Care Bill (HL Bill 1)

3 (1) The relevant authority, having received an assessment notice and having in
light of it carried out a needs assessment and (where applicable) a carer’s
assessment, must inform the NHS body responsible for the patient—

(a) whether the patient has needs for care and support,

(b) 5(where applicable) whether a carer has needs for support,

(c) whether any of the needs referred to in paragraphs (a) and (b) meet
the eligibility criteria, and

(d) how the authority plans to meet such of those needs as meet the
eligibility criteria.

(2) 10Where, having carried out a needs assessment or carer’s assessment in a case
within section 27(4), the relevant authority considers that the patient’s needs
for care and support or (as the case may be) the carer’s needs for support
have changed, it must inform the NHS body responsible for the patient of
the change.

15Cases where discharge of the patient is delayed

4 (1) If the relevant authority, having received an assessment notice and a
discharge notice, has not carried out a needs or (where applicable) carer’s
assessment and the patient has not been discharged by the end of the
relevant day, the NHS body responsible for the patient may require the
20relevant authority to pay the specified amount for each day of the specified
period.

(2) If the relevant authority has not put in place arrangements for meeting some
or all of those of the needs under sections 18 to 20 that it proposes to meet in
the case of the patient or (where applicable) a carer, and the patient has for
25that reason alone not been discharged by the end of the relevant day, the
NHS body responsible for the patient may require the relevant authority to
pay the specified amount for each day of the specified period.

(3) If, in a case within sub-paragraph (1) or (2), the assessment notice ceases to
be in force, any liability arising under that sub-paragraph before it ceased to
30be in force is unaffected.

(4) A payment under sub-paragraph (1) or (2) must be made to—

(a) the NHS body responsible for the patient, or

(b) in such a case as regulations may specify, the person specified.

(5) The “relevant day” has the meaning given by paragraph 2(5).

(6) 35A reference to a requirement to pay the specified amount is a reference to a
requirement to pay the amount specified in regulations; and the reference to
the specified period is a reference to the period specified in or determined in
accordance with regulations.

(7) In specifying the amount of a payment, the Secretary of State must have
40regard in particular to either or both of—

(a) costs to NHS bodies of providing accommodation and personal care
to patients ready to be discharged, and

(b) costs to local authorities of meeting needs under sections 18 to 20 in
the case of persons who have been discharged.

Delegation to management of independent hospital

5 (1) An NHS body may make arrangements with any person connected with the
management of an independent hospital for that person (or an employee of
that person) to do, on behalf of the NHS body and in accordance with the
5arrangements, anything which is required or authorised to be done by the
NHS body by or under this Schedule in relation to hospital patients
accommodated in that hospital.

(2) Anything done or omitted to be done by or in relation to the authorised
person (or an employee of that person) under such arrangements is to be
10treated as done or omitted to be done by or in relation to the NHS body.

(3) Nothing in this paragraph prevents anything being done by or in relation to
the NHS body.

Adjustments between local authorities

6 (1) Regulations may modify, or otherwise make provision about, the
15application of a provision of this Schedule in a case where it appears to the
NHS body responsible for a hospital patient that the patient is ordinarily
resident in the area of another local authority.

(2) The regulations may, in particular, authorise or require a local authority—

(a) to accept an assessment notice given to it even though it may wish to
20dispute that it was the correct authority to which to give the notice;

(b) to become the relevant authority in the patient’s case;

(c) to recover expenditure incurred—

(i) in the exercise of functions under this Schedule;

(ii) in meeting needs under sections 18 to 20 in a case under this
25Schedule.

Meaning of “hospital patient”, “NHS hospital, “NHS body”, etc.

7 (1) A hospital patient is a person ordinarily resident in England who—

(a) is being accommodated at an NHS hospital, or at an independent
hospital as a result of arrangements made by an NHS body, and

(b) 30is receiving (or has received or can reasonably be expected to receive)
acute care.

(2) “NHS hospital” means a health service hospital (as defined by the National
Health Service Act 2006) in England.

(3) “Independent hospital” means a hospital (as defined by that Act) in the
35United Kingdom which is not—

(a) an NHS hospital,

(b) a health service hospital as defined by section 206 of the National
Health Service (Wales) Act 2006,

(c) a health service hospital as defined by section 108 of the National
40Health Service (Scotland) Act 1978, or

(d) a hospital vested in the Department of Health, Social Services and
Public Safety in Northern Ireland or managed by a Health and Social
Care trust.

(4) “NHS body” means—

(a) an NHS trust established under section 25 of the National Health
Service Act 2006,

(b) an NHS foundation trust,

(c) the National Health Service Commissioning Board, or

(d) 5a clinical commissioning group.

(5) A reference to the NHS body responsible for a hospital patient is—

(a) if the hospital is an NHS hospital, a reference to the NHS body
managing it, or

(b) if the hospital is an independent hospital, a reference to the NHS
10body that arranged for the patient to be accommodated in it.

(6) “Acute care” means intensive medical treatment provided by or under the
supervision of a consultant, that lasts for a limited period after which the
person receiving the treatment no longer benefits from it.

(7) Care is not “acute care” if the patient has given an undertaking (or one has
15been given on the patient’s behalf) to pay for it; nor is any of the following
“acute care”—

(a) care of an expectant or nursing mother;

(b) mental health care;

(c) palliative care;

(d) 20a structured programme of care provided for a limited period to help
a person maintain or regain the ability to live at home;

(e) care provided for recuperation or rehabilitation.

(8) “Mental health care” means psychiatric services, or other services provided
for the purpose of preventing, diagnosing or treating illness, the
25arrangements for which are the primary responsibility of a consultant
psychiatrist.

Further provision about assessment notices, discharge notices, etc.

8 Regulations may—

(a) specify the form and content of an assessment notice, a discharge
30notice or a withdrawal notice;

(b) specify the manner in which an assessment notice, a discharge notice
or a withdrawal notice may be given;

(c) specify when a discharge notice may be given;

(d) specify circumstances in which a withdrawal notice must be given;

(e) 35make provision for determining the day on which an assessment
notice, a discharge notice or a withdrawal notice is to be regarded as
given.

Section 68

SCHEDULE 4 After-care under the Mental Health Act 1983: direct payments

1 (1) 40Sections 31 (adults with capacity to request direct payments), 32 (adults
without capacity to request direct payments) and 33 (direct payments:
further provision) apply in relation to section 117 of the Mental Health Act
1983 but as if the following modifications were made to those sections.

(2) For subsection (1) of section 31, substitute—

“(1) This section applies where an adult to whom section 117 of the
Mental Health Act 1983 (after-care) applies requests the local
authority to make payments to the adult or a person nominated by
5the adult that are equivalent to the cost of providing or arranging for
the provision of after-care services for the adult under that section.”

(3) In subsection (5) of that section—

(a) in paragraph (a), for “meeting the adult’s needs” substitute
“discharging its duty under section 117 of the Mental Health Act
101983”, and

(b) in paragraph (b), for “to meet the adult’s needs” substitute “to
discharge its duty under that section”.

(4) In subsection (7) of that section, for “to meet the needs in question”
substitute “to discharge its duty under section 117 of the Mental Health Act
151983”.

(5) For subsection (1) of section 32, substitute—

“(1) This section applies where—

(a) an adult to whom section 117 of the Mental Health Act 1983
(after-care) applies lacks capacity to request the local
20authority to make payments equivalent to the cost of
providing or arranging for the provision of after-care services
for the adult under that section, and

(b) an authorised person requests the local authority to make
such payments to the authorised person.”

(6) 25In subsection (4)(a) of that section, for “the adult’s needs for care and
support” substitute “the provision to the adult of after-care services under
section 117 of the Mental Health Act 1983”.

(7) In subsection (6) of that section—

(a) in paragraph (a), for “meeting the adult’s needs” substitute
30“discharging its duty under section 117 of the Mental Health Act
1983”, and

(b) in paragraph (b), for “to meet the adult’s needs” substitute “to
discharge its duty under that section”.

(8) In subsection (7) of that section, for “the provision of the care and support”
35substitute “the provision of after-care services under section 117 of the
Mental Health Act 1983”.

(9) In subsection (9) of that section, for “to meet the needs in question”
substitute “to discharge its duty under section 117 of the Mental Health Act
1983”.

(10) 40In subsection (2)(a) of section 33, for “meet needs” substitute “discharge its
duty under section 117 of the Mental Health Act 1983”.

(11) For subsection (3) of that section, substitute—

“(3) A direct payment is made on condition that it be used only to pay for
arrangements under which after-care services for the adult are
45provided under section 117 of the Mental Health Act 1983.”

2 (1) Section 117(2C) of the Mental Health Act 1983 (references to after-care
services to include those provided by means of direct payments) is amended
as follows.

(2) In paragraph (a), for “regulations under section 57 of the Health and Social
5Care Act 2001 or” substitute “—

(i) sections 31 to 33 of the Care Act 2013 (as applied by
Schedule 4 to that Act), or

(ii) regulations under”.

(3) In paragraph (b), after “apart from” insert “those sections (as so applied) or”.

Section 83

10SCHEDULE 5 Health Education England

Part 1 Constitution

Membership

1 (1) 15HEE consists of—

(a) a chair appointed by the Secretary of State,

(b) six other members appointed by the Secretary of State,

(c) a chief executive appointed by the members appointed under
paragraphs (a) and (b), and

(d) 20no more than four other members appointed by the members
appointed under paragraphs (a) and (b).

(2) The members appointed under sub-paragraph (1)(a) and (b)—

(a) are not employees of HEE, and

(b) are referred to in this Schedule as the “non-executive members”.

(3) 25The members appointed under sub-paragraph (1)(c) and (d)—

(a) are employees of HEE, and

(b) are referred to in this Schedule as the “executive members”.

2 (1) The members of HEE must include persons who have clinical expertise of a
description specified in regulations.

(2) 30The regulations may require—

(a) a specified number of members to have that expertise;

(b) a specified number of non-executive members to have that expertise;

(c) a specified number of executive members to have that expertise.

Non-executive members: terms of office

3 (1) 35A person holds office as a non-executive member of HEE on the terms of that
person’s appointment.

(2) A person may not be appointed as a non-executive member for a period of
more than four years.

(3) A person who ceases to be a non-executive member is eligible for re-
appointment.

(4) A person may resign from office as a non-executive member by giving notice
to the Secretary of State.

(5) 5The Secretary of State may remove a person from office as a non-executive
member on any of the following grounds—

(a) incapacity;

(b) misbehaviour;

(c) failure to carry out his or her duties as a non-executive member.

(6) 10The Secretary of State may suspend a person from office as a non-executive
member if it appears to the Secretary of State that there are or may be
grounds to remove that person from office under sub-paragraph (5).

Non-executive members: suspension from office

4 (1) Having decided to suspend a person under paragraph 3(6), the Secretary of
15State must give notice of the decision to the person; and the suspension takes
effect when the person receives the notice.

(2) The notice may be—

(a) delivered in person (in which case the person is taken to receive it
when it is delivered), or

(b) 20sent by first class post to the person’s last known address (in which
case, the person is taken to receive it on the third day after the day on
which it is posted).

(3) The initial period of suspension must not exceed six months.

(4) The Secretary of State may review the suspension.

(5) 25The Secretary of State—

(a) must review the suspension, if requested in writing by the person to
do so, but

(b) need not review the suspension less than three months after the
beginning of the initial period of suspension.

(6) 30Following a review during a period of suspension, the Secretary of State
may—

(a) revoke the suspension, or

(b) suspend the person for a period of no more than six months from the
expiry of the current period.

(7) 35The Secretary of State must revoke the suspension if the Secretary of State—

(a) decides that there are no grounds to remove the person from office
under paragraph 3(5), or

(b) decides that there are grounds to do so but nonetheless decides not
to do so.

5 (1) 40Where a person is suspended from office as the chair under paragraph 3(6),
the Secretary of State may appoint a non-executive member as interim chair
to exercise the chair’s functions.

(2) Appointment as interim chair is for a term not exceeding the shorter of—

(a) the period ending with either—

(i) the appointment of a new chair, or

(ii) the revocation or expiry of the existing chair’s suspension,
and

(b) the remainder of the interim chair’s term as a non-executive member.

(3) 5A person who ceases to be the interim chair is eligible for re-appointment.

Non-executive members: pay

6 (1) HEE must pay its non-executive members such remuneration as the
Secretary of State may decide.

(2) HEE must pay, or provide for the payment of, such allowances or gratuities
10as the Secretary of State may decide to a person who is or has been a non-
executive member of HEE.

Employees: terms of office

7 (1) Each executive member of HEE is appointed as an employee of HEE on such
terms as it decides.

(2) 15A person may not be appointed as chief executive without the consent of the
Secretary of State.

(3) HEE may appoint, on such terms as it decides, other persons as employees
of HEE (in addition to those appointed as executive members).

Employees: pay

8 (1) 20HEE must pay its employees such remuneration as it decides.

(2) HEE may pay, or provide for the payment of, such pensions, allowances or
gratuities as it decides to or in respect of a person who is or has been an
employee of HEE.

(3) Before making a decision about pay under this paragraph, HEE must obtain
25the approval of the Secretary of State to its policy on the matter.

Committees and sub-committees

9 (1) HEE may appoint committees and sub-committees.

(2) A committee or sub-committee may consist of or include persons who are
not members or employees of HEE.

(3) 30HEE may pay such remuneration and allowances as it decides to a person
who is a member of a committee (including a committee which HEE is
required to appoint under section 90(1) (LETBs)) or sub-committee, but is
not an employee of HEE, regardless of whether the person is a non-executive
member of HEE.

(4) 35Any committees and sub-committees of the Special Health Authority called
Health Education England in existence immediately before its abolition are
to become respectively committees and sub-committees of HEE (and are to
be treated as appointed under this paragraph).

Procedure

10 (1) HEE may regulate its own procedure.

(2) A vacancy among the members of HEE, or a defect in the appointment of a
member, does not affect the validity of any act of HEE.

5Seal and evidence

11 (1) The application of HEE’s seal must be authenticated by the signature of a
member of HEE or a person who has been authorised (whether generally or
specifically) for the purpose.

(2) A document purporting to be duly executed under HEE’s seal or to be
10signed on its behalf must be received in evidence and, unless the contrary is
proved, taken to be so executed or signed.

(3) But this paragraph does not apply in relation to a document which is, or is
to be, signed in accordance with the law of Scotland.

Status of HEE

12 (1) 15HEE is not to be regarded as a servant or agent of the Crown, or as enjoying
any status, privilege or immunity of the Crown.

(2) HEE’s property is not to be regarded as property of, or property held on
behalf of, the Crown.

Part 2 20Functions

Exercise of functions

13 (1) HEE must exercise its functions effectively, efficiently and economically.

(2) HEE may arrange for any person to help it to exercise its functions (whether
in a particular case or in cases of a particular description).

(3) 25Arrangements under sub-paragraph (2) may provide for the payment of
remuneration and allowances to the persons with whom HEE makes the
arrangements.

(4) HEE may not arrange for a committee which is not an LETB to exercise a
function which is exercisable by an LETB.

(5) 30HEE may in any way it thinks appropriate involve health care workers,
persons to whom health services are provided or carers for such persons, in
decisions it makes about the exercise of its functions; and “carer” means an
adult who provides or intends to provide care for another person.

(6) HEE may do anything which appears to it to be necessary or desirable for
35the purposes of or in connection with the exercise of its functions.

(7) In section 247C of the National Health Service Act 2006 (Secretary of State’s
duty to keep health service functions of certain bodies under review), in
subsection (2), after paragraph (e) insert—

“(ea) Health Education England;”.

Help or advice for other public authorities

14 (1) HEE may provide help or advice to another public authority for the purpose
of the exercise by that authority of its functions.

(2) Help or advice under this paragraph may be provided on such terms as HEE
5decides (including terms relating to payment of remuneration or
allowances).

(3) “Public authority”—

(a) includes any person certain of whose functions are functions of a
public nature, but

(b) 10does not include either House of Parliament or a person exercising
functions in connection with proceedings in Parliament.

(4) A reference to a public authority—

(a) includes a public authority in the Channel Islands or the Isle of Man,
but

(b) 15subject to that, does not include a reference to a public authority
outside the United Kingdom.

Co-operation

15 (1) HEE must, in the exercise of its functions, co-operate with the Secretary of
State in the exercise of the Secretary of State’s public health functions (as
20defined by section 1H of the National Health Service Act 2006).

(2) In section 72 of that Act (co-operation between NHS bodies), after subsection
(3) insert—

“(4) For the purposes of this section, Health Education England is an
NHS body.”

(3) 25In section 290(3) of the Health and Social Care Act 2012 (bodies which must
co-operate with Monitor and the Care Quality Commission in the exercise of
their functions), after paragraph (c) (but before the following “and”) insert—

“(ca) Health Education England,”.

(4) Regulations may require HEE and a specified person to co-operate with each
30other in the exercise of their respective functions or such of their functions
as are specified.

NHS contracts

16 In section 9(4) of the National Health Service Act 2006 (NHS contracts: health
service bodies), after paragraph (kb) insert—

“(kc) 35Health Education England,”.

Arrangements with devolved authorities

17 (1) HEE may arrange with a devolved authority for HEE—

(a) to exercise on behalf of the devolved authority any function which
corresponds to a function of HEE;

(b) 40to provide services or facilities in so far as the devolved authority
requires them in connection with the exercise of such a function.

(2) The terms and conditions on which arrangements under this paragraph may
be made include provision for payment to HEE in respect of its costs in
giving effect to the arrangements.

Failure to exercise functions

18 (1) 5If the Secretary of State considers that HEE is failing or has failed to exercise
any of its functions, and that the failure is significant, the Secretary of State
may direct HEE to exercise such of its functions, in such manner and within
such period, as the direction specifies.

(2) If HEE fails to comply with a direction under this section, the Secretary of
10State may—

(a) exercise the functions specified in the direction, or

(b) make arrangements for some other person to exercise them on the
Secretary of State’s behalf.

(3) Where the Secretary of State exercises a power under sub-paragraph (1) or
15(2), the Secretary of State must publish the reasons for doing so.

(4) The reference in sub-paragraph (1) to exercising a function includes a
reference to exercising it properly.

Part 3 Finance and reports

20Funding

19 (1) The Secretary of State must pay HEE for each financial year sums not
exceeding the amount the Secretary of State has allotted for that year
towards meeting the expenditure that is attributable to HEE’s exercise of its
functions in that year.

(2) 25An amount is to be regarded as allotted when the Secretary of State notifies
HEE accordingly.

(3) The Secretary of State may make a new allotment under this paragraph
increasing or decreasing the allotment previously made, but only if—

(a) HEE agrees,

(b) 30a parliamentary general election takes place, or

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

(4) The Secretary of State may give directions to HEE about the payment by it
to the Secretary of State of sums in respect of charges or other amounts
35relating to the valuation or disposal of assets.

(5) Sums payable to HEE under this paragraph are payable subject to such
conditions as to records, certificates or otherwise as the Secretary of State
may decide.

(6) In this Part of this Schedule, “financial year” includes the period—

(a) 40beginning with the day on which HEE is established, and

(b) ending with the following 31 March or, if the period ending with that
date is 3 months or less, ending with the 31 March following that
date.