National Health Service Act 2006

Part 11 E+WProperty and finance

Chapter 1E+WLand and other property

211Acquisition, use and maintenance of propertyE+W

(1)The Secretary of State may acquire—

(a)any land, either by agreement or compulsorily,

(b)any other property,

required by him for the purposes of this Act.

(2)In particular, land may be so acquired to provide residential accommodation for persons employed for any of those purposes.

(3)The Secretary of State may use for the purposes of any of the functions conferred on him by this Act any property belonging to him by virtue of this Act, and he has power to maintain all such property.

(4)[F1A local authority] may be authorised to purchase land compulsorily for the purposes of this Act by means of an order made by the authority and confirmed by the Secretary of State.

[F2(4A)In subsection (4), “local authority” has the same meaning as in section 2B.]

(5)The Acquisition of Land Act 1981 (c. 67) applies to the compulsory purchase of land under this section.

(6)Section 120(3) of the Local Government Act 1972 (c. 70) (which relates to the application of Part 1 of the Compulsory Purchase Act 1965 (c. 56) where a council is authorised to acquire land by agreement) applies to the acquisition of land by the Secretary of State under this section as it applies to such acquisition by a council under that section.

(7)Sections 238 and 239 of the Town and Country Planning Act 1990 (c. 8) (use and development of consecrated land and burial grounds) apply to consecrated land or land comprised in a burial ground (within the meaning of section 240 of that Act) which—

(a)the Secretary of State holds for the purposes of the health service, and

(b)has not been the subject of a relevant acquisition (within the meaning of that section) by him,

as if that land had been the subject of such an acquisition by him for those purposes.

Textual Amendments

Modifications etc. (not altering text)

Chapter 2E+WTrusts

F3212Special trustees for a university hospital or teaching hospitalE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

213Transfers of trust propertyE+W

(1)The Secretary of State may, having regard to any change or proposed change—

(a)in the arrangements for the administration of a hospital or other establishment or facility, or

(b)in the area or functions of any NHS body other than an NHS foundation trust,

by order provide for the transfer of any trust property from any relevant health service body to any other relevant health service body.

(2)In this section “relevant health service body” means—

(a)an NHS body,

(b)[F4Welsh] special trustees, or

(c)trustees for F5... F6... an NHS trust F5....

(3)Where property is transferred by an order under this section to two or more bodies, it must be apportioned by them in such proportions as they may agree, or as may in default of agreement be determined by the Secretary of State, and the order may provide for the way in which the property must be apportioned.

(4)Where property is so apportioned, the Secretary of State may by order make any consequential amendments of the trust instrument relating to the property.

(5)In this section [F7“Welsh special trustees” means] special trustees within the meaning of section 160 of the National Health Service (Wales) Act 2006 (c. 42).

Textual Amendments

F6Words in s. 213(2)(c) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 109(b); S.I. 2013/160, art. 2(2) (with arts. 7-9)

214Transfer of functions and property to or from [F8Welsh] special trusteesE+W

(1)If it appears to the Secretary of State at any time that all the functions of any [F9Welsh special trustees] should be discharged by [F10the Board, a clinical commissioning group,] F11... an NHS trust, a Special Health Authority or an NHS foundation trust, he may by order provide for the transfer of all trust property from the [F9Welsh special trustees] to the body or, in such proportions as may be specified in the order, to those bodies.

(2)Before acting under subsection (1) the Secretary of State must consult the [F9Welsh special trustees] and other bodies concerned.

(3)If it appears to the Secretary of State at any time that—

(a)the functions of any [F9Welsh special trustees] should be discharged by the trustees for F12... F13... an NHS trust F12... (“the trustees of the body”), or

(b)the functions of the trustees of the body should be discharged by [F9Welsh special trustees],

he may, after consulting the [F9Welsh special trustees] and the trustees of the body, by order provide for the transfer of all trust property from the [F9Welsh special trustees] to the trustees of the body, or from the trustees of the body to the [F9Welsh special trustees].

(4)Where property is transferred by an order under this section to two or more bodies, it must be apportioned by them in such proportions as they may agree, or as may in default of agreement be determined by the Secretary of State, and the order may provide for the way in which the property must be apportioned.

(5)Where property is so apportioned, the Secretary of State may by order make any consequential amendments of the trust instrument relating to the property.

(6)[F14“Welsh special trustees” means] special trustees within the meaning of section 160 of the National Health Service (Wales) Act 2006.

Textual Amendments

F12Words in s. 214(3)(a) omitted (17.6.2021) by virtue of NHS (Charitable Trusts Etc) Act 2016 (c. 10), s. 5(1), Sch. 1 para. 3(c); S.I. 2021/712, reg. 3(c)

215Trustees and property under section 222E+W

F15(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F15(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3)Subsection (4) applies where property is given in pursuance of section 222—

F16(za). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F17(zb). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F18(a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b)on trust for any purposes of an NHS trust for which trustees have been appointed under paragraph 10 of Schedule 4, or paragraph 10 of Schedule 3 to the National Health Service (Wales) Act 2006 (c. 42), F19...

F19(c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(4)Where this subsection applies and the trustees and [F20the Board, clinical commissioning group,] F21... NHS trust or NHS foundation trust agree, the property may be held, administered and applied by the trustees instead of by [F22the Board, clinical commissioning group,] F21... NHS trust or NHS foundation trust.

(5)Property given in pursuance of section 222 on trust may be transferred by order of the Secretary of State under section 213 or 214 in the same circumstances as other trust property may be transferred under either of those sections.

Textual Amendments

216Application of trust property: further provisionsE+W

(1)Any discretion given by a trust instrument to the trustees of property transferred under—

(a)section 24 of the National Health Service Reorganisation Act 1973 (c. 32) (transfer of trust property from abolished authorities),

(b)section 25 of that Act (transfer of trust property held for health services by local health authorities),

(c)section 92 of the National Health Service Act 1977 (c. 49) (further transfers of trust property), or

(d)section 213 or 214 of this Act,

is exercisable by the person to whom the property is so transferred and, subject to this section, the transfer does not affect the trusts on which the property is held.

(2)Where—

(a)property has been transferred under section 24 of the National Health Service Reorganisation Act 1973, or section 92 of the National Health Service Act 1977, and

(b)any discretion is given by a trust instrument to the trustees to apply the property, or income arising from the property, to such hospital services (including research) as the trustees consider appropriate without any restriction on the kinds of hospital services and without any restriction to one or more specified hospitals,

the discretion is enlarged so as to allow the application of the property or of the income arising from the property, to such extent as the trustees consider appropriate, for any other part of the health service associated with any hospital.

(3)Subsection (2) applies on any subsequent transfer of the property under section 213 or 214 [F23of this Act or section 300 or 302 of the Health and Social Care Act 2012].

Textual Amendments

217Trusts: supplementary provisionsE+W

(1)This section applies in relation to—

F24(a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b)sections [F25213 and] 214,

(c)section 216,

(d)section 218,

(e)section 220,

F26(ea). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F27(eb). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F28(f). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F29(g). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(h)paragraph 10 of Schedule 4, and

(i)[F30paragraph 8] of Schedule 6.

(2)A provision—

(a)contained in a provision to which this section applies,

(b)for the transfer of any property,

includes provision for the transfer of any rights and liabilities arising from that property.

(3)Where a transfer of property by virtue of a provision to which this section applies is of, or includes—

(a)land held on lease from a third party, or

(b)any other asset leased or hired from a third party or in which a third party has an interest,

the transfer is binding on the third party notwithstanding that, apart from this subsection, it would have required his consent or concurrence.

(4)“Third party” means a person other than the Secretary of State or an NHS body.

(5)Nothing in a provision to which this section applies affects any power of Her Majesty, [F31the court (as defined in the Charities Act 2011)] or any other person, to alter the trusts of any charity.

(6)Nothing in section 12 of the Finance Act 1895 (c. 16) (which requires certain Acts and certain instruments relating to the vesting of property by virtue of an Act to be stamped as conveyances on sale) applies to—

(a)a provision to which this section applies, or

(b)an order made in pursuance of any such provision.

(7)Stamp duty is not payable on an order falling within subsection (6)(b).

Textual Amendments

F31Words in s. 217(5) substituted (14.3.2012) by Charities Act 2011 (c. 25), s. 355, Sch. 7 para. 111 (with s. 20(2), Sch. 8)

Modifications etc. (not altering text)

218Private trusts for hospitalsE+W

(1)Subsection (2) applies where the terms of a trust instrument authorise or require the trustees, whether immediately or in the future, to apply any part of the capital or income of the trust property for the purposes of any health service hospital.

(2)The trust instrument must be construed as authorising or requiring the trustees to apply the trust property to the like extent, and at the like times, for the purpose of making payments, whether of capital or income, to the appropriate hospital authority.

(3)Any sum paid to the appropriate hospital authority must, so far as practicable, be applied by it for the purpose specified in the trust instrument.

(4)“The appropriate hospital authority” means—

(a)where [F32Welsh] special trustees are appointed for the hospital, those trustees,

(b)where the hospital is managed by, and trustees have been appointed for, an NHS trust, F33... F34..., the trustees,

(c)where the hospital is managed by an NHS trust, an NHS foundation trust F35... and neither paragraph (a) nor paragraph (b) applies, the NHS trust, NHS foundation trust F35..., and

[F36(d)in any other case—

(i)where the hospital is vested in the Secretary of State, the Special Health Authority exercising functions of the Secretary of State in respect of it or, where there is no such Special Health Authority, the Secretary of State,

(ii)where the Welsh Ministers have functions in respect of the hospital, the Special Health Authority or Local Health Board exercising those functions.]

(5)Nothing in this section applies to property transferred under section 24 of the National Health Service Reorganisation Act 1973.

(6)In this section—

  • “health service hospital” includes such a hospital within the meaning of section 206 of the National Health Service (Wales) Act 2006 (c. 42), and

  • [F37“Welsh special trustees” means] special trustees within the meaning of section 160 of that Act.

Textual Amendments

F34Words in s. 218(4)(b) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 114(a); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F35Words in s. 218(4)(c) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 114(b); S.I. 2013/160, art. 2(2) (with arts. 7-9)

Chapter 3E+WProperty transferred under the National Health Service Act 1946

219Transferred property free of trustsE+W

(1)All property vested in the Secretary of State in consequence of the transfer of that property under section 6 of the National Health Service Act 1946 (c. 81) (transfer of hospitals) is vested free of any trust existing immediately before that transfer.

(2)The Secretary of State may use any such property for the purpose of any of his functions under this Act, but he must so far as practicable secure that the objects for which any such property was used immediately before that transfer are not prejudiced by the exercise of the power conferred by this subsection.

220Trust property previously held for general hospital purposesE+W

(1)This section applies to property—

(a)transferred under section 23 of the National Health Service Reorganisation Act 1973 (c. 32) (winding-up of hospital endowment funds), or

(b)transferred under section 24 of that Act (transfer of trust property from abolished authorities) and which immediately before the day appointed for the purposes of that section was, in accordance with any provision contained in or made under section 7 of the National Health Service Act 1946, applicable for purposes relating to hospital services or relating to some form of research,

including any such property which has been further transferred under section 92 of the National Health Service Act 1977 (c. 49).

(2)This section continues to apply to any such property after any further transfer under section 213 or 214 [F38of this Act or section 300 or 302 of the Health and Social Care Act 2012].

(3)The person holding the property after the transfer or last transfer must secure, so far as is reasonably practicable, that the objects of any original endowment, and the observance of any conditions attached to that endowment, including in particular conditions intended to preserve the memory of any person or class of persons, are not prejudiced by this Part of this Act.

(4)“Original endowment” means a hospital endowment which was transferred under section 7 of the National Health Service Act 1946 (c. 81) and from which the property in question is derived.

(5)Subject to subsection (3), the property must be held on trust for such purposes relating to hospital services (including research), or to any other part of the health service associated with any hospital, as the person holding the property considers appropriate.

F39(6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

221Voluntary hospitalsE+W

(1)Subsection (2) applies where—

(a)any hospital provided by the Secretary of State in accordance with this Act was a voluntary hospital transferred by virtue of the National Health Service Act 1946, and

(b)the character and associations of that hospital before its transfer were such as to link it with a particular religious denomination.

(2)Regard must be had in the general administration of the hospital to the preservation of that character and those associations.

Chapter 4E+WRaising money

222Power to raise moneyE+W

(1)This section applies to any NHS body other than a Local Health Board.

(2)A body to which this section applies has power to engage in activities intended to stimulate the giving (whether on trust or otherwise) of money or other property to—

(a)assist the body in providing or improving any services or any facilities or accommodation which is or are, or will be, provided as part of the health service, or

(b)assist it in connection with its functions with respect to research.

(3)Subject to any directions of [F40the appropriate authority] excluding specified descriptions of activity, the activities authorised by this section include—

(a)public appeals or collections,

(b)competitions,

(c)entertainments,

(d)bazaars,

(e)sales of produce or other goods, and

(f)other similar activities.

[F41(3A)In subsection (3) “appropriate authority” means—

(a)in relation to a clinical commissioning group, the Board, and

(b)in relation to any other body to which this section applies, the Secretary of State.]

(4)The activities may involve the use of land, premises or other property held by or for the benefit of the body exercising the power.

(5)Subsection (4) is subject to any restrictions on the purposes for which trust property may be used.

(6)Subject to this section and section 215, the body at whose instance property is given in pursuance of this section must, after defraying out of it any expenses incurred in obtaining it, hold, administer and apply the property on trust for or for the purpose for which it was given.

(7)Where property held by a body under this section is more than sufficient to enable the purpose for which it was given to be fulfilled, the excess is applicable, in default of any provision for its application made by the trust or other instrument under or in accordance with which the property comprising the excess was given, for such purposes connected with any of the functions of the body as it considers appropriate.

(8)Where property held by a body under this section is insufficient to enable the purpose for which it was given to be fulfilled the body may apply so much of the capital or income at its disposal as is needed to enable the purpose to be fulfilled.

(9)Subsection (8) is subject in the case of trust property to any restrictions on the purpose for which the trust property may be applied and, in the case of money paid or payable by the Secretary of State under [F42section 225], to any directions he may give.

(10)Where the capital or income applicable under subsection (8) is insufficient or is not applied to enable the purpose to be fulfilled, the property held by the body is applicable, in default of any provision for its application made by the trust or other instrument under or in accordance with which the property was given, for such purposes connected with any of the functions of the body as it considers appropriate.

(11)Where under subsection (7) or (10) property becomes applicable for purposes other than that for which it was given the body applying the property must have regard to the desirability of applying it for a purpose similar to that for which it was given.

(12)References in this section to the purposes for which trust property may be used or applied include, in the case of trust property which has been transferred under section 213 or 214, references to those purposes as enlarged by section 216.

Textual Amendments

Chapter 5E+WFormation of companies

223Public-private partnershipsE+W

(1)The Secretary of State [F43or the Board] may form, or participate in forming, companies to provide facilities or services to persons or bodies exercising functions, or otherwise providing services, under this Act.

(2)The Secretary of State [F44or the Board] may, with a view to securing or facilitating the provision by companies of facilities or services to persons or bodies falling within subsection (1)—

(a)invest in the companies (whether by acquiring assets, securities or rights or otherwise), or

(b)provide loans and guarantees and make other kinds of financial provision to or in respect of them,

or both.

(3)For the purposes of subsections (1) and (2) it is immaterial that the facilities or services provided or to be provided by the companies in question are not provided or to be provided—

(a)only to persons or bodies falling within subsection (1), or

(b)to persons or bodies falling within subsection (1) only in their capacities as persons or bodies such as are mentioned in that provision.

(4)“Companies” means companies [F45as defined in section 1(1) of the Companies Act 2006] (c. 6).

(5)This section does not affect any powers of the Secretary of State [F46or the Board] exercisable otherwise than by virtue of this section.

Textual Amendments

[F47223AApplication of section 223 to clinical commissioning groupsE+W

(1)Section 223 applies in relation to a clinical commissioning group as it applies in relation to the Board.

(2)But the powers conferred by that section are exercisable by a clinical commissioning group only for the purpose of securing improvement—

(a)in the physical and mental health of the people for whom it has responsibility for the purposes of section 3, or

(b)in the prevention, diagnosis and treatment of illness in such people.]

Textual Amendments

Chapter 6E+WFinance

[F48The BoardE+W

Textual Amendments

F48Ss. 223B-223F and cross-heading inserted (27.3.2012 for specified purposes, 1.10.2012 for specified purposes, 1.4.2013 in so far as not already in force) by Health and Social Care Act 2012 (c. 7), ss. 24, 306(1)(d)(4); S.I. 2012/1831, art. 2(2); S.I. 2013/160, art. 2(2) (with arts. 7-9)

223BFunding of the BoardE+W

(1)The Secretary of State must pay to the Board in respect of each financial year sums not exceeding the amount allotted for that year by the Secretary of State towards meeting the expenditure of the Board which is attributable to the performance by it of its functions in that year.

(2)An amount is allotted to the Board for a financial year under this section when the Board is notified in writing by the Secretary of State that the amount is allotted to it for that year.

(3)The Secretary of State may make a new allotment under this section increasing or reducing the allotment previously so made only if—

(a)the Board agrees to the change,

(b)a parliamentary general election takes place, or

(c)the Secretary of State considers that there are exceptional circumstances that make a new allotment necessary.

(4)The Secretary of State may give directions to the Board with respect to the payment of sums by it to the Secretary of State in respect of charges or other sums referable to the valuation or disposal of assets.

(5)Sums falling to be paid to the Board under this section are payable subject to such conditions as to records, certificates or otherwise as the Secretary of State may determine.

[F49(6)Where the mandate specifies objectives relating to service integration, the requirements that may be specified under section 13A(2)(b) include such requirements relating to the use by the Board of an amount of the sums paid to it under this section as the Secretary of State considers it necessary or expedient to impose.

(7)The amount referred to in subsection (6)—

(a)is to be determined in such manner as the Secretary of State considers appropriate, and

(b)must be specified in the mandate.

(8)The reference in subsection (6) to service integration is a reference to the integration of the provision of health services with the provision of health-related services or social care services, as referred to in sections 13N and 14Z1.]

Textual Amendments

223CFinancial duties of the Board: expenditureE+W

(1)The Board must ensure that total health expenditure in respect of each financial year does not exceed the aggregate of—

(a)the amount allotted to the Board for that year under section 223B,

(b)any sums received by the Board or clinical commissioning groups in that year under any provision of this Act (other than sums received by the Board under section 223B or by clinical commissioning groups under section 223G), and

(c)any sums received by the Board or clinical commissioning groups in that year otherwise than under this Act for the purpose of enabling it or them to defray such expenditure.

(2)In this section, “total health expenditure”, in relation to a financial year, means—

(a)expenditure which is attributable to the performance by the Board of its functions in that year, other than sums paid by it under section 223G, and

(b)expenditure which is attributable to the performance by clinical commissioning groups of their functions in that year.

(3)The Secretary of State may by directions determine whether expenditure by the Board or a clinical commissioning group which is of a description specified in the directions must, or must not, be treated for the purposes of this section as part of total health expenditure.

(4)The Secretary of State may by directions determine the extent to which, and the circumstances in which, sums received by the Board or a clinical commissioning group under section 223B or (as the case may be) 223G but not yet spent must be treated for the purposes of this section as part of total health expenditure, and to which financial year's expenditure they must be attributed.

(5)The Secretary of State may by directions require the Board to use banking facilities specified in the directions for any purposes so specified.

223DFinancial duties of the Board: controls on total resource useE+W

(1)In this Chapter—

  • “total capital resource use”, in relation to a financial year, means the use of capital resources in that year by the Board and clinical commissioning groups (taken together);

  • “total revenue resource use”, in relation to a financial year, means the use of revenue resources in that year by the Board and clinical commissioning groups (taken together).

(2)The Board must ensure that total capital resource use in a financial year does not exceed the amount specified by the Secretary of State.

(3)The Board must ensure that total revenue resource use in a financial year does not exceed the amount specified by the Secretary of State.

(4)The Secretary of State may give directions, in relation to a financial year, specifying descriptions of resources which must, or must not, be treated as capital resources or revenue resources for the purposes of this Chapter.

(5)The Secretary of State may give directions, in relation to a financial year, specifying uses of capital resources or revenue resources which must not be taken into account for the purposes of this Chapter.

(6)The Secretary of State may give directions, in relation to a financial year, specifying uses of capital resources or revenue resources which must be taken into account for the purposes of this section.

(7)The amount specified for the purposes of subsection (2) or (3) may be varied only if—

(a)the Board agrees to the change,

(b)a parliamentary general election takes place, or

(c)the Secretary of State considers that there are exceptional circumstances which make the variation necessary.

(8)Any reference in this Chapter to the use of capital resources or revenue resources is a reference to their expenditure, consumption or reduction in value.

223EFinancial duties of the Board: additional controls on resource useE+W

(1)The Secretary of State may direct the Board to ensure that total capital resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified.

(2)The Secretary of State may direct the Board to ensure that total revenue resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified.

(3)The Secretary of State may direct the Board to ensure —

(a)that total revenue resource use in a financial year which is attributable to such prescribed matters relating to administration as are specified in the direction does not exceed an amount so specified;

(b)that the Board's use of revenue resources in a financial year which is attributable to such prescribed matters relating to administration as are specified in the direction does not exceed an amount so specified.

(4)The Secretary of State may give directions, in relation to a financial year, specifying uses of capital resources or revenue resources which must, or must not, be taken into account for the purposes of subsection (1) or (as the case may be) subsection (2) or (3).

(5)The Secretary of State may not give a direction under subsection (1) or (2) unless the direction is for the purpose of complying with a limit imposed by the Treasury.

223FPower to establish contingency fundE+W

(1)The Board may use a proportion of the sums paid to it under section 223B to establish a contingency fund.

(2)The Board may make a payment out of the fund where the payment is necessary in order to enable—

(a)the Board to discharge any of its commissioning functions, or

(b)a clinical commissioning group to discharge any of its functions.

(3)The Board must publish guidance as to how it proposes to exercise its powers to make payments out of the contingency fund.

(4)In this section, “commissioning functions” means functions in arranging for the provision of services as part of the health service.]

[F50Clinical commissioning groupsE+W

Textual Amendments

F50Ss. 223G-223K and cross-heading inserted (27.3.2012 for specified purposes, 1.10.2012 for specified purposes, 1.4.2013 in so far as not already in force) by Health and Social Care Act 2012 (c. 7), ss. 27, 306(1)(d)(4); S.I. 2012/1831, art. 2(2); S.I. 2013/160, art. 2(2) (with arts. 7-9)

223GMeans of meeting expenditure of clinical commissioning groups out of public fundsE+W

(1)The Board must pay in respect of each financial year to each clinical commissioning group sums not exceeding the amount allotted for that year by the Board to the group towards meeting the expenditure of the group which is attributable to the performance by it of its functions in that year.

(2)In determining the amount to be allotted to a clinical commissioning group for any year, the Board may take into account—

(a)the expenditure of the clinical commissioning group during any previous financial year, and

(b)the amount that it proposes to hold, during the year to which the allotment relates, in any contingency fund established under section 223F.

(3)An amount is allotted to a clinical commissioning group for a year under this section when the group is notified in writing by the Board that the amount is allotted to it for that year.

(4)The Board may make a new allotment under this section increasing or reducing an allotment previously so made.

(5)Where the Board allots an amount to a clinical commissioning group or makes a new allotment under subsection (4), it must notify the Secretary of State.

(6)The Board may give directions to a clinical commissioning group with respect to—

(a)the application of sums paid to it by virtue of a new allotment increasing an allotment previously so made, and

(b)the payment of sums by it to the Board in respect of charges or other sums referable to the valuation or disposal of assets.

(7)Sums falling to be paid to clinical commissioning groups under this section are payable subject to such conditions as to records, certificates or otherwise as the Board may determine.

(8)In this section and sections 223H to 223K “financial year” includes the period which begins on the day the clinical commissioning group is established and ends on the following 31 March.

[F51223GAExpenditure on integrationE+W

(1)Where the mandate includes a requirement in reliance on section 223B(6) (requirements relating to use by the Board of an amount paid to the Board where mandate specifies service integration objectives), the Board may direct a clinical commissioning group that an amount (a “designated amount”) of the sums paid to the group under section 223G is to be used for purposes relating to service integration.

(2)The designated amount is to be determined—

(a)where the mandate includes a requirement (in reliance on section 223B(6)) that designated amounts are to be determined by the Board in a manner specified in the mandate, in that manner;

(b)in any other case, in such manner as the Board considers appropriate.

(3)The conditions under section 223G(7) subject to which the payment of a designated amount is made must include a condition that the group transfers the amount into one or more funds (“pooled funds”) established under arrangements under section 75(2)(a) (“pooling arrangements”).

(4)The conditions may also include—

(a)conditions relating to the preparation and agreement by the group and each local authority and other clinical commissioning group that is party to the pooling arrangements of a plan for how to use the designated amount (a “spending plan”);

(b)conditions relating to the approval of a spending plan by the Board;

(c)conditions relating to the inclusion of performance objectives in a spending plan;

(d)conditions relating to the meeting of any performance objectives included in a spending plan or specified by the Board.

(5)Where a condition subject to which the payment of a designated amount is made is not met, the Board may—

(a)withhold the payment (in so far as it has not been made);

(b)recover the payment (in so far as it has been made);

(c)direct the clinical commissioning group as to the use of the designated amount for purposes relating to service integration or for making payments under section 256.

(6)Where the Board withholds or recovers a payment under subsection (5)(a) or (b)—

(a)it may use the amount for purposes consistent with such objectives and requirements relating to service integration as are specified in the mandate, and

(b)in so far as the exercise of the power under paragraph (a) involves making a payment to a different clinical commissioning group or some other person, the making of the payment is subject to such conditions as the Board may determine.

(7)The requirements that may be specified in the mandate in reliance on section 223B(6) include requirements to consult the Secretary of State or other specified persons before exercising a power under subsection (5) or (6).

(8)The power under subsection (5)(b) to recover a payment may be exercised in a financial year after the one in respect of which the payment was made.

(9)The payments that may be made out of a pooled fund into which a designated amount is transferred include payments to a local authority which is not party to the pooling arrangements in question in connection with the exercise of its functions under Part 1 of the Housing Grants, Construction and Regeneration Act 1996 (disabilities facilities grants).

(10)In exercising a power under this section, the Board must have regard to the extent to which there is a need for the provision of each of the following—

(a)health services (see subsection (12)),

(b)health-related services (within the meaning given in section 14Z1), and

(c)social care services (within the meaning given in that section).

(11)A reference in this section to service integration is a reference to the integration of the provision of health services with the provision of health-related services or social care services, as referred to in sections 13N and 14Z1.

(12)“Health services” means services provided as part of the health service in England.]

Textual Amendments

223HFinancial duties of clinical commissioning groups: expenditureE+W

(1)Each clinical commissioning group must, in respect of each financial year, perform its functions so as to ensure that its expenditure which is attributable to the performance by it of its functions in that year does not exceed the aggregate of—

(a)the amount allotted to it for that year under section 223G,

(b)any sums received by it in that year under any provision of this Act (other than sums received by it under section 223G), and

(c)any sums received by it in that year otherwise than under this Act for the purpose of enabling it to defray such expenditure.

(2)The Board may by directions determine—

(a)whether specified sums must, or must not, be treated for the purposes of this section as received by a specified clinical commissioning group,

(b)whether specified expenditure must, or must not, be treated for those purposes as expenditure within subsection (1) of a specified clinical commissioning group, or

(c)the extent to which, and the circumstances in which, sums received by a clinical commissioning group under section 223G but not yet spent must be treated for the purposes of this section as part of the expenditure of the group, and to which financial year's expenditure they must be attributed.

(3)The Secretary of State may by directions require a clinical commissioning group to use specified banking facilities for any specified purposes.

(4)In this section, “specified” means specified in the directions.

223IFinancial duties of clinical commissioning groups: use of resourcesE+W

(1)For the purposes of this section and section 223J—

(a)a clinical commissioning group's capital resource use, in relation to a financial year, means the group's use of capital resources in that year, and

(b)a clinical commissioning group's revenue resource use, in relation to a financial year, means the group's use of revenue resources in that year.

(2)A clinical commissioning group must ensure that its capital resource use in a financial year does not exceed the amount specified by direction of the Board.

(3)A clinical commissioning group must ensure that its revenue resource use in a financial year does not exceed the amount specified by direction of the Board.

(4)Any directions given in relation to a financial year under subsection (6) of section 223D apply (in relation to that year) for the purposes of this section as they apply for the purposes of that section.

(5)The Board may by directions make provision for determining to which clinical commissioning group a use of capital resources or revenue resources is to be attributed for the purposes of this section or section 223J.

(6)Where the Board gives a direction under subsection (2) or (3), it must notify the Secretary of State.

223JFinancial duties of clinical commissioning groups: additional controls on resource useE+W

(1)The Board may direct a clinical commissioning group to ensure that its capital resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified.

(2)The Board may direct a clinical commissioning group to ensure that its revenue resource use in a financial year which is attributable to matters specified in the direction does not exceed an amount so specified.

(3)The Board may direct a clinical commissioning group to ensure that its revenue resource use in a financial year which is attributable to prescribed matters relating to administration does not exceed an amount specified in the direction.

(4)The Board may give directions, in relation to a financial year, specifying uses of capital resources or revenue resources which must, or must not, be taken into account for the purposes of subsection (1) or (as the case may be) subsection (2) or (3).

(5)The Board may not exercise the power conferred by subsection (1) or (2) in relation to particular matters unless the Secretary of State has given a direction in relation to those matters under subsection (1) of section 223E or (as the case may be) subsection (2) of that section.

(6)The Board may not exercise the power conferred by subsection (3) in relation to prescribed matters relating to administration unless the Secretary of State has given a direction in relation to those matters under subsection (3)(a) of section 223E.

223KPayments in respect of qualityE+W

(1)The Board may, after the end of a financial year, make a payment to a clinical commissioning group.

(2)For the purpose of determining whether to make a payment under subsection (1) and (if so) the amount of the payment, the Board must take into account at least one of the following factors—

(a)the quality of relevant services provided during the financial year;

(b)any improvement in the quality of relevant services provided during that year (in comparison to the quality of relevant services provided during previous financial years);

(c)the outcomes identified during the financial year as having been achieved from the provision at any time of relevant services;

(d)any improvement in the outcomes identified during that financial year as having been so achieved (in comparison to the outcomes identified during previous financial years as having been so achieved).

(3)For that purpose, the Board may also take into account either or both of the following factors—

(a)relevant inequalities identified during that year;

(b)any reduction in relevant inequalities identified during that year (in comparison to relevant inequalities identified during previous financial years).

(4)Regulations may make provision as to the principles or other matters that the Board must or may take into account in assessing any factor mentioned in subsection (2) or (3).

(5)Regulations may provide that, in prescribed circumstances, the Board may, if it considers it appropriate to do so—

(a)not make a payment that would otherwise be made to a clinical commissioning group under subsection (1), or

(b)reduce the amount of such a payment.

(6)Regulations may make provision as to how payments under subsection (1) may be spent (which may include provision as to circumstances in which the whole or part of any such payments may be distributed to members of the clinical commissioning group).

(7)A clinical commissioning group must publish an explanation of how the group has spent any payment made to it under subsection (1).

(8)In this section—

  • “relevant services” means services provided in pursuance of arrangements made by the clinical commissioning group—

    (a)

    under section 3 or 3A or Schedule 1, or

    (b)

    by virtue of section 7A;

  • “relevant inequalities” means inequalities between the persons for whose benefit relevant services are at any time provided with respect to—

    (a)

    their ability to access the services, or

    (b)

    the outcomes achieved for them by their provision.]

Strategic Health Authorities and Special Health AuthoritiesE+W

F52224Means of meeting expenditure of Strategic Health Authorities out of public fundsE+W

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Textual Amendments

225Means of meeting expenditure of Special Health Authorities out of public fundsE+W

(1)The Secretary of State must pay in respect of each financial year to each Special Health Authority sums not exceeding the amount allotted for that year by the Secretary of State to the Special Health Authority towards meeting the expenditure of the Special Health Authority which is attributable to the performance by it of its functions in that year.

(2)An amount is allotted to a Special Health Authority for a year under this section when it is notified by the Secretary of State that the amount is allotted to it for that year.

(3)The Secretary of State may make an allotment under this section increasing or reducing an allotment previously so made.

(4)The Secretary of State may give directions to a Special Health Authority with respect to—

(a)the application of sums paid to it under this section, or

(b)the payment of sums by it to the Secretary of State in respect of charges or other sums referable to the valuation or disposal of assets.

(5)Sums falling to be paid to Special Health Authorities under this section are payable subject to such conditions as to records, certificates or otherwise as the Secretary of State may determine.

226Financial duties of F53... Special Health AuthoritiesE+W

F54(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2)Each Special Health Authority must, in respect of each financial year, perform its functions so as to secure that its expenditure which is attributable to the performance by it of its functions in that year does not exceed the aggregate of—

(a)the amount allotted to it for that year under section 225(1),

(b)any sums received by it in that year under any provision of this Act (other than sums received by it under that subsection), and

(c)any sums received by it in that year otherwise than under this Act for the purpose of enabling it to defray any such expenditure.

(3)The Secretary of State may give such directions to a F55... Special Health Authority as appear to be requisite to secure that the Authority complies with the duty under [F56subsection (2)].

(4)To the extent to which—

(a)any expenditure is defrayed by a F57... Special Health Authority as trustee F58..., or

(b)any sums are received by a F57... Special Health Authority as trustee or under section 222,

that expenditure and, subject to subsection (6), those sums, must be disregarded for the purposes of this section.

(5)For the purposes of this section sums which, in the hands of a F59... Special Health Authority, cease to be trust funds and become applicable by the Authority otherwise than as trustee must be treated, on their becoming so applicable, as having been received by the Authority otherwise than as trustee.

(6)Of the sums received by a F60... Special Health Authority under section 222, so much only as accrues to the Authority after defraying any expenses incurred in obtaining them must be disregarded under subsection (4).

(7)Subject to subsection (4), the Secretary of State may by directions determine—

(a)whether specified sums must, or must not, be treated for the purposes of this section as received under this Act by a F61... specified Special Health Authority,

(b)whether specified expenditure must, or must not, be treated for those purposes as—

F62(i). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(ii)expenditure within subsection (2) of a specified Special Health Authority, or

(c)the extent to which, and the circumstances in which, sums received—

F63(i). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(ii)by a Special Health Authority under section 225,

but not yet spent must be treated for the purposes of this section as part of the expenditure of the F64... Special Health Authority and to which financial year's expenditure they must be attributed.

(8)“Specified” means of a description specified in the directions.

Textual Amendments

F53Words in s. 226 heading omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 119(8); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F57Words in s. 226(4) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 119(4); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F59Words in s. 226(5) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 119(5); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F60Words in s. 226(6) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 119(6); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F61Words in s. 226(7)(a) omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 119(7)(a); S.I. 2013/160, art. 2(2) (with arts. 7-9)

227Resource limits for F65... Special Health AuthoritiesE+W

(1)Each F66... Special Health Authority must ensure that the use of its resources in a financial year does not exceed the amount specified for it in relation to that year by the Secretary of State.

(2)For the purpose of subsection (1) the Secretary of State may give directions—

(a)specifying uses of resources which must, or must not, be taken into account,

(b)making provision for determining to which F67... Special Health Authority certain uses of resources must be attributed,

(c)specifying descriptions of resources which must, or must not, be taken into account.

(3)The Secretary of State may give such directions to a F68... Special Health Authority as appear to be requisite to secure that the Authority complies with the duty under subsection (1).

(4)Subsections (4) to (6) of section 226 apply in relation to the duty under subsection (1) of this section as they apply in relation to the duties under [F69subsection (2)] of that section; and for that purpose references to the defraying of expenditure and the receipt of sums are references to the incurring of liabilities and the acquisition of assets.

(5)Where the Secretary of State has specified an amount under this section in respect of a financial year, he may vary the amount by a later specification.

(6)In this section a reference to the use of resources is a reference to their expenditure, consumption or reduction in value.

Textual Amendments

F65Words in s. 227 heading omitted (1.4.2013) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(4), Sch. 4 para. 120(6); S.I. 2013/160, art. 2(2) (with arts. 7-9)

Primary Care TrustsE+W

F70228Public funding of Primary Care TrustsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F70229Financial duties of Primary Care TrustsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F70230Resource limits for Primary Care TrustsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F70231Further provision about the expenditure of Primary Care TrustsE+W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

Accounts and auditE+W

232Accounts and auditE+W

Schedule 15 makes provision about the accounts of certain health service bodies and the auditing of such accounts.

Allowances and remunerationE+W

233Allowances for members of certain bodiesE+W

(1)The Secretary of State may pay to members of any body specified by him in an order as a body formed for the purpose of performing a function connected with the provision of services under this Act, such travelling and other allowances, including compensation for loss of remunerative time, as he may determine.

(2)Payments under this section are subject to such conditions as to records, certificates, or otherwise as the Secretary of State may determine.

234Special arrangement as to payment of remunerationE+W

(1)Subsection (2) applies where the Secretary of State considers it appropriate for remuneration in respect of—

(a)primary medical services, primary dental services, primary ophthalmic services or pharmaceutical services, or

(b)services provided under a pilot scheme [F71established under section 134(1) of this Act] or an LPS scheme,

to be paid by a particular body.

(2)Where this subsection applies, and the functions of the body do not include the function of paying the remuneration, the Secretary of State may by order confer that function on that body.

(3)Any sums required to enable a body to pay the remuneration must, if apart from this section there is no provision authorising the payment of the sums by the Secretary of State or out of money provided by Parliament, be paid by him.

F72(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F71Words in s. 234(1)(b) inserted (19.1.2010) by Health Act 2009 (c. 21), s. 40(1), Sch. 1 para. 7(d); S.I. 2010/30, art. 2(b)

235Superannuation of officers of certain hospitalsE+W

(1)The Secretary of State may enter into an agreement with the governing body of any hospital to which this section applies—

(a)for admitting officers of the hospital of such classes as may be provided in the agreement to participate, on such terms and conditions as may be so provided, in the superannuation benefits provided under regulations made under section 10 of the Superannuation Act 1972 (c. 11) in like manner as officers of NHS trusts, and

(b)those regulations apply accordingly in relation to the officers so admitted subject to such modifications as may be provided in the agreement.

(2)The governing body of any hospital to which this section applies has such powers as may be necessary for the purpose of giving effect to any terms and conditions on which their officers are admitted to participate in those superannuation benefits.

(3)This section applies to any hospital (not vested in the Secretary of State) which is used, in pursuance of arrangements made by the governing body of the hospital with the Secretary of State, for the provision of services under this Act or the National Health Service (Wales) Act 2006 (c. 42).

(4)“Superannuation benefits” means annual superannuation allowances, gratuities and periodical payments payable on retirement, death or incapacity, and similar benefits.

236Payments for certain medical examinationsE+W

(1)Where a medical practitioner carries out a medical examination of any person with a view to an application for his admission to hospital for assessment or treatment being made under Part 2 of the Mental Health Act 1983 (c. 20) [F73the prescribed clinical commissioning group] must pay to that medical practitioner—

(a)reasonable remuneration in respect of that examination and in respect of any recommendation or report made by him with regard to the person examined, and

(b)the amount of any expenses reasonably incurred by him in connection with the examination or the making of any such recommendation or report.

(2)No payment may be made under this section to a medical practitioner—

(a)in respect of an examination carried out in the provision of primary medical services for that person, or

(b)in respect of an examination carried out or any recommendation or report made[F74—

(i)]as part of his duty as an officer of F75... [F76an] NHS trust, Special Health Authority, NHS foundation trust or Local Health Board[F77, or

(ii)pursuant to arrangements made by the National Health Service Commissioning Board or a clinical commissioning group, or

(iii)pursuant to arrangements made in the exercise (by any person) of the public health functions of the Secretary of State or a local authority].

(3)This section applies only in a case where it is intended, when the medical examination of the person in question is carried out, that if he is admitted to hospital in pursuance of an application mentioned in subsection (1), the whole cost of his maintenance and treatment will be defrayed out of moneys provided by Parliament.

Textual Amendments

F73Words in s. 236(1) substituted (27.3.2012 for specified purposes, 1.4.2013 in so far as not already in force) by Health and Social Care Act 2012 (c. 7), s. 306(1)(d)(4), Sch. 4 para. 123(2); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F74Word in s. 236(2)(b) inserted (27.3.2012 for specified purposes, 1.4.2013 in so far as not already in force) by Health and Social Care Act 2012 (c. 7), s. 306(1)(d)(4), Sch. 4 para. 123(3)(a); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F75Words in s. 236(2)(b) omitted (27.3.2012 for specified purposes, 1.4.2013 in so far as not already in force) by virtue of Health and Social Care Act 2012 (c. 7), s. 306(1)(d)(4), Sch. 4 para. 123(3)(b); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F76Word in s. 236(2)(b) inserted (27.3.2012 for specified purposes, 1.4.2013 in so far as not already in force) by Health and Social Care Act 2012 (c. 7), s. 306(1)(d)(4), Sch. 4 para. 123(3)(c); S.I. 2013/160, art. 2(2) (with arts. 7-9)

F77S. 236(2)(b)(ii)(iii) and word inserted (27.3.2012 for specified purposes, 1.4.2013 in so far as not already in force) by Health and Social Care Act 2012 (c. 7), s. 306(1)(d)(4), Sch. 4 para. 123(3)(d); S.I. 2013/160, art. 2(2) (with arts. 7-9)