Summary of The Health and Care Bill 

Once the bill is enacted it will bring the proposals of the DHSC white paper Working together to improve health and social care for all into effect.

Integrated Care Boards (ICBs)

The bill allows the establishment of ICBs and the abolition of Clinical Commissioning Groups. The function of these ICBs will be to arrange the provision of health services in England – this means commissioning both primary healthcare services and other care services. It will be possible for NHS England to delegate some of its functions to these ICBs.

NHS England will need to create a list of areas covered by each ICB in order to distribute resources effectively. ‘The general duties of an ICB will include improving the quality of services, reducing inequalities, promoting patient involvement and patient choice, promoting innovation, research, education and training.’ In the spirit of public accountability, members of the public are welcome to attend ICB meetings.

ICBs and their partner NHS Trusts and NHS Foundation Trusts must prepare yearly plans laying out their intended use of allocated funds and resources. They must also produce (and update yearly) plans for their services over the next five years. NHS England will undertake yearly performance reviews in order to assess the effectiveness of the ICBs.

Changes to the structure of NHS England

The NHS Trust Development Authority (currently operating as part of NHS Improvement) will be abolished and have its functions transferred to NHS England. As this may generate conflicts of interest in the merging process, arrangements are set to be put in place to manage these and make this a smooth transition.

NHS England will have the power to provide financial assistance to any person providing healthcare services, forging a stronger and more efficient care continuum between the NHS and local or combined authorities. Once the bill comes into law it will be the duty of The Care Quality Commission (CQC) to review adult social care organised and delivered by local authorities. Rules around patient choice are also adjusted by the bill, meaning that patients have more freedom to choose where they receive care.

In light of this new model of integrated care, NHS England, ICBs, NHS Trusts and NHS Foundation Trusts will have a duty to consider the wider effects their decisions will have on the entire NHS system. In addition to the impacts on the NHS, they must consider the effects their choices have on:

• ‘the health and well-being of the people of England
• the quality of healthcare services provided to individuals in England
• efficient and sustainable use of resources.’

The bill makes provisions to establish the Health Services Safety Investigations Board (HSSIB) as an independent entity. The HSSIB will investigate incidents that have patient safety implications that occur during the provision of care.

Information protection

In light of the recent GPDPR programme, the bill lays out further details on the sharing of anonymised information within the health and care sectors. Information may need to be shared between public bodies that are operating within ICBs, but this will only take place if the data is already in a form that does not allow individuals to be identified. The bill also clarifies that information may only be shared with the purpose of providing care or promoting better health. 

Additionally, ‘there will be a new offence in relation to information disclosure that could result in imprisonment and/or a fine.’ The risk of such penalties will ensure companies dealing with patient data are rigorous with securing and protecting their data. ICBs will result in more centralised and collated data sets, benefiting those in research and analytics. For patients, the knowledge that their data is so securely safeguarded may increase their willingness to share their data for the purposes of research and improving public health.