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Part 2 Standards

Chapter 1 Regulatory bodies

41 The Commission for Healthcare Audit and Inspection

(1) There is to be a body corporate known as the Commission for Healthcare Audit and Inspection (in this Part referred to as the CHAI).

(2) Schedule 6 (which makes further provision about the CHAI) has effect.

42 The Commission for Social Care Inspection

(1) There is to be a body corporate known as the Commission for Social Care Inspection (in this Part referred to as the CSCI).

(2) Schedule 7 (which makes further provision about the CSCI) has effect.

43 Transfer of property etc to CHAI and CSCI

Schedule 8 (which makes provision for the transfer of property, rights and liabilities to the CHAI and the CSCI) has effect.

44 Abolition of former regulatory bodies

(1) The Commission for Health Improvement is abolished.

(2) The National Care Standards Commission is abolished.

Chapter 2 NHS health care: introductory

45 Quality in health care

(1) It is the duty of each NHS body to put and keep in place arrangements for the purpose of monitoring and improving the quality of health care provided by and for that body.

(2) In this Part “health care” means—

(a) services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness; and

(b) the promotion and protection of public health.

(3) In subsection (2)(a), “illness” has the meaning given by section 128(1) of the 1977 Act.

46 Standards set by Secretary of State

(1) The Secretary of State may prepare and publish statements of standards in relation to the provision of health care by and for English NHS bodies and cross-border SHAs.

(2) The Secretary of State must keep the standards under review and may publish amended statements whenever he considers it appropriate.

(3) The Secretary of State must consult such persons as he considers appropriate—

(a) before publishing a statement under this section;

(b) before publishing an amended statement under this section which in the opinion of the Secretary of State effects a substantial change in the standards.

(4) The standards set out in statements under this section are to be taken into account by every English NHS body and cross-border SHA in discharging its duty under section 45.

47 Standards set by Assembly

(1) The Assembly may prepare and publish statements of standards in relation to the provision of health care by and for Welsh NHS bodies.

(2) The Assembly must keep the standards under review and may publish amended statements whenever it considers it appropriate.

(3) The Assembly must consult such persons as it considers appropriate—

(a) before publishing a statement under this section;

(b) before publishing an amended statement under this section which in the opinion of the Assembly effects a substantial change in the standards.

(4) The standards set out in statements under this section are to be taken into account by every Welsh NHS body in discharging its duty under section 45.

Chapter 3 NHS health care: functions of CHAI

Healthcare provided by and for NHS bodies

48 Introductory

(1) The CHAI has the general function of encouraging improvement in the provision of health care by and for NHS bodies.

(2) In exercising its functions under subsection (1) and sections 49 to 56 in relation to such provision, the CHAI shall be concerned in particular with—

(a) the availability of, and access to, the health care;

(b) the quality and effectiveness of the health care;

(c) the economy and efficiency of the provision of the health care;

(d) the availability and quality of information provided to the public about the health care;

(e) the need to safeguard and promote the rights and welfare of children; and

(f) the effectiveness of measures taken for the purpose of paragraph (e) by the body in question and any person who provides, or is to provide, health care for that body.

49 National performance data

The CHAI has the function of publishing data relating to the provision of health care by and for NHS bodies.

50 Annual reviews

(1) In each financial year the CHAI must conduct a review of the provision of health care by and for—

(a) each English NHS body, and

(b) each cross-border SHA,

and must award a performance rating to each such body.

(2) The CHAI is to exercise its function under subsection (1) by reference to criteria from time to time devised by it and approved by the Secretary of State.

(3) The CHAI must publish the criteria devised and approved from time to time under subsection (2).

(4) In exercising its functions under this section in relation to any health care the CHAI must take into account the standards set out in statements published under section 46.

(5) For the purposes of this section the CHAI may, subject to this Part, conduct an inspection of—

(a) the body being reviewed; and

(b) any person who provides, or is to provide, health care for that body (wherever the health care is or is to be provided).

(6) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the award of a performance rating under this section.

51 Reviews: England and Wales

(1) The CHAI has the function of conducting reviews of—

(a) the overall provision of health care by and for NHS bodies;

(b) the overall provision of particular kinds of health care by and for NHS bodies;

(c) the provision of health care, or a particular kind of health care, by and for NHS bodies of a particular description.

(2) If the Secretary of State so requests, the CHAI must conduct—

(a) a review under subsection (1)(a);

(b) a review under subsection (1)(b) of the overall provision of a kind of health care specified in the request; or

(c) a review under subsection (1)(c) of the provision of health care, or health care of a kind specified in the request, by or for NHS bodies of a description so specified.

(3) The Secretary of State must consult the Assembly before making a request under subsection (2).

(4) In conducting a review under this section in relation to any health care the CHAI must take into account—

(a) the standards set out in statements published under section 46, where the health care is provided by or for an English NHS body or cross-border SHA;

(b) the standards set out in statements published under section 47, where the health care is provided by or for a Welsh NHS body.

(5) For the purposes of this section the CHAI may carry out an inspection of—

(a) any NHS body; and

(b) any person who provides, or is to provide, health care for an NHS body (wherever the health care is or is to be provided).

(6) Where the CHAI conducts a review under this section it must publish a report.

(7) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of a report under this section.

52 Reviews and investigations: England

(1) The CHAI has the function of conducting other reviews of, and investigations into, the provision of health care by and for English NHS bodies and cross-border SHAs.

(2) The CHAI may in particular under this section conduct—

(a) a review of the overall provision of health care by and for English NHS bodies and cross-border SHAs;

(b) a review of the overall provision of a particular kind of health care by and for English NHS bodies and cross-border SHAs;

(c) a review of, or investigation into, the provision of any health care by or for a particular English NHS body or cross-border SHA.

(3) The CHAI has the function of conducting reviews of the arrangements made by English NHS bodies and cross-border SHAs for the purpose of discharging their duty under section 45.

(4) If the Secretary of State so requests, the CHAI must conduct—

(a) a review under subsection (2)(a);

(b) a review under subsection (2)(b) of the overall provision of a kind of health care specified in the request;

(c) a review or investigation under subsection (2)(c), or a review under subsection (3), in relation to the provision of such health care by or for such body as may be specified in the request.

(5) In exercising its functions under this section in relation to any health care the CHAI must take into account the standards set out in statements published under section 46.

(6) For the purposes of this section the CHAI may carry out an inspection of—

(a) any English NHS body or cross-border SHA; and

(b) any person who provides, or is to provide, health care for such a body (wherever the health care is or is to be provided).

(7) Where the CHAI conducts a review or investigation under this section it must publish a report.

(8) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of a report under this section.

(9) The Secretary of State may by regulations require an NHS body to publish a statement as to the action it proposes to take as a result of any review or investigation conducted under this section in relation to it.

(10) Regulations under subsection (9) may make provision—

(a) as to the matters with which a statement under the regulations must deal;

(b) as to the time by which any such statement must be published;

(c) requiring an NHS body, before publishing any such statement, to obtain the consent of any person specified in the regulations;

(d) requiring the NHS body publishing any such statement to send a copy of it to any person so specified.

53 Failings

(1) This section applies where the CHAI conducts—

(a) a review under section 50 or 51; or

(b) a review or investigation under section 52.

(2) The CHAI must make a report to the Secretary of State if it is of the view that—

(a) there are significant failings in relation to the provision of health care by or for an English NHS body or cross-border SHA;

(b) there are significant failings in the running of an English NHS body or cross-border SHA; or

(c) there are significant failings in the running of any body, or the practice of any individual, providing health care for an English NHS body or cross-border SHA.

(3) A report made to the Secretary of State under subsection (2) may include a recommendation that, with a view to remedying the failings in question, the Secretary of State take special measures in relation to—

(a) in a case falling within paragraph (a) or (b) of subsection (2), the English NHS body or cross-border SHA in question;

(b) in a case falling within paragraph (c) of that subsection, any person, other than a Welsh NHS body, referred to in that paragraph.

(4) The CHAI must also report to the Assembly where it is of the view that—

(a) there are significant failings in relation to the provision of health care by or for a Welsh NHS body;

(b) there are significant failings in the running of a Welsh NHS body; or

(c) there are significant failings in the running of any body, or the practice of any individual, providing health care for a Welsh NHS body.

(5) A report made to the Assembly under subsection (4) may include a recommendation that, with a view to remedying the failings in question, the Assembly take special measures in relation to—

(a) in a case falling within paragraph (a) or (b) of subsection (4), the Welsh NHS body in question; and

(b) in a case falling within paragraph (c) of that subsection, any person, other than an English NHS body or cross-border SHA, referred to in that paragraph.

(6) The CHAI must also make a report to the regulator where it is of the view that—

(a) there are significant failings in relation to the provision of health care by or for an NHS foundation trust;

(b) there are significant failings in the running of an NHS foundation trust; or

(c) there are significant failings in the running of any body, or the practice of any individual, providing health care for an NHS foundation trust.

(7) A report made to the regulator under subsection (6) may include a recommendation that, with a view to remedying the failings in question, the regulator take special measures in relation to the NHS foundation trust in question.

(8) A report under this section must give the CHAI’s reasons for its view and for any recommendation made.

(9) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of a report under this section.

54 Functions relating to Secretary of State and Assembly

(1) The CHAI is to keep the appropriate authority informed about the provision of health care by and for any NHS body.

(2) The CHAI may at any time give advice to the appropriate authority on any matter connected with the provision of such health care (including, in particular, advice on any changes which it thinks should be made to the standards under section 46 or 47 for the purpose of securing improvement in the quality of the health care).

(3) When requested to do so by the appropriate authority, the CHAI must give the authority advice or information on such matters connected with the provision of health care by or for any NHS body as may be specified in the request.

(4) The CHAI may give advice to the appropriate authority or any NHS body about the establishment or conduct of any inquiry held, or to be held, by the authority or the body in relation to the provision of health care by or for that body.

(5) In this section, the “appropriate authority” means—

(a) the Secretary of State, in relation to the provision of health care by or for an English NHS body or cross-border SHA; or

(b) the Assembly, in relation to the provision of health care by or for a Welsh NHS body.

55 Reviews of data

(1) The CHAI may review—

(a) the quality of data obtained by others in relation to the provision of health care by and for NHS bodies;

(b) the methods used in the collection and analysis of such data; and

(c) the validity of conclusions drawn from such data.

(2) Where the CHAI conducts a review under this section it must publish a report.

56 Co-ordination of reviews

The CHAI has the function of promoting the effective co-ordination of reviews or assessments carried out by public bodies or other persons in relation to the provision of health care by or for English NHS bodies and cross-border SHAs.

Other functions

57 Studies as to economy, efficiency etc

(1) The CHAI has the function of promoting or undertaking comparative or other studies designed to enable it to make recommendations for improving economy, efficiency and effectiveness in the exercise of any of the functions of an English NHS body, other than a Special Health Authority (whether the functions are exercised by the English NHS body or by another person).

(2) The CHAI may exercise its function under subsection (1) in relation to a body on the CHAI’s own initiative or at the request of the body concerned.

(3) For the purposes of this section the CHAI may carry out an inspection of—

(a) any English NHS body other than a Special Health Authority;

(b) any person exercising the functions of such a body.

(4) The CHAI must publish its recommendations and the result of any studies under this section.

(5) The Secretary of State may, after consulting the CHAI, by regulations make provision as to the procedure to be followed in respect of the making of representations to the CHAI before the publication of any recommendations or the result of any studies under this section.

(6) The CHAI’s functions under this section may be exercised on its behalf by the Audit Commission, if the Audit Commission and the CHAI so agree.

(7) Where the Audit Commission exercises functions under subsection (6), it shall do so on such terms, including terms as to payment, as the CHAI and the Audit Commission may agree.

58 Additional functions

(1) The Secretary of State may by regulations provide that the CHAI is to have such additional functions as may be prescribed in relation to—

(a) the provision of health care by or for NHS bodies;

(b) the improvement of—

(i) economy, efficiency and effectiveness in the exercise of the functions of English NHS bodies; and

(ii) the financial or other management, or operations, of English NHS bodies.

(2) The Secretary of State must consult the regulator before making provision under subsection (1) in relation to NHS foundation trusts.

(3) The Secretary of State must obtain the consent of the Assembly before making provision under subsection (1)(a) in relation to health care provided by or for a Welsh NHS body other than health care provided by or for an English NHS body or cross-border SHA.

Supplementary

59 Criteria

(1) The Secretary of State may, after consulting the CHAI, make regulations requiring the CHAI to devise and publish statements of criteria to be used in—

(a) the exercise of any of its functions under section 48(1), 49, 51 or 53 in relation to the provision of health care by or for an English NHS body or cross-border SHA;

(b) the exercise of any of its functions under section 52, 56, 57 or 58(1)(b).

(2) The Assembly may, after consulting the CHAI, make regulations requiring the CHAI to devise and publish statements of criteria to be used in the exercise of its functions under section 48(1), 49, 51 or 53 in relation to the provision of health care by or for a Welsh NHS body.

(3) In relation to any function conferred on the CHAI under subsection (1)(a) of section 58, regulations under that section may provide that any one or more of the following provisions of this section shall have effect as if it included a reference to the exercise of that function—

(a) subsection (1)(a);

(b) subsection (1)(b);

(c) subsection (2).

(4) Regulations under this section may require the CHAI—

(a) to consult any person specified in the regulations before publishing a statement under subsection (1) or (2);

(b) to obtain the consent of the Secretary of State before publishing a statement under subsection (1);

(c) to obtain the consent of the Assembly before publishing a statement under subsection (2).

60 Provision of material

(1) The CHAI must, on request, provide the Comptroller and Auditor General with any material relevant to a review or investigation under sections 50 to 52 or a study under section 57.

(2) The CHAI must, on request, provide the regulator with—

(a) any material which is relevant to a review or investigation under sections 50 to 52 and relates to the provision of health care by or for an NHS foundation trust;

(b) any material which is relevant to a study under section 57 and relates to an NHS foundation trust.

61 Co-operation between CHAI and the regulator

(1) The CHAI and the regulator must co-operate with each other in the exercise of their respective functions under Part 1 and this Chapter.

(2) In particular, for the purposes of subsection (1)—

(a) the CHAI must keep the regulator informed about the provision of health care by and for NHS foundation trusts;

(b) the regulator must give to the CHAI any information it has about the provision of health care by or for an NHS foundation trust which it considers would assist the CHAI in the discharge of its functions.

62 Fees

(1) The CHAI may from time to time make and publish provision—

(a) requiring an English NHS body or cross-border SHA to pay a fee in respect of the exercise by the CHAI, in relation to that body or to health care provided by or for that body, of such of its functions under this Chapter as may be prescribed;

(b) requiring a person of a prescribed description who provides health care for an English NHS body or cross-border SHA to pay a fee in respect of the exercise by the CHAI, in relation to the health care so provided by that person, of such of its functions under this Chapter as may be prescribed.

(2) The CHAI may not under subsection (1)(b) require a Welsh NHS body to pay a fee.

(3) The amount of a fee payable under provision under subsection (1) shall be such as may be specified in, or calculated or determined under, the provision.

(4) Provision under subsection (1) may include provision—

(a) for different fees to be paid in different cases, or classes of case;

(b) for different fees to be paid by persons of different descriptions;

(c) for the amount of a fee to be determined by the CHAI in accordance with specified factors;

(d) for the time by which a fee must be paid.

(5) Before making any provision under subsection (1) the CHAI must consult such persons as appear to it appropriate.

(6) The Secretary of State may by regulations make provision as to—

(a) the manner in which provision under subsection (1) is to be made and published;

(b) the matters to be taken into account by the CHAI before making the provision.

(7) The Secretary of State may by regulations make provision for an independent person or panel to review the amount charged under subsection (1) in any particular case and, if that person or panel thinks fit, to substitute a lesser amount for that amount.

(8) For the purpose of determining the fee payable by a person or body under subsection (1), the person or body must provide the CHAI with such information, in such form, as the CHAI may require.

(9) A fee payable by virtue of this section may, without prejudice to any other method of recovery, be recovered summarily as a civil debt.