Your views: Legislation and policy

Current legislation and guidance relating to patient engagement and experience can be found below:

Health and Social Care Act 2012

The White Paper, ‘Equity and Excellence: Liberating the NHS’, and subsequent Health and Social Care Act 2012, set out the Coalition Government’s plans for the future of the NHS. Built upon the principles of the NHS – a comprehensive service, available to all, free at the point of use, based on need, not ability to pay, the 2012 Act places a specific duty on CCGs to ensure that health services are provided in a way which promotes the NHS Constitution, and awareness of the NHS Constitution. The requirements in the 2012 Act specifically associated with engagement updated the previous Section (s) 242 of the consolidated NHS Act of 2006. Read more.  

CCGs (and NHS England) general duties under the NHS Act 2006

The NHS Act 2006 (including as amended by the Health and Social Care Act 2012) sets out the range of general duties on clinical commissioning groups and NHS England.

Commissioners’ general duties are largely set out at s13C to s13Q and s14P to s14Z2 of the NHS Act 2006, and also s116B of the Local Government and Public Involvement in Health Act 2007.

  • Duty to promote the NHS Constitution (13C and 14P)
  • Quality (13E and 14R)
  • Inequality (13G and 14T)
  • Promotion of patient choice (13I and 14V)
  • Promotion of integration ((13K and 14Z1)
  • Public involvement (13Q and 14Z2)
  • Innovation (13k and 14X)
  • Research (13L and 14Y)
  • Obtaining advice (13J and 14 W)
  • The duty to have regard to joint strategic needs assessments and joint health and wellbeing strategies (116B of the Local Government and Public Involvement in Health Act 2007)

Commissioners should also ensure they are familiar with s244 of the NHS Act 2006 regarding the duty to consult the relevant local authority in is health scrutiny capacity. Of particular relevance to engagement and experience is s14Z2 of the 2012 Act, which states that CCGs must involve and consult patients and the public:

  • in their planning of commissioning arrangements;
  • in the development and consideration of proposals for changes in the commissioning arrangements where the implementation of the proposals would have an impact on the manner in which services are delivered to the individuals or the range of health services available to them; and
  • in decisions affecting the operation of commissioning arrangements where the implementation of the decisions would (if made) have such an impact.

The Act also updates s244 of the consolidated NHS Act 2006, which requires NHS organisations to consult relevant Local Authority Overview and Scrutiny Committees on any proposals for a substantial development of the health service in the area of the Local Authority, or a substantial variation in the provision of services.

Read more.

The Equality Act 2010

The Equality Act 2010 unifies and extends previous equality legislation. Nine ‘protected characteristics’ are described in the 2010 Act: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Section 149 of the Equality Act 2010 states that all public authorities must have due regard to the need to a) eliminate discrimination, harassment and victimisation, b) advance ‘Equality of Opportunity’, and c) foster good relations. GCCG has developed an Equality and Diversity Strategy, which details our approach locally and includes guidance regarding the undertaking of Equality Impact Analysis (EIA) to support GCCG activities including engagement and consultation.

Read more. 

The NHS Constitution 2010

The NHS Constitution was established in law in section 1 of the Health Act in 2009 and came into force in January 2010. The NHS Constitution places statutory duties on NHS bodies and sets out a number of patient rights, which are a legal entitlement protected by law. It also sets out individual personal responsibilities. One of the rights relevant to engagement is the right to be involved directly or through representatives:

  • in the planning of healthcare services;
  • the development and consideration of proposals for changes in the way those services are provided; and
  • in the decisions to be made affecting the operation of those services.

Statutory duty of candour for health and adult social care providers

From October 2014, subject to parliamentary approval, NHS providers will be required to comply with the duty of candour. Meaning providers must be open and transparent with service users about their care and treatment, including when it goes wrong. The duty is being introduced as part of the fundamental standard requirements for all providers. It will apply to all NHS trusts, foundation trusts and special health authorities from October and the government plans to implement the standards for all other providers by April 2015, subject to parliamentary approval. The CCG will consider processes to be put in place locally from 2015 with our providers during the annual contract discussions. Read more.

Clinical Senate Review Process

Resources

Single Operating Framework

Guidance Note

What does Clinical Senate Review mean?

NHS England has a role to support and assure the development of proposals for service change by commissioners via the NHS England Assurance Process. One step in this process is to review major service change proposals against the clinical evidence base for it – it is this role that NCAT delivered previously and which Senates will now take on.

There are other elements of service change which are reviewed (patient engagement, patient choice, quality benefits, fit with best practice etc.). Clinical Senates will only be involved in the review of the clinical evidence base.

What is the expected process?

  • Request for clinical review will come from either sponsoring commissioner or local area team of NHS England (with 3 months notice)
  • Terms of reference (timescale, scope et.) for review agreed and signed off by Clinical Senate Council
  • Review Team developed (minimum 8 weeks notice)
  • Commissioner provides information (options appraisal etc.)
  • Review of data, interviews and meetings led by Review Team
  • Report written to be signed off by Clinical Senate Council (determining strength of evidence base)

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