apply in relation to the original plan.
(3)
If the clinical commissioning group revises the plan in any other way,
the group must—
5
(a)
publish a document setting out the changes it has made to the
plan, and
(b)
give a copy of the document to the Board and each relevant
Health and Wellbeing Board.
14Z13
Consultation about commissioning plans
10
(1)
This section applies where a clinical commissioning group is—
(a)
preparing a plan under section 14Z11, or
(b)
revising a plan under section 14Z12 in a way which it considers
to be significant.
(2)
The clinical commissioning group must consult individuals for whom
15
it has responsibility for the purposes of section 3.
(3)
The clinical commissioning group must involve each relevant Health
and Wellbeing Board in preparing or revising the plan.
(4)
The clinical commissioning group must, in particular—
(a)
give each relevant Health and Wellbeing Board a draft of the
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plan or (as the case may be) the plan as revised, and
(b)
consult each such Board on whether the draft takes proper
account of each joint health and wellbeing strategy published
by it which relates to the period (or any part of the period) to
which the plan relates.
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(5)
Where a Health and Wellbeing Board is consulted under subsection
(4)(b), the Health and Wellbeing Board must give the clinical
commissioning group its opinion on the matter mentioned in that
subsection.
(6)
Where a Health and Wellbeing Board is consulted under subsection
30
(4)(b)—
(a)
it may also give the Board its opinion on the matter mentioned
in that subsection, and
(b)
if it does so, it must give the clinical commissioning group a
copy of its opinion.
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(7)
If a clinical commissioning group revises or further revises a draft after
it has been given to each relevant Health and Wellbeing Board under
subsection (4), subsections (4) to (6) apply in relation to the revised
draft as they apply in relation to the original draft.
(8)
A clinical commissioning group must include in a plan published
40
under section 14Z11(4) or 14Z12(2)—
(a)
a summary of the views expressed by individuals consulted
under subsection (2),
(b)
an explanation of how the group took account of those views,
and
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(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 health and wellbeing strategy” means a strategy
under section 116A of the Local Government and Public Involvement
5
in Health Act 2007 which is prepared and published by a Health and
Wellbeing Board by virtue of section 196 of the Health and Social Care
Act 2012.
14Z14
Opinion of Health and Wellbeing Boards on commissioning plans
(1)
A relevant Health and Wellbeing Board—
10
(a)
may give the Board its opinion on whether a plan published by
a clinical commissioning group under section 14Z11(4) or
14Z12(2) takes proper account of each joint health and
wellbeing strategy published by the Health and Wellbeing
Board which relates to the period (or any part of the period) to
15
which the plan relates, and
(b)
if it does so, must give the clinical commissioning group a copy
of its opinion.
(2)
In this section, “joint health and wellbeing strategy” has the same
meaning as in section 14Z13.
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14Z15
Reports by clinical commissioning groups
(1)
In each financial year other than its first financial year, a clinical
commissioning group must 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—
25
(a)
explain how the clinical commissioning group has discharged
its duties under sections 14R, 14T and 14Z2, and
(b)
review the extent to which the group has contributed to the
delivery of any joint health and wellbeing strategy to which it
was required to have regard under section 116B(1)(b) of the
30
Local Government and Public Involvement in Health Act 2007.
(3)
In preparing the review required by subsection (2)(b), the clinical
commissioning group must consult each relevant Health and
Wellbeing Board.
(4)
The Board may give directions to clinical commissioning groups as to
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the form and content of an annual report.
(5)
A clinical commissioning group must give a copy of its annual report
to the Board before the date specified by the Board in a direction.
(6)
A clinical commissioning group must—
(a)
publish its annual report, and
40
(b)
hold a meeting for the purpose of presenting the report to
members of the public.