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Health and Social Care Act 2008

Reviews and investigations

Section 49: Power to extend periodic review function

201.Whereas section 46 provides for periodic reviews of publicly funded health and social care, this section enables the Secretary of State to make regulations requiring the Commission to carry out periodic reviews of the carrying on of regulated activities by any registered service provider. The regulations can also require the Commission to publish reports of its reviews or assess the performance of registered service providers following such reviews and publish reports of its assessment.

202.Section 49 also allows for a greater degree of specificity about what is covered by the review. Regulations under this section can require the Commission to carry out periodic reviews of some or all registered service providers, in respect of some or all of the regulated activities they provide, or even in respect of particular aspects of a regulated activity. Direct overlap with section 46 is prevented by subsection (3) but this subsection still permits a particular aspect of the carrying on of a regulated activity by a PCT, other English NHS provider or English local authority to be reviewed separately, despite the fact that it may already have formed part of a broader review under section 46.

203.This will allow the Commission to look at certain types of services. For instance, it is the Government’s intention to use this power to require the Commission to review and assess all residential premises providing adult social care, whether run privately or by a local authority, as the CSCI has done through its “Quality Ratings” scheme. Similarly, regulations could require that all maternity services should be reviewed by the Commission. This will be possible even if these services have already been covered under the review of health care provision in a PCT area under section 46(1).

204.In other cases, the Secretary of State may want the Commission to publish information on a particular aspect of a service. For instance, many NHS Trusts sub-contract with private hospitals to provide additional capacity for routine surgery such as hip operations. Although these services would be covered by reviews by the Commission (under section 46) of the overall provision of health care by a Trust, the Secretary of State may want the Commission separately to review the quality of provision under such arrangements. The Secretary of State may also prefer the Commission to carry out periodic reviews of such care, rather than a one-off review under section 48, because they will demonstrate how performance changes over time. Although it may not be useful to aggregate performance across a small number of indicators into results for each provider of hip operations, the Commission could still be required to publish details of the review.

205.Where regulations are made extending periodic reviews, the Commission must publish details of how often these reviews will be conducted, as with periodic reviews under section 46. These reviews will also be by reference to a set of indicators devised or approved by the Secretary of State.

206.As with periodic reviews under section 46, the Commission must devise a methodology for assessing and evaluating bodies against relevant indicators, and this methodology must be approved by the Secretary of State. It must publish its methodology, as well as the indicators used for reviews, whether they are set by the Secretary of State, or set by the Commission and approved by the Secretary of State.

207.Regulations may set out the procedure that should apply to allow people to make representations to the Commission before a report is published. The reason for setting out this procedure is to ensure that the reviewed body is given time to comment, and that any comments are considered by the Commission

208.It is intended that, where possible and appropriate, the same information will be used to inform a review under this section as is used in other reviews of health or adult social care provision that the Commission carries out. This will help avoid duplication in the information requests that providers and commissioners receive.

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