Health and Social Care Bill (HL Bill 132)

13K Duty to promote innovation

(1) The Board 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) 5The Board may make payments as prizes to promote innovation in the
provision of health services.

(3) A prize may relate to—

(a) work at any stage of innovation (including research);

(b) work done at any time (including work before the
10commencement of section 23 of the Health and Social Care Act
2012).

13L Duty in respect of research

The Board must, in the exercise of its functions, promote—

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

(b) 15the use in the health service of evidence obtained from research.

13M Duty as to promoting education and training

The Board must, in exercising its functions, have regard to the need to
promote education and training for the persons mentioned in section
1F(1) so as to assist the Secretary of State in the discharge of the duty
20under that section.

13N Duty as to promoting integration

(1) The Board 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) 25improve 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
30outcomes achieved for them by the provision of those services.

(2) The Board 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) 35improve 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) 40reduce inequalities between persons with respect to the
outcomes achieved for them by the provision of those services.

(3) The Board must encourage clinical commissioning groups to enter into
arrangements with local authorities in pursuance of regulations under
section 75 where it considers that this would secure—

(a) that health services are provided in an integrated way and that
this would have any of the effects mentioned in subsection
(1)(a) to (c), or

(b) that the provision of health services is integrated with the
5provision of health-related services or social care services and
that this would have any of the effects mentioned in subsection
(2)(a) to (c).

(4) In this section—

• “health-related services” means services that may have an effect
  10on 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
  (within the meaning of the Local Authority Social Services Act
  151970).

13O Duty to have regard to impact on services in certain areas

(1) In making commissioning decisions, the Board must have regard to the
likely impact of those decisions on the provision of health services to
persons who reside in an area of Wales or Scotland that is close to the
20border with England.

(2) In this section, “commissioning decisions”, in relation to the Board,
means decisions about the carrying out of its functions in arranging for
the provision of health services.

13P Duty as respects variation in provision of health services

25The Board must not exercise its functions for the purpose of causing a
variation in the proportion of services provided as part of the health
service that is provided by persons of a particular description if that
description is by reference to—

(a) whether the persons in question are in the public or (as the case
30may be) private sector, or

(b) some other aspect of their status.

Public involvement

13Q Public involvement and consultation by the Board

(1) This section applies in relation to any health services which are, or are
35to be, provided pursuant to arrangements made by the Board in the
exercise of its functions (“commissioning arrangements”).

(2) The Board 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) 40in the planning of the commissioning arrangements by the
Board,

(b) in the development and consideration of proposals by the
Board for changes in the commissioning arrangements where
the implementation of the proposals would have an impact on
45the manner in which the services are delivered to the

individuals or the range of health services available to them,
and

(c) in decisions of the Board affecting the operation of the
commissioning arrangements where the implementation of the
5decisions would (if made) have such an impact.

(3) 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.

Functions in relation to information

13R Information on safety of services provided by the health service

(1) 10The Board must establish and operate systems for collecting and
analysing information relating to the safety of the services provided by
the health service.

(2) The Board must make information collected by virtue of subsection (1),
and any other information obtained by analysing it, available to such
15persons as the Board considers appropriate.

(3) The Board may impose charges, calculated on such basis as it considers
appropriate, in respect of information made available by it under
subsection (2).

(4) The Board must give advice and guidance, to such persons as it
20considers appropriate, for the purpose of maintaining and improving
the safety of the services provided by the health service.

(5) The Board must monitor the effectiveness of the advice and guidance
given by it under subsection (4).

(6) A clinical commissioning group must have regard to any advice or
25guidance given to it under subsection (4).

(7) The Board may arrange for any other person (including another NHS
body) to exercise any of the Board’s functions under this section.

(8) Arrangements made under subsection (7) do not affect the liability of
the Board for the exercise of any of its functions.

13S 30Guidance in relation to processing of information

(1) The Board must publish guidance for registered persons on the practice
to be followed by them in relation to the processing of—

(a) patient information, and

(b) any other information obtained or generated in the course of the
35provision of the health service.

(2) Registered persons who carry on an activity which involves, or is
connected with, the provision of health care must have regard to any
guidance published under this section.

(3) In this section, “patient information”, “processing” and “registered
40person” have the same meanings as in section 20A of the Health and
Social Care Act 2008.

Business plan and report

13T Business plan

(1) Before the start of each financial year, the Board must publish a
business plan setting out how it proposes to exercise its functions in
5that year and each of the next two financial years.

(2) The business plan must, in particular, explain how the Board proposes
to discharge its duties under—

(a) sections 13E and 13Q, and

(b) sections 223C to 223E.

(3) 10The business plan must, in particular, explain how the Board proposes
to achieve the objectives, and comply with the requirements, specified
in the mandate for the first financial year to which the plan relates.

(4) The Board may revise the plan.

(5) The Board must publish any revised plan.

13U 15Annual report

(1) As soon as practicable after the end of each financial year, the Board
must publish an annual report on how it has exercised its functions
during the year.

(2) The annual report must, in particular, contain an assessment of—

(a) 20the extent to which it met any objectives or requirements
specified in the mandate for that year,

(b) the extent to which it gave effect to the proposals for that year
in its business plan, and

(c) how effectively it discharged its duties under sections 13E, 13G
25and 13Q.

(3) The Board must—

(a) lay the annual report before Parliament, and

(b) once it has done so, send a copy of it to the Secretary of State.

(4) The Secretary of State must, having considered the annual report, set
30out in a letter to the Board the Secretary of State’s assessment of the
Board’s performance of its functions in the financial year in question.

(5) The letter must, in particular, contain the Secretary of State’s
assessment of the matters mentioned in subsection (2)(a) to (c).

(6) The Secretary of State must—

(a) 35publish the letter to the Board, and

(b) lay it before Parliament.

Additional powers

13V Establishment of pooled funds

(1) The Board and one or more clinical commissioning groups may
40establish and maintain a pooled fund.

(2) A pooled fund is a fund—

(a) which is made up of contributions by the bodies which
established it, and

(b) out of which payments may be made, with the agreement of
those bodies, towards expenditure incurred in the discharge of
5any of their commissioning functions.

(3) In this section, “commissioning functions” means functions in
arranging for the provision of services as part of the health service.

13W Board’s power to generate income, etc.

(1) The Board has power to do anything specified in section 7(2) of the
10Health and Medicines Act 1988 (provision of goods, services, etc.) for
the purpose of making additional income available for improving the
health service.

(2) The Board may exercise a power conferred by subsection (1) only to the
extent that its exercise does not to any significant extent interfere with
15the performance by the Board of its functions.

13X Power to make grants etc.

(1) The Board 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 Board has
20functions.

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

13Y Board’s incidental powers: further provision

The power conferred on the Board by section 2 includes, in particular,
25power to—

(a) enter into agreements,

(b) acquire and dispose of property, and

(c) accept gifts (including property to be held on trust for the
purposes of the Board).

30Exercise of functions of Board

13Z Exercise of functions

(1) This section applies to functions exercisable by the Board under or by
virtue of this Act or any prescribed provision of any other Act.

(2) The Board may arrange for any such function to be exercised by or
35jointly with—

(a) a Special Health Authority,

(b) a clinical commissioning group, or

(c) such other body as may be prescribed.

(3) Regulations may provide that the power in subsection (2) does not
40apply in relation to a function of a prescribed description.

(4) Where any functions are (by virtue of subsection (2)) exercisable jointly
by the Board and another body, they may be exercised by a joint
committee of the Board and the other body.

(5) 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 other party to the arrangements.

(6) Arrangements made under this section do not affect the liability of the
5Board for the exercise of any of its functions.

Power to confer additional functions

13Z1 Power to confer additional functions on the Board

(1) Regulations may provide that the Board is to have such additional
functions in relation to the health service as may be specified in the
10regulations.

(2) A function may be specified in regulations under subsection (1) only if
the function is connected to another function of the Board.

Intervention powers

13Z2 Failure by the Board to discharge any of its functions

(1) 15The Secretary of State may give a direction to the Board if the Secretary
of State considers that—

(a) the Board—

(i) is failing or has failed to discharge any of its functions,
or

(ii) 20is failing or has failed properly to discharge any of its
functions, and

(b) the failure is significant.

(2) A direction under subsection (1) may direct the Board to discharge such
of those functions, and in such manner and within such period or
25periods, as may be specified in the direction.

(3) If the Board fails to comply with a direction under subsection (1), the
Secretary of State may—

(a) discharge the functions to which it relates, or

(b) make arrangements for any other person to discharge them on
30the Secretary of State’s behalf.

(4) Where the Secretary of State exercises a power under subsection (1) or
(3), the Secretary of State must publish the reasons for doing so.

(5) For the purposes of this section a failure to discharge a function
properly includes a failure to discharge it consistently with what the
35Secretary of State considers to be the interests of the health service.

Disclosure of information

13Z3 Permitted disclosures of information

(1) The Board may disclose information obtained by it in the exercise of its
functions if—

(a) 40the information has previously been lawfully disclosed to the
public,

(b) the disclosure is made under or pursuant to regulations under
section 113 or 114 of the Health and Social Care (Community
Health and Standards) Act 2003 (complaints about health care
or social services),

(c) 5the disclosure is made in accordance with any enactment or
court order,

(d) the disclosure is necessary or expedient for the purposes of
protecting the welfare of any individual,

(e) the disclosure is made to any person in circumstances where it
10is necessary or expedient for the person to have the information
for the purpose of exercising functions of that person under any
enactment,

(f) the disclosure is made for the purpose of facilitating the exercise
of any of the Board’s functions,

(g) 15the disclosure is made in connection with the investigation of a
criminal offence (whether or not in the United Kingdom), or

(h) the disclosure is made for the purpose of criminal proceedings
(whether or not in the United Kingdom).

(2) Paragraphs (a) to (c) and (h) of subsection (1) have effect
20notwithstanding any rule of common law which would otherwise
prohibit or restrict the disclosure.

Interpretation

13Z4 Interpretation

(1) In this Chapter—

• 25“the health service” means the health service in England;

• “health services” means services provided as part of the health
  service and, in sections 13O and 13Q, also includes services that
  are to be provided as part of the health service.

(2) Any reference (however expressed) in the following provisions of this
30Act to the functions of the Board includes a reference to the functions of
the Secretary of State that are exercisable by the Board by virtue of
arrangements under section 7A—

• section 6E(7) and (10)(b),

• section 13A(2),

• 35section 13C(1),

• section 13D,

• section 13E(1),

• section 13F,

• section 13G,

• 40section 13H,

• section 13I,

• section 13J,

• section 13K(1),

• section 13L,

• 45section 13M,

• section 13N(1) and (2),

• section 13O(2),

Health and Social Care BillPage 27

• section 13Q(1),

• section 13T(1),

• section 13U(1) and (4),

• section 13W(2),

• 5section 13X(1),

• section 13Z2(1),

• section 13Z3(1),

• section 72(1),

• section 75(1)(a) and (2),

• 10section 82,

• section 223C(2)(a),

• in Schedule A1, paragraph 13.

(3) Any reference (however expressed) in the following provisions of other
Acts to the functions of the Board includes a reference to the functions
15of the Secretary of State that are exercisable by the Board by virtue of
arrangements under section 7A—

• sections 116 to 116B of the Local Government and Public
  Involvement in Health Act 2007 (joint strategic needs
  assessments etc.),

• 20section 197(6) of the Health and Social Care Act 2012 (participation
  of the Board in work of Health and Wellbeing Boards),

• section 199(4) of that Act (supply of information to Health and
  Wellbeing Boards),

• section 290(1) and (2) of that Act (duties to co-operate),

• 25section 291(2)(d) of that Act (breaches of duties to co-operate).

(4) The Secretary of State may by order amend the list of provisions
specified in subsection (2) or (3).”

(2) In section 272 of that Act (orders, regulations, rules and directions), in
subsection (6) after paragraph (za) insert—

“(zb) 30regulations under section 13Z1,”.

24 Financial arrangements for the Board

Before the cross-heading preceding section 224 of the National Health Service
Act 2006 insert—

“The Board

223B 35Funding of the Board

(1) The Secretary of State must pay to the Board in respect of each financial
year sums not exceeding the amount allotted for that year by the
Secretary of State towards meeting the expenditure of the Board which
is attributable to the performance by it of its functions in that year.

(2) 40An amount is allotted to the Board for a financial year under this
section when the Board is notified in writing by the Secretary of State
that the amount is allotted to it for that year.

(3) The Secretary of State may make a new allotment under this section
increasing or reducing the allotment previously so made only if—

(a) the Board agrees to the change,

(b) a parliamentary general election takes place, or

(c) the Secretary of State considers that there are exceptional
circumstances that make a new allotment necessary.

(4) 5The Secretary of State may give directions to the Board with respect to
the payment of sums by it to the Secretary of State in respect of charges
or other sums referable to the valuation or disposal of assets.

(5) Sums falling to be paid to the Board under this section are payable
subject to such conditions as to records, certificates or otherwise as the
10Secretary of State may determine.

223BC Financial duties of the Board: expenditure

(1) The Board must ensure that total health expenditure in respect of each
financial year does not exceed the aggregate of—

(a) the amount allotted to the Board for that year under section
15223B,

(b) any sums received by the Board or clinical commissioning
groups in that year under any provision of this Act (other than
sums received by the Board under section 223B or by clinical
commissioning groups under section 223G), and

(c) 20any sums received by the Board or clinical commissioning
groups in that year otherwise than under this Act for the
purpose of enabling it or them to defray such expenditure.

(2) In this section, “total health expenditure”, in relation to a financial year,
means—

(a) 25expenditure which is attributable to the performance by the
Board of its functions in that year, other than sums paid by it
under section 223G, and

(b) expenditure which is attributable to the performance by clinical
commissioning groups of their functions in that year.

(3) 30The Secretary of State may by directions determine whether
expenditure by the Board or a clinical commissioning group which is of
a description specified in the directions must, or must not, be treated
for the purposes of this section as part of total health expenditure.

(4) The Secretary of State may by directions determine the extent to which,
35and the circumstances in which, sums received by the Board or a
clinical commissioning group under section 223B or (as the case may
be) 223G but not yet spent must be treated for the purposes of this
section as part of total health expenditure, and to which financial year’s
expenditure they must be attributed.

(5) 40The Secretary of State may by directions require the Board to use
banking facilities specified in the directions for any purposes so
specified.

223D Financial duties of the Board: controls on total resource use

(1) In this Chapter—

• 45“total capital resource use”, in relation to a financial year, means
  the use of capital resources in that year by the Board and clinical
  commissioning groups (taken together);

Health and Social Care BillPage 29

• “total revenue resource use”, in relation to a financial year, means
  the use of revenue resources in that year by the Board and
  clinical commissioning groups (taken together).

(2) The Board must ensure that total capital resource use in a financial year
5does not exceed the amount specified by the Secretary of State.

(3) The Board must ensure that total revenue resource use in a financial
year does not exceed the amount specified by the Secretary of State.

(4) The Secretary of State may give directions, in relation to a financial
year, specifying descriptions of resources which must, or must not, be
10treated as capital resources or revenue resources for the purposes of
this Chapter.

(5) The Secretary of State may give directions, in relation to a financial
year, specifying uses of capital resources or revenue resources which
must not be taken into account for the purposes of this Chapter.

(6) 15The Secretary of State may give directions, in relation to a financial
year, specifying uses of capital resources or revenue resources which
must be taken into account for the purposes of this section.

(7) The amount specified for the purposes of subsection (2) or (3) may be
varied only if—

(a) 20the Board agrees to the change,

(b) a parliamentary general election takes place, or

(c) the Secretary of State considers that there are exceptional
circumstances which make the variation necessary.

(8) Any reference in this Chapter to the use of capital resources or revenue
25resources is a reference to their expenditure, consumption or reduction
in value.

223E Financial duties of the Board: additional controls on resource use

(1) The Secretary of State may direct the Board to ensure that total capital
resource use in a financial year which is attributable to matters
30specified in the direction does not exceed an amount so specified.

(2) The Secretary of State may direct the Board to ensure that total revenue
resource use in a financial year which is attributable to matters
specified in the direction does not exceed an amount so specified.

(3) The Secretary of State may direct the Board to ensure —

(a) 35that total revenue resource use in a financial year which is
attributable to such prescribed matters relating to
administration as are specified in the direction does not exceed
an amount so specified;

(b) that the Board’s use of revenue resources in a financial year
40which is attributable to such prescribed matters relating to
administration as are specified in the direction does not exceed
an amount so specified.

(4) The Secretary of State may give directions, in relation to a financial
year, specifying uses of capital resources or revenue resources which
45must, or must not, be taken into account for the purposes of subsection
(1) or (as the case may be) subsection (2) or (3).