Health and Care Act 2022

The Health and Care Act is an Act of the Parliament of the United Kingdom. It was introduced into the House of Commons in July 2021 and is intended 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 is 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]

Provisions

The Act puts integrated care systems on a statutory footing, and merges NHS England and NHS Improvement.

It provides for the Care Quality Commission to assess how local authorities deliver their adult social care functions.[2]

It establishes an integrated care board and an integrated care partnership in every part of England. Each board is required to have, as a minimum:

  • Four executives: the chief executive and finance, nursing and medical directors.
  • Three independent non-executives: a chair and at least two others. They "will normally not hold positions or offices in other health and care organisations within the ICS footprint".
  • Three "partner members": one from an NHS trust/foundation trust in the patch, one from general practice, and one from a local authority.[3]

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 and effectively ends the NHS internal market as NHS commissioners will no longer be automatically obliged to put clinical services out to tender.[4]

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.[5]

It puts a £86,000 cap on the amount anyone in England will have to spend on their personal care over their lifetime.[6]

It is claimed that it will "dispose of unnecessary bureaucracy that has held the health service back", and will ensure the NHS is "more accountable to government".[7]

It includes provisions which would 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 will be defined in regulations.[8] If ministers "call in" a reconfiguration proposal for review, they must make a final decision within six months.[9]

The Act criminalises "aiding and abetting" women to undergo hymenorrhaphy, or hymen reconstruction surgery, along with virginity testing.[10]

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.[11]

The Act also includes a target of the NHS achieving net zero carbon emissions by 2040.[12]

Reception

Its social care provisions are criticized as insufficient, especially for failing to deal with the workforce crisis, 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.[13]

References
  1. "ICS launch delayed until July". Health Service Journal. 21 December 2021. Retrieved 27 December 2021.
  2. "Health and Care Bill 2021-22". House of Commons Library. July 2021. Retrieved 27 July 2021.
  3. "NHS England reveals who will sit on ICS boards". Health Service Journal. 16 June 2021. Retrieved 28 July 2021.
  4. "Government reveals details of plans to scale back NHS competition". Health Service Journal. 22 February 2022. Retrieved 21 April 2022.
  5. "Health bill introduces new criminal offence for sharing NHS data". Health Service Journal. 7 July 2021. Retrieved 3 September 2021.
  6. "Health and Social Care Bill 2022 is passed". Building Better Healthcare. 13 May 2022. Retrieved 30 June 2022.
  7. "Government ploughs ahead with Health & Care Bill". Local Government Chronicle. 6 July 2021. Retrieved 27 July 2021.
  8. "First major NHS legislation in nine years confirms DHSC power grab". Health Service Journal. 6 July 2021. Retrieved 27 July 2021.
  9. "New time limit for government to decide on reconfigurations". Health Service Journal. 25 April 2022. Retrieved 6 June 2022.
  10. Sandhu, Rajdeep (25 January 2022). "Hymen repair surgery and virginity testing to be banned in UK". BBC News. Retrieved 27 January 2022.
  11. "Government agrees Health and Care Bill concessions". Health Service Journal. 23 February 2022. Retrieved 21 April 2022.
  12. "Greener NHS » Delivering a net zero NHS". www.england.nhs.uk. Retrieved 26 August 2022.
  13. "'Unfinished business' for social care as Health and Care Bill receives Royal Assent, say leaders". Home Care Insight. 3 May 2022. Retrieved 6 June 2022.
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