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01
Mar

NHS England proposes legal changes to accelerate its Long Term Plan


NHS England is inviting feedback on a series of legislative changes it is proposing in order to speed up and simplify the implementation of the Long Term Plan.

 

Patients, NHS staff, partner organisations and interested members of the public are all invited to give their views via a survey. Full detail of the proposed changes, why it is felt they are required and the survey can be found here. The deadline for completing the survey is April 25, 2019.

 

Among the proposals are:

* Removing CMA’s function to review mergers involving NHS Foundation Trusts

* Removing NHS Improvement’s competition powers and duties

* Removing the need for NHS Improvement to refer contested licence conditions or National Tariff provisions to the CMA

* Regulations made under section 75 of the Health and Social Care Act 2012 should be revoked and the powers in primary legislation under which they are made should be repealed and replaced by a best value test

* Arrangements between NHS commissioners and NHS providers should be removed from the scope of the Public Contracts Regulations and commissioners should be subject to a new ‘best value’ test when making such arrangements, supported by statutory guidance

* Changes to the National Tariff Payment System to provide more flexibility

* Removing the power to apply to NHS Improvement to make local modifications to tariff prices once ICSs are fully developed

* Changing primary legislation so the national tariff can include prices for ‘section 7A’ public health services (commissioned by NHS England or CCGs on behalf of the Secretary of State

* Clarification to enable the Secretary of State to set up new NHS Trusts to deliver integrated care across a given area

* Giving NHS Improvement targeted powers to direct mergers or acquisitions involving NHS Foundation Trusts – in specific circumstances only – where there are clear patient benefits

* Giving NHS Improvement the power to set annual capital spending limits for NHS Foundation Trusts in the same way that it can currently do for NHS Trusts

* Giving organisations such as CCGs and NHS providers the power and ability to create joint committees to take joint decisions in the interests of their local population – with new provisions relating to the formation and governance of joint committees and the decisions that could appropriately be delegated to them

* Removing present restrictions so the designated nurse and secondary care doctor appointed to CCG governing bodies may be clinicians who work for local providers

* Making provision to enable CCGs and NHS providers to make joint appointments

* Introducing a shared duty to require CCGs and NHS providers of care to promote the ‘triple aim’ of better health for everyone, better care for all patients and efficient use of NHS resources

* Giving NHS England the ability to allow groups of CCGs to collaborate to arrange services for their combined populations, to carry out delegated functions (to avoid ‘double delegation’) and to use joint and lead commissioner arrangements to make decisions and pool funds across functions

* Enabling NHS England to jointing commission with CCGs the specific services currently commissioned under the section 7A agreement, or to delegate the commissioning of these services to groups of CCGs

* Enabling NHS England to enter into formal joint commissioning arrangements with CCGs

* Bringing NHS England and NHS Improvement more closely together, either by creating a single organisation or providing more flexibility for them to work together with powers to carry out functions jointly 

* Enabling wider collaboration between ALBs by giving the Secretary of State new powers to transfer or require delegation of ALB functions to other ALBs and create new functions of ALBs.

 

Please refer to the full document for commentary around these proposals and the rationale behind them.

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