The Bill sets out that a new schedule 10A will be inserted into the National Health Service Act 2006 to confer intervention powers on the Secretary of State in relation to the reconfiguration of NHS services.

The schedule provides for:

• NHS commissioners and providers to notify the Secretary of State if they are aware of circumstances that are likely to result in a need for reconfiguration;
• Commissioners to notify the Secretary of State if they are proposing a reconfiguration of NHS services;
• The Secretary of State may “call in” any proposal for reconfiguration. Where a proposal has been “called in”, the Secretary of State may take any decision in relation to the proposal that could have been taken by the NHS commissioning body. This includes:
  • deciding whether a proposal should, or should not, proceed, or should proceed in a modified form;
  • requiring the commissioning body to achieve particular results when making its decision in respect of the proposal;
  • deciding procedural or other steps that should, or should not, be taken in relation to the proposal; and
  • re-taking any decision previously taken by the NHS commissioning body.

At present, the Secretary of State can only intervene formally in a service reconfiguration where there is a referral by a local authority under the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013. The Bill therefore introduces much more wide ranging powers for the Secretary of State to intervene at any stage in the reconfiguration process. According to the Explanatory Notes to the Bill, the current system for reconfigurations works well for the majority of changes, and “this will be left in place for many day-to-day transactions.” The new intervention powers will be for “the minority of cases which are complex, a significant cause for public concern, or where Ministers can see a critical benefit to taking a particular course of action.”

The Bill does not provide for the abolition of the Independent Reconfiguration Panel, and so the Secretary of State will be able to continue to take advice from the IRP when considering how to exercise his intervention powers.

Comment: These changes will make it even more important for the NHS to engage effectively with local communities at all stages in the development and decision-making around service reconfiguration, and to try to ensure that key stakeholders are on-board so that the proposals are not called in.

For more information on how the above changes will impact your organisation, please contact Peter Edwards.

Other highlights from the Health and Care Bill

We have prepared a series of “bite sized” updates on those aspects of the Bill that are likely to have most practical impact on your day-to-day work.

What does the Health and Care Bill mean for:

• procurement, patient choice and competition?
  
• information governance and data sharing?
• employers and workforces?
• CQC regulation?
• the establishment and governance of Integrated Care Systems?