Care Bill (HL Bill 53)

(4) Before giving an assessment notice, the NHS body responsible for the
patient must consult—

(a) the patient, and

(b) where it is feasible to do so, any carer that the patient has.

(5) 5An assessment notice remains in force until—

(a) the patient is discharged (whether by the NHS body responsible for
the patient or by the patient himself or herself),

(b) the patient dies, or

(c) the NHS body responsible for the patient withdraws the notice by
10giving a notice (a “withdrawal notice”) to the relevant authority.

(6) A reference in this paragraph to a hospital patient includes a reference to a
person who it is reasonable to expect is about to become one.

Assessment notice given by responsible NHS body to local authority

2 (1) The NHS body responsible for a hospital patient, having given the relevant
15authority an assessment notice, must—

(a) consult the authority before deciding what it will do for the patient
in order for discharge to be safe, and

(b) give the authority notice of the day on which it proposes to discharge
the patient.

(2) 20A notice under sub-paragraph (1)(b) is referred to in this Schedule as a
“discharge notice”.

(3) A discharge notice must specify—

(a) whether the NHS body responsible for the patient will be providing
or arranging for the provision of services under the National Health
25Service Act 2006 to the patient after discharge, and

(b) if it will, what those services are.

(4) A discharge notice remains in force until—

(a) the end of the relevant day, or

(b) the NHS body responsible for the patient withdraws the notice by
30giving a withdrawal notice to the relevant authority.

(5) The “relevant day” is the later of—

(a) the day specified in the discharge notice, and

(b) the last day of such period as regulations may specify.

(6) A period specified under sub-paragraph (5)(b) must—

(a) 35begin with the day after that on which the assessment notice is given,
and

(b) last for a period of at least two days.

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
40assessment, must inform the NHS body responsible for the patient—

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

(b) (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) Where, 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
5for 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.

Cases where discharge of the patient is delayed

4 (1) If the relevant authority, having received an assessment notice and a
10discharge 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
relevant authority to pay the specified amount for each day of the specified
period.

(2) 15If 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
that 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
20pay 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
be in force is unaffected.

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

(a) 25the 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) A 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
30the 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
regard in particular to either or both of—

(a) costs to NHS bodies of providing accommodation and personal care
35to 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
40management 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
arrangements, 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
treated 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
5the NHS body.

Adjustments between local authorities

6 (1) Regulations may modify, or otherwise make provision about, the
application 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
10resident 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
dispute that it was the correct authority to which to give the notice;

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

(c) 15to 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
Schedule.

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

7 (1) 20A 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) is receiving (or has received or can reasonably be expected to receive)
acute care.

(2) 25“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
United Kingdom which is not—

(a) an NHS hospital,

(b) 30a 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
Health Service (Scotland) Act 1978, or

(d) a hospital vested in the Department of Health, Social Services and
35Public 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) 40an NHS foundation trust,

(c) the National Health Service Commissioning Board, or

(d) a 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
body that arranged for the patient to be accommodated in it.

(6) 5“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
been given on the patient’s behalf) to pay for it; nor is any of the following
10“acute care”—

(a) care of an expectant or nursing mother;

(b) mental health care;

(c) palliative care;

(d) a structured programme of care provided for a limited period to help
15a 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
arrangements for which are the primary responsibility of a consultant
20psychiatrist.

Further provision about assessment notices, discharge notices, etc.

8 Regulations may—

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

(b) 25specify 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) make provision for determining the day on which an assessment
30notice, a discharge notice or a withdrawal notice is to be regarded as
given.

Section 74

SCHEDULE 4

Part 1 After-care under the Mental Health Act 1983: direct payments

1 (1) 35Sections 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) 40This 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

the 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
5“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”.

(4) In subsection (7) of that section, for “to meet the needs in question”
10substitute “to discharge its duty under section 117 of the Mental Health Act
1983”.

(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
15(after-care) applies lacks capacity to request the local
authority 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
20such payments to the authorised person.”

(6) In 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) 25in paragraph (a), for “meeting the adult’s needs” substitute
“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) 30In subsection (7) of that section, for “the provision of the care and support”
substitute “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
351983”.

(10) In 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
40arrangements under which after-care services for the adult are
provided under section 117 of the Mental Health Act 1983.”

Part 2 Provision to be inserted in Social Services and Well-Being (Wales) Act 2013

“Direct payments: after-care under the Mental Health Act 1983

General

1 5Sections 34 (direct payments to meet an adult’s needs), 35 (direct
payments to meet a child’s needs) and 37 (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.

10Modifications to section 34

2 For subsection (1) of section 34 substitute—

“(1) Regulations may require or allow a local authority to
make payments to an adult to whom section 117 of the
Mental Health Act 1983 (after-care) applies that are
15equivalent to the cost of providing or arranging for the
provision of after-care services for the adult under that
section.”

3 In subsection (3) of that section—

(a) in paragraph (a), for “who has needs for care and support
20(“A”)” substitute “in respect of the provision to the adult
(“A”) of after-care services under section 117 of the Mental
Health Act 1983”, and

(b) in paragraph (c)(i), for “of meeting A’s needs” substitute
“of discharging its duty towards A under section 117 of the
25Mental Health Act 1983”.

4 In subsection (4) of that section—

(a) in paragraph (a), for “who has needs for care and support
(“A”)” substitute “to whom section 117 of the Mental
Health Act 1983 applies (“A”)”, and

(b) 30in paragraph (d)(i), for “meeting A’s needs” substitute
“discharging its duty towards A under section 117 of the
Mental Health Act 1983”.

5 In subsection (5) of that section—

(a) in paragraph (a), for “A’s needs for care and support”
35substitute “the provision to A of after-care services under
section 117 of the Mental Health Act 1983”, and

(b) in paragraph (b), for “towards the cost of meeting A’s
needs for care and support” substitute “equivalent to the
cost of providing or arranging the provision to A of after-
40care services under section 117 of the Mental Health Act
1983”.

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

Modifications to section 35

7 5For subsection (1) of section 35 substitute—

“(1) Regulations may require or allow a local authority to
make payments to a person in respect of a child to whom
section 117 of the Mental Health Act 1983 (after-care)
applies that are equivalent to the cost of providing or
10arranging the provision of after-care services for the
child under that section.”

8 In subsection (3)(a), (b) and (c) of that section, for “who has needs
for care and support” (in each place it occurs) substitute “to whom
section 117 of the Mental Health Act 1983 applies”.

9 15In subsection (5)(a) of that section, for “meeting the child’s needs”
substitute “discharging its duty towards the child under section
117 of the Mental Health Act 1983”.

Modifications to section 37

10 In subsection (1) of section 37—

(a) 20in the opening words, for “34, 35 and 36” substitute “34 and
35”,

(b) omit paragraphs (a), (b) and (c),

(c) in paragraph (i), for “a local authority’s duty or power to
meet a person’s needs for care and support or a carer’s
25needs for support is displaced” substitute “a local
authority’s duty under section 117 of the Mental Health
Act 1983 (after-care) is discharged”, and

(d) in paragraph (k), for “34 to 36” substitute “34 and 35”.

11 Omit subsections (2) to (8) of that section.

12 30After subsection (8) of that section insert—

“(8A) Regulations under sections 34 and 35 must specify that
direct payments to meet the cost of providing or
arranging for the provision of after-care services under
section 117 of the Mental Health Act 1983 (after-care)
35must be made at a rate that the local authority estimates
to be equivalent to the reasonable cost of securing the
provision of those services to meet those needs.”

13 In subsection (9) of that section—

(a) for “, 35 or 36” substitute “or 35”, and

(b) 40for “care and support” substitute “after-care services”.

14 In subsection (10) of that section, for “care and support to meet
needs” substitute “after-care services”.”

Section 94

SCHEDULE 5 Health Education England

Part 1 Constitution

5Membership

1 (1) HEE 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
10paragraphs (a) and (b), and

(d) no 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) 15are referred to in this Schedule as the “non-executive members”.

(3) The 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
20description specified in regulations.

(2) The 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.

(3) 25The non-executive members of HEE must include a person who will
represent the interests of patients.

Non-executive members: terms of office

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

(2) 30A 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
35to the Secretary of State.

(5) The 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) 40failure to carry out his or her duties as a non-executive member.

(6) The 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) 5Having decided to suspend a person under paragraph 3(6), the Secretary of
State 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
10when it is delivered), or

(b) sent 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) 15The Secretary of State may review the suspension.

(5) The 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
20beginning of the initial period of suspension.

(6) Following 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
25expiry of the current period.

(7) The 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
30to do so.

5 (1) Where 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) 35the 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) 40A 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
as 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) 5Each executive member of HEE is appointed as an employee of HEE on such
terms as it decides.

(2) A 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
10of HEE (in addition to those appointed as executive members).

Employees: pay

8 (1) HEE 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
15employee of HEE.

(3) Before making a decision about pay under this paragraph, HEE must obtain
the 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) 20A committee or sub-committee may consist of or include persons who are
not members or employees of HEE.

(3) HEE 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 101(1) (LETBs)) or sub-committee, but is
25not an employee of HEE, regardless of whether the person is a non-executive
member of HEE.

(4) Any 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
30be 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.

35Seal 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.