Act of Parliament | |
Long title | An Act to make provision about health and social care. |
---|---|
Citation | 2022 c. 31 |
Introduced by | Sajid Javid, Secretary of State for Health and Social Care (Commons) Lord Kamall, Parliamentary Under-Secretary of State for Technology, Innovation and Life Sciences (Lords) |
Territorial extent | England and Wales |
Dates | |
Royal assent | 28 April 2022 |
Status: Current legislation | |
History of passage through Parliament | |
Text of statute as originally enacted | |
Text of the Health and Care Act 2022 as in force today (including any amendments) within the United Kingdom, from legislation.gov.uk. |
The Health and Care Act 2022 (c. 31) is an act of the Parliament of the United Kingdom, which was created to dismantle many of the structures established by the Health and Social Care Act 2012. Many of the proposals were drafted under the leadership of Simon Stevens and are intended to reinforce the ambitions of the NHS Long Term Plan.
It was introduced into the House of Commons in July 2021 and was the first substantial health legislation in the premiership of Boris Johnson. It was proposed to take effect in April 2022, but in December 2021 it was reported that implementation would be delayed until July 2022. [1]
The legislation provided for a lifetime £86,000 cap on the amount anyone in England would have to spend on their social care. It was originally planned that the cap would be introduced in October 2023, but in the 2022 autumn statement the Chancellor of the Exchequer, Jeremy Hunt, announced it would be delayed until October 2025. In July 2024 the new Chancellor, Rachel Reeves, announced her decision to cancel the introduction of the cap on social care costs entirely. [2] [3]
The act put integrated care systems on a statutory footing, and merged NHS England and NHS Improvement. It provided for the Care Quality Commission to assess how local authorities deliver their adult social care functions. [4] The Department of Health and Social Care launched a consultation on a proposed new 'provider selection regime' in 2022. This took effect with the passing of the act,[ verification needed ] and effectively ended the NHS internal market as NHS commissioners are no longer automatically obliged to put clinical services out to tender. [5] It includes provisions which give the Secretary of State for Health and Social Care more power to direct NHS agencies, including NHS England and Improvement, and over "notifiable" service changes, which are to be defined in regulations. [6] If ministers "call in" a reconfiguration proposal for review, they must make a final decision within six months. [7] It established an integrated care board and an integrated care partnership in every part of England. Each board is required to have, as a minimum: [8]
It allows NHS Digital to collect more information on medicines to analyse their use and safety and request information from private providers, and makes it a criminal offence to share that data inappropriately. [9]
It puts an £86,000 cap on the amount anyone in England will have to spend on their personal care over their lifetime. [10] The act criminalises "aiding and abetting" women to undergo hymenorrhaphy, or hymen reconstruction surgery, along with virginity testing. [11] The government agreed three amendments in discussions in the House of Lords relating to mental health in February 2022: requiring the definition of 'health' to include mental health; to place a duty on new integrated care boards to have mental health expertise; and to require more transparency and accountability on mental health funding. [12]
It was claimed that the act will "dispose of unnecessary bureaucracy that has held the health service back", and will ensure the NHS is "more accountable to government". [13] The act also includes a target of the NHS achieving net zero carbon emissions by 2040. [14]
The act's social care provisions have been criticised as insufficient, especially for failing to address the workforce shortage, and for leaving the "cap on care costs far less fair and generous than originally expected. Poorer people with lower wealth will be hit hardest – and some will still face crippling social care costs," according to the Health Foundation. [15]
The Department of Health and Social Care (DHSC) is a ministerial department of the Government of the United Kingdom. It is responsible for government policy on health and adult social care matters in England, along with a few elements of the same matters which are not otherwise devolved to the Scottish Government, Welsh Government or Northern Ireland Executive. It oversees the English National Health Service (NHS). The department is led by the Secretary of State for Health and Social Care with three ministers of state and three parliamentary under-secretaries of state.
An NHS foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care. As of March 2019 there were 151 foundation trusts.
Strategic health authorities (SHA) were part of the structure of the National Health Service in England between 2002 and 2013. Each SHA was responsible for managing performance, enacting directives and implementing health policy as required by the Department of Health at a regional level. Initially 28 in number, they were reduced to 10 in 2006. Along with primary care trusts, they were replaced by clinical commissioning groups and Public Health England in 2013 under the Health and Social Care Act 2012.
NHS Scotland, sometimes styled NHSScotland, is the publicly–funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.
The Health and Social Care Select Committee is a Departmental Select Committee of the British House of Commons, the lower house of the United Kingdom Parliament. Its remit is to examine the policy, administration and expenditure of the Department of Health and Social Care (DHSC) and its associated agencies and public bodies. The Clerks of the Committee are Previn Desai and Joanna Dodd.
The Independent Reconfiguration Panel (IRP) is the independent expert on National Health Service (NHS) service change in England. Set up in 2003, the IRP advises the Secretary of State for Health and Social Care on contested proposals for health service change in England. The IRP also offers informal support and guidance to the NHS and other organisations on achieving successful change. The secretary of state can refer reconfigurations to the panel for scrutiny but only after a local authority has formally referred the changes to him. He can then choose whether to adopt their advice.
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom, comprising the NHS in England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services, provided without charge for residents of the United Kingdom apart from dental treatment and optical care. In England, NHS patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt.
In England, social care is defined as the provision of social work, personal care, protection or social support services to children or adults in need or at risk, or adults with needs arising from illness, disability, old age or poverty. The main legal definitions flow from the National Health Service and Community Care Act 1990, with other provisions covering disability and responsibilities to informal carers. That provision may have one or more of the following aims: to protect people who use care services from abuse or neglect, to prevent deterioration of or promote physical or mental health, to promote independence and social inclusion, to improve opportunities and life chances, to strengthen families and to protect human rights in relation to people's social needs.
The Health and Social Care Act 2012 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date. It removed responsibility for the health of citizens from the Secretary of State for Health, which the post had carried since the inception of the NHS in 1948. It abolished primary care trusts (PCTs) and strategic health authorities (SHAs) and transferred between £60 billion and £80 billion of "commissioning", or healthcare funds, from the abolished PCTs to several hundred clinical commissioning groups, partly run by the general practitioners (GPs) in England. A new executive agency of the Department of Health, Public Health England, was established under the act on 1 April 2013.
NHS England, formerly the NHS Commissioning Board, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the National Health Service in England as set out in the Health and Social Care Act 2012. It directly commissions NHS general practitioners, dentists, optometrists and some specialist services. The Secretary of State publishes annually a document known as the NHS mandate which specifies the objectives which the Board should seek to achieve. National Health Service Regulations are published each year to give legal force to the mandate.
The Isle of Wight NHS Trust is an NHS trust which provides physical health, mental health and ambulance services for the Isle of Wight. The trust is unique in being the only integrated acute, community, mental health and ambulance health care provider in England. It runs St Mary's Hospital and the Isle of Wight Ambulance Service.
Healthcare in Kent has, from 1 July 2022, been mainly the responsibility of the Kent & Medway Integrated Care Board. Certain specialised services are directly commissioned by NHS England, coordinated through the South East integrated regional team. Some NHS England structures are aligned on a Kent and Medway basis, others on a South East basis and there is liaison with London to provide many tertiary healthcare services.
Healthcare in Bedfordshire is the responsibility of Bedfordshire and Luton Integrated Care Systems.
The "Greater Manchester Model" of NHS health care was a system uniquely devolved within England, by way of close integration with the Greater Manchester Combined Authority and local authorities, led by the Mayor of Greater Manchester. In July 2022 the Greater Manchester integrated care system took over responsibility for health and social care in the conurbation. The financial plan for 2022–23 had an initial shortage of £187 million.
Healthcare in Gloucestershire was the responsibility of two clinical commissioning groups, covering Gloucestershire and South Gloucestershire, until July 2022. The health economy of Gloucestershire has always been linked with that of Bristol.
The NHS internal market was established by the National Health Service and Community Care Act 1990, to separate the roles of purchasers and providers within the National Health Service in the United Kingdom. Previously, healthcare was provided by regional health authorities which were given a budget to run hospitals and community health services in their area. The Health and Social Care Act 2012 was intended to open up the internal market to external competition. The 2019 NHS Long Term Plan called for the establishment of integrated care systems across England by 2021, effectively ending the internal market.
In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service. The plans were introduced in 2016 but by 2018 had been overtaken by progress towards integrated care systems.
In England, an integrated care system (ICS) is a statutory partnership of organisations who plan, buy, and provide health and care services in their geographical area. The organisations involved include the NHS, local authorities, voluntary and charity groups, and independent care providers. The NHS Long Term Plan of January 2019 called for the whole of England to be covered by ICSs by April 2021. On 1 July 2022, ICSs replaced clinical commissioning groups in England.
The National Care Service (NCS) is a proposed publicly funded system of social care in the United Kingdom which was partially introduced by the Labour government of Gordon Brown in 2010 but abandoned soon after when the coalition government of David Cameron and Nick Clegg came to power in May 2010. Similar to the National Health Service, it would be free at the point of need and paid for through taxation. The Labour Party has continued to propose the creation of an NCS while in opposition, and has done so under each consecutive leader since Ed Miliband's leadership in 2010.