Health and Social Care Bill (HL Bill 132)

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) 5improve 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
10outcomes achieved for them by the provision of those services.

(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) 15improve 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) 20reduce inequalities between persons with respect to the
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
  25care 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
  1970).

30Public involvement

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
35commissioning group in the exercise of its functions (“commissioning
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
40in other ways)—

(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
45the implementation of the proposals would have an impact on
the 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 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) 5a description of the arrangements made by it under subsection
(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
10the discharge of their functions under this section.

(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.

15Arrangements with others

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) 20The arrangements may provide for—

(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) 25For the purposes of the arrangements a clinical commissioning group
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) 30For the purposes of the arrangements, all the clinical commissioning
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
35incurred in the discharge of any of the commissioning functions
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
40clinical commissioning groups in arranging for the provision of
services as part of the health service (including the function of making
a request to the Board for the purposes of section 14Z9).

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
5subsection (1)) exercisable jointly by a clinical commissioning group
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
10functions.

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
15(provision of goods etc.) for the purpose of making additional income
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
20functions.

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
25which the group has functions.

(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) 30The Board may publish a document specifying—

(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
35commissioning functions, and

(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
40by virtue of subsection (2), no other clinical commissioning group is
liable to make it.

(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
5recovery).

(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
10functions of clinical commissioning groups in arranging for the
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) 15Each clinical commissioning group must have regard to guidance
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) 20before it publishes any revised guidance containing changes
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) 25any of its functions under section 3 or 3A which are specified in
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
30apply in relation to functions of a prescribed description.

(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
35clinical commissioning group for the exercise of any of its functions.

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) 40financial assistance, and

(b) making the services of the Board’s employees or any other
resources of the Board available to the clinical commissioning
group.

(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
5financial or other assistance or support provided under this section.

(5) A clinical commissioning group must comply with any restrictions
imposed under subsection (4).

Commissioning plans and reports

14Z11 Commissioning plan

(1) 10Before the start of each relevant period, a clinical commissioning group
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) 15the period which —

(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) 20The plan must, in particular, explain how the group proposes to
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) 25The clinical commissioning group must give a copy of the plan to the
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
30the discharge of their functions by virtue of this section and sections
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
35clinical commissioning group, means a Health and Wellbeing Board
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
40under section 14Z11.

(2) If the clinical commissioning group revises the plan in a way which it
considers to be significant—

(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,
5the group must—

(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 10 Consultation about commissioning plans

(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) 15The clinical commissioning group must consult individuals for whom
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) 20give each relevant Health and Wellbeing Board a draft of the
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
25which the plan relates.

(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) 30Where a Health and Wellbeing Board is consulted under subsection
(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
35copy of its opinion.

(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) 40A clinical commissioning group must include in a plan published
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,
45and

(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
5under section 116A of the Local Government and Public Involvement
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) 10A relevant Health and Wellbeing Board—

(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
15Board which relates to the period (or any part of the period) to
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
20meaning as in section 14Z13.

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) 25An annual report must, in particular—

(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
30was required to have regard under section 116B(1)(b) of the
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) 35The Board may give directions to clinical commissioning groups as to
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) 40publish its annual report, and

(b) hold a meeting for the purpose of presenting the report to
members of the public.

Performance assessment of clinical commissioning groups

14Z16 Performance assessment of clinical commissioning groups

(1) The Board must conduct a performance assessment of each clinical
commissioning group in respect of each financial year.

(2) 5A performance assessment is an assessment of how well the clinical
commissioning group has discharged its functions during that year.

(3) The assessment must, in particular, include an assessment of how well
the group has discharged its duties under—

(a) sections 14R, 14W and 14Z2,

(b) 10sections 223H to 223J, and

(c) section 116B(1) of the Local Government and Public
Involvement in Health Act 2007 (duty to have regard to
assessments and strategies).

(4) In conducting a performance assessment, the Board must consult each
15relevant Health and Wellbeing Board as to its views on the clinical
commissioning group’s contribution to the delivery of any joint health
and wellbeing strategy to which the group was required to have regard
under section 116B(1)(b) of that Act of 2007.

(5) The Board must, in particular, have regard to—

(a) 20any document published by the Secretary of State for the
purposes of this section, and

(b) any guidance published under section 14Z8.

(6) The Board must publish a report in respect of each financial year
containing a summary of the results of each performance assessment
25conducted by the Board in respect of that year.

Powers to require information etc.

14Z17 Circumstances in which powers in sections 14Z18 and 14Z19 apply

(1) Sections 14Z18 and 14Z19 apply where the Board has reason to
believe—

(a) 30that the area of a clinical commissioning group is no longer
appropriate, or

(b) that a clinical commissioning group might have failed, might be
failing or might fail to discharge any of its functions.

(2) For the purposes of this section—

(a) 35a failure to discharge a function includes a failure to discharge
it properly, and

(b) a failure to discharge a function properly includes a failure to
discharge it consistently with what the Board considers to be
the interests of the health service.

14Z18 40 Power to require documents and information etc.

(1) Where this section applies, the Board may require a person mentioned
in subsection (2) to provide to the Board any information, documents,
records or other items that the Board considers it necessary or

expedient to have for the purposes of any of its functions in relation to
the clinical commissioning group.

(2) The persons mentioned in this subsection are—

(a) the clinical commissioning group if it has possession or control
5of the item in question;

(b) any member or employee of the group who has possession or
control of the item in question.

(3) A person must comply with a requirement imposed under subsection
(1).

(4) 10The power conferred by subsection (1) includes power to require that
any information, documents or records kept by means of a computer be
provided in legible form.

(5) The power conferred by subsection (1) does not include power to
require the provision of personal records.

(6) 15In subsection (5), “personal records” has the meaning given by section
12 of the Police and Criminal Evidence Act 1984.

14Z19 Power to require explanation

(1) Where this section applies, the Board may require the clinical
commissioning group to provide it with an explanation of any matter
20which relates to the exercise by the group of any of its functions,
including an explanation of how the group is proposing to exercise any
of its functions.

(2) The Board may require the explanation to be given—

(a) orally at such time and place as the Board may specify, or

(b) 25in writing.

(3) The clinical commissioning group must comply with a requirement
imposed under subsection (1).

14Z20 Use of information

Any information, documents, records or other items that are obtained
30by the Board in pursuance of section 14Z18 or 14Z19 may be used by
the Board in connection with any of its functions in relation to clinical
commissioning groups.

Intervention powers

14Z21 Power to give directions, dissolve clinical commissioning groups etc.

(1) 35This section applies if the Board is satisfied that—

(a) a clinical commissioning group is failing or has failed to
discharge any of its functions, or

(b) there is a significant risk that a clinical commissioning group
will fail to do so.

(2) 40The Board may direct the clinical commissioning group to discharge
such of those functions, and in such manner and within such period or
periods, as may be specified in the direction.

(3) The Board may direct—

(a) the clinical commissioning group, or

(b) the accountable officer of the group,

to cease to perform any functions for such period or periods as may be
specified in the direction.

(4) 5The Board may—

(a) terminate the appointment of the clinical commissioning
group’s accountable officer, and

(b) appoint another person to be its accountable officer.

(5) Paragraph 12(4) of Schedule 1A does not apply to an appointment
10under subsection (4)(b).

(6) The Board may vary the constitution of the clinical commissioning
group, including doing so by—

(a) varying its area,

(b) adding any person who is a provider of medical services to the
15list of members, or

(c) removing any person from that list.

(7) The Board may dissolve the clinical commissioning group.

(8) Where a direction is given under subsection (3) the Board may—

(a) exercise any of the functions that are the subject of the direction
20on behalf of the clinical commissioning group or (as the case
may be) the accountable officer;

(b) direct another clinical commissioning group or (as the case may
be) the accountable officer of another clinical commissioning
group to perform any of those functions on behalf of the group
25or (as the case may be) the accountable officer, in such manner
and within such period or periods as may be specified in the
directions.

(9) A clinical commissioning group to which a direction is given under
subsection (3) must—

(a) 30where the Board exercises a function of the group under
subsection (8)(a), co-operate with the Board, and

(b) where a direction is given under subsection (8)(b) to another
clinical commissioning group or to the accountable officer of
another clinical commissioning group, co-operate with the
35other group or (as the case may be) the accountable officer.

(10) Before exercising the power conferred by subsection (8)(b) the Board
must consult the clinical commissioning group to which it is proposing
to give the direction.

(11) Where the Board exercises a power conferred by subsection (6) or (7),
40the Board may make a property transfer scheme or a staff transfer
scheme.

(12) In subsection (11), “property transfer scheme” and “staff transfer
scheme” have the same meaning as in section 14I.

(13) Part 3 of Schedule 1A applies in relation to a property transfer scheme
45or a staff transfer scheme under subsection (11) as it applies in relation
to a property transfer scheme or (as the case may be) a staff transfer
scheme under section 14I(1).