Health and Social Care Bill

House of Commons

Session 2010 - 11
Internet Publications
Other Bills before Parliament

Health and Social Care Bill

Health and Social Care Bill
Part 1 — The health service in England
24

223D
Financial duties of the Board: general
(1)
The Board must, in respect of each financial year, perform its functions
so as to ensure that its expenditure which is attributable to the
performance by it of its functions in that year does not exceed the
aggregate of—
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(a)
the amount allotted to it for that year under section 223B,
(b)
any sums received by it in that year under any provision of this
Act (other than sums received by it under section 223B), and
(c)
any sums received by it in that year otherwise than under this
Act for the purpose of enabling it to defray such expenditure.
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(2)
The Secretary of State may by directions determine whether
expenditure by the Board of a description specified in the directions
must, or must not, be treated for the purposes of this section as
expenditure within subsection (1).
(3)
The Secretary of State may by directions determine the extent to which,
15
and the circumstances in which, sums received by the Board under
section 223B but not yet spent must be treated for the purposes of this
section as part of the expenditure of the Board, and to which financial
year’s expenditure they must be attributed.
(4)
The Secretary of State may by directions require the Board to use
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banking facilities specified in the direction for any purposes so
specified.
223E
Financial duties of the Board: use of resources
(1)
The Board must ensure that the use of its resources in a financial year
does not exceed the resource allocation specified in relation to that year
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by the Secretary of State under section 223C.
(2)
For the purposes of subsection (1) the Secretary of State may give
directions—
(a)
specifying uses of resources which must, or must not, be taken
into account;
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(b)
specifying descriptions of resources which must, or must not,
be taken into account.
223F
Financial duties of the Board: restriction on certain types of
expenditure
(1)
The Board must ensure that its capital expenditure in respect of a
35
financial year does not exceed such sum as the Secretary of State may
specify in relation to that year.
(2)
The Board must ensure that its revenue expenditure in respect of a
financial year does not exceed such sum as the Secretary of State may
specify in relation to that year.
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(3)
The Board must ensure that its expenditure in respect of a financial year
on prescribed matters relating to administration does not (in total)
exceed the sum specified by the Secretary of State under section
223B(4)(b) in relation to that year.
(4)
The Secretary of State may vary any sum specified for the purposes of
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this section.

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(5)
The Secretary of State may by directions determine whether
expenditure by the Board of a description specified in the directions
must, or must not, be treated for the purposes of this section as
expenditure within subsection (1) or (2).
(6)
For the purposes of this section, expenditure is to be disregarded if it is
5
met otherwise than from sums paid to the Board under section 223B.
223G
Power to establish contingency fund
(1)
The Board may use a proportion of the sums paid to it under section
223B to establish a contingency fund.
(2)
The Board may make a payment out of the fund where the payment is
10
necessary in order to enable—
(a)
the Board to discharge any of its commissioning functions, or
(b)
a commissioning consortium to discharge any of its functions.
(3)
The Board must publish guidance as to how it proposes to exercise its
powers to make payments out of the contingency fund.
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(4)
In this section, “commissioning functions” means functions in
arranging for the provision of services as part of the health service.”
Further provision about commissioning consortia
21
Commissioning consortia: establishment etc.
(1)
After Chapter A1 of Part 2 of the National Health Service Act 2006 insert—
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“Chapter A2
Commissioning consortia
Establishment of commissioning consortia
14A
General duties of Board in relation to commissioning consortia
(1)
The Board must exercise its functions under this Chapter so as to ensure
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that at any time after the day specified in writing by the Secretary of
State for the purposes of this section each provider of primary medical
services is a member of a commissioning consortium.
(2)
The Board must exercise its functions under this Chapter so as to ensure
that at any time after the day so specified the areas specified in the
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constitutions of commissioning consortia—
(a)
together cover the whole of England, and
(b)
do not coincide or overlap.
(3)
For the purposes of this Chapter, “provider of primary medical
services” means a person who is a party to an arrangement mentioned
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in subsection (4).
(4)
The arrangements mentioned in this subsection are—
(a)
a general medical services contract to provide primary medical
services of a prescribed description,

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(b)
arrangements under section 83(2) for the provision of primary
medical services of a prescribed description,
(c)
section 92 arrangements for the provision of services of primary
medical services of a prescribed description.
(5)
Where a person who is a provider of primary medical services is a party
5
to more than one arrangement mentioned in subsection (4), the person
is to be treated for the purposes of this Chapter as a separate provider
of primary medical services in respect of each of those arrangements.
(6)
Where two or more individuals practising in partnership are parties to
an arrangement mentioned in subsection (4), the partnership is to be
10
treated for the purposes of this Chapter as a provider of primary
medical services (and the individuals are not to be so treated).
(7)
Where two or more individuals are parties to an arrangement
mentioned in subsection (4) but are not practising in partnership, those
persons collectively are to be treated for the purposes of this Chapter as
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a provider of primary medical services (and the individuals are not to
be so treated).
14B
Applications for the establishment of commissioning consortia
(1)
An application for the establishment of a commissioning consortium
may be made to the Board.
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(2)
The application may be made by any two or more persons each of
whom—
(a)
is or wishes to be a provider of primary medical services, and
(b)
wishes to be a member of the commissioning consortium.
(3)
The application must be accompanied by—
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(a)
a copy of the proposed constitution of the commissioning
consortium,
(b)
the name of the person whom the consortium wishes the Board
to appoint as its accountable officer (as to which see paragraph
9 of Schedule 1A), and
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(c)
such other information as the Board may specify in a document
published for the purposes of this section.
(4)
At any time before the Board determines the application—
(a)
a person who is or wishes to be a provider of primary medical
services (and wishes to be a member of the consortium) may
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become a party to the application, with the agreement of the
Board and the existing applicants;
(b)
any of the applicants may withdraw.
(5)
At any time before the Board determines the application, the applicants
may modify the proposed constitution with the agreement of the
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Board.
(6)
Part 1 of Schedule 1A makes provision about the constitution of a
commissioning consortium.
14C
Determination of applications
(1)
The Board must grant an application under section 14B if it is satisfied
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as to the following matters.

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(2)
Those matters are—
(a)
that the constitution complies with the requirements of Part 1 of
Schedule 1A and is otherwise appropriate,
(b)
that each of the members specified in the constitution will be a
provider of primary medical services on the date the
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consortium is established,
(c)
that the area specified in the constitution is appropriate,
(d)
that it would be appropriate for the Board to appoint, as the
accountable officer of the consortium, the person named by the
consortium under section 14B(3)(b),
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(e)
that the applicants have made appropriate arrangements to
ensure that the commissioning consortium will be able to
discharge its functions, and
(f)
such other matters as may be prescribed.
(3)
Regulations may make provision—
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(a)
as to factors which the Board must or may take into account in
deciding whether it is satisfied as to the matters mentioned in
subsection (2);
(b)
as to the procedure for the making and determination of
applications under section 14B.
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14D
Effect of grant of application
(1)
If the Board grants an application under section 14B—
(a)
a commissioning consortium is established, and
(b)
the proposed constitution has effect as the commissioning
consortium’s constitution.
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(2)
Part 2 of Schedule 1A makes further provision about commissioning
consortia.
Variation of constitution
14E
Applications for variation of constitution
(1)
A commissioning consortium may apply to the Board to vary its
30
constitution (including doing so by varying its area or its list of
members).
(2)
If the Board grants the application, the constitution of the
commissioning consortium has effect subject to the variation.
(3)
Regulations may make provision—
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(a)
as to the circumstances in which the Board must or may grant,
or must or may refuse, applications under this section;
(b)
as to factors which the Board must or may take into account in
determining whether to grant such applications;
(c)
as to the procedure for the making and determination of such
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applications.
14F
Variation of constitution otherwise on application
(1)
The Board may vary the area specified in the constitution of a
commissioning consortium.

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(2)
The Board may—
(a)
add any person who is a provider of primary medical services
to the list of members specified in the constitution of a
commissioning consortium;
(b)
remove any person from such a list.
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(3)
The power conferred by subsection (1) or (2) is exercisable if—
(a)
the consortium consents to the variation, or
(b)
the Board considers that the variation is necessary for the
purpose of discharging any of its duties under section 14A.
(4)
Before varying the constitution of a commissioning consortium under
10
subsection (1) or (2), the Board must consult—
(a)
that consortium, and
(b)
any other consortium that the Board thinks might be affected by
the variation.
(5)
Regulations may—
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(a)
confer powers on the Board to vary the constitution of a
commissioning consortium;
(b)
make provision as to the circumstances in which those powers
are exercisable and the procedure to be followed before they are
exercised.
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Mergers, dissolution etc.
14G
Mergers
(1)
Two or more commissioning consortia may apply to the Board for—
(a)
those consortia to be dissolved, and
(b)
another consortium to be established under this section.
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(2)
An application under this section must be accompanied by—
(a)
a copy of the proposed constitution of the commissioning
consortium,
(b)
the name of the person whom the consortium wishes the Board
to appoint as its accountable officer, and
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(c)
such other information as the Board may specify in a document
published for the purposes of this section.
(3)
The applicants may, with the agreement of the Board, modify the
application or the proposed constitution at any time before the Board
determines the application.
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(4)
Sections 14C and 14D(1) apply in relation to an application under this
section as they apply in relation to an application under section 14B.
14H
Dissolution
(1)
A commissioning consortium may apply to the Board for the
consortium to be dissolved.
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(2)
Regulations may make provision—
(a)
as to the circumstances in which the Board must or may grant,
or must or may refuse, applications under this section;

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(b)
as to factors which the Board must or may take into account in
determining whether to grant such applications;
(c)
as to the procedure for the making and determination of such
applications.
Supplemental provision about variation, mergers etc.
5
14I
Transfers in connection with variation, merger, dissolution etc.
(1)
The Board may make a property transfer scheme or a staff transfer
scheme in connection with—
(a)
the variation of the constitution of a commissioning consortium
under section 14E or 14F, or
10
(b)
the dissolution of a commissioning consortium under section
14G or 14H.
(2)
A property transfer scheme is a scheme for the transfer from the
commissioning consortium of any property, rights or liabilities, other
than rights or liabilities under or in connection with a contract of
15
employment, to the Board or another commissioning consortium.
(3)
A staff transfer scheme is a scheme for the transfer from the
commissioning consortium of any rights or liabilities under or in
connection with a contract of employment to the Board or another
commissioning consortium.
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(4)
Part 3 of Schedule 1A makes further provision about property transfer
schemes and staff transfer schemes.
14J
Guidance about the establishment of commissioning consortia etc.
The Board may publish guidance as to—
(a)
the making of applications under section 14B for the
25
establishment of a commissioning consortium, including
guidance on the form, content or publication of the proposed
constitution;
(b)
the making of applications under section 14E, 14G or 14H.”
(2)
After Schedule 1 to the National Health Service Act 2006 insert the Schedule set
30
out in Schedule 2 to this Act.
22
Commissioning consortia: general duties etc.
After section 14J of the National Health Service Act 2006 insert—
General duties of consortia
14K
Duty as to effectiveness, efficiency etc.
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Each commissioning consortium must exercise its functions effectively,
efficiently and economically.
14L
Duty as to improvement in quality of services
(1)
Each commissioning consortium must exercise its functions with a
view to securing continuous improvement in the quality of services
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provided to individuals for or in connection with the prevention,
diagnosis or treatment of illness.
(2)
In discharging its duty under subsection (1), a commissioning
consortium must, in particular, act with a view to securing continuous
improvement in the outcomes that are achieved from the provision of
5
the services.
(3)
The outcomes relevant for the purposes of subsection (2) include, in
particular, outcomes which show—
(a)
the effectiveness of the services,
(b)
the safety of the services, and
10
(c)
the quality of the experience undergone by patients.
(4)
In discharging its duty under subsection (1), a commissioning
consortium must have regard to any guidance published under section
14V.
14M
Duty in relation to quality of primary medical services
15
Each commissioning consortium must assist and support the Board in
discharging its duty under section 13D so far as relating to securing
continuous improvement in the quality of primary medical services.
14N
Duties as to reducing inequalities, promoting patient involvement etc.
(1)
Each commissioning consortium must, in the exercise of its functions,
20
have regard to the need to—
(a)
reduce inequalities between patients with respect to their ability
to access health services;
(b)
reduce inequalities between patients with respect to the
outcomes achieved for them by the provision of health services;
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(c)
promote the involvement of patients and their carers in
decisions about the provision of health services to them;
(d)
enable patients to make choices with respect to aspects of
services provided to them as part of the health service.
(2)
In this section, “health services” means services provided as part of the
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health service.
14O
Duty to obtain appropriate advice
Each commissioning consortium must make arrangements with a view
to securing that it obtains advice appropriate for enabling it effectively
to discharge its functions from persons with professional expertise
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relating to the physical or mental health of individuals.
Public involvement
14P
Public involvement and consultation by commissioning consortia
(1)
This section applies in relation to any health services which are, or are
to be, provided pursuant to arrangements made by a commissioning
40
consortium (“commissioning arrangements”).
(2)
The consortium 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)—