The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012

Regulation 4

SCHEDULE 1 Additional persons for whom a CCG has responsibility

1.  In this Schedule—

“care home” and “children’s home” have the same meaning as in the Care Standards Act 2000(1);

“child” means a person under the age of 18;

“continuing care” means care provided over an extended period of time to a person to meet physical or mental health needs which have arisen as the result of illness;

“independent hospital” means a hospital as defined in section 275(1) of the 2006 Act (interpretation), that is not a health service hospital as defined there;

“local authority” means a county council, a district council for an area for which there is no county council, a London borough council, the Common Council of the City of London, or the Council of the Isles of Scilly;

“planned service” means any service whose provision is planned and arranged by a CCG as part of the health service in response to the results of an assessment of a person’s physical or mental health needs and which is intended to bring about or promote a specific outcome in relation to those needs.

2.  The list of persons referred to in regulation 4(1) is as follows—

(a) every person present in the CCG’s area, in relation to the provision of ambulance services or accident and emergency services, whether provided at a hospital accident and emergency department, a minor injuries unit, a walk-in centre or elsewhere (but excluding any services provided after the person has been accepted as an in-patient, or at an out-patient appointment);

(b) every person aged 18 or over who falls within paragraph 3, in relation to the provision of the accommodation or services referred to in paragraph 3(b);

(c) every child who falls within paragraph 4;

(d) every person who falls within paragraph 5 in relation to the provision of the accommodation or services referred to in paragraph 5(b);

(e) every person who falls within paragraph 6 in relation to the provision of the accommodation or services referred to in paragraph 6(b);

(f) every child who falls within paragraph 7 in relation to the provision of the accommodation or services referred to in paragraph 7(b);

(g) every child who falls within paragraph 8;

(h) every person present in the CCG’s area who is resident outside the United Kingdom and not provided with primary medical services by a member of any CCG;

(i) every person resident in Scotland, Wales or Northern Ireland and present in the CCG’s area who is a qualifying patient within the meaning of section 130C of the 1983 Act(2)(section 130A:supplemental), and not provided with primary medical services by a member of any CCG;

(j) every person who is a qualifying patient within the meaning of section 130C of the 1983 Act and liable to be detained under that Act in a hospital or registered establishment (within the meaning of that Act) in the CCG’s area.

3.  A person falls within this paragraph if—

(a) the CCG has made an arrangement in the exercise of its commissioning functions (by itself or jointly with a local authority) by virtue of which the person is to be provided with services to meet his or her continuing care needs,

(b) those services consist of or include the provision of the following accommodation and services to meet the person’s continuing care needs—

(i) accommodation in a care home or independent hospital situated in the area of another CCG, and

(ii) at least one planned service (other than a service consisting only of NHS-funded nursing care) which is connected to the provision of such accommodation (whether or not the accommodation is arranged by the CCG referred to in sub-paragraph (a)),

(c) the person is resident in that accommodation and continues to need that planned service (or those planned services), and

(d) the person would not be a person for whom the CCG is responsible under section 3(1A)(a) of the 2006 Act.

4.—(1) A child falls within this paragraph if both of sub-paragraphs (2) and (3) apply to the child.

(2) This sub-paragraph applies to a child if any of the following is the case—

(a) the child is looked after by a local authority within the meaning of section 22 of the Children Act 1989(3) (general duty of local authority in relation to children looked after by them), other than by way of being accommodated in a secure children’s home in respect of which the National Health Service Commissioning Board(4) must arrange for the provision of services to children detained there(5);

(b) the child is a relevant child within the meaning of section 23A of that Act(6)(the responsible authority and relevant children);

(c) the child is a person to whom section 24(1A) or (1B) of that Act(7)(persons qualifying for advice and assistance) applies;

(d) the child is provided with accommodation at a school to which he or she is admitted in accordance with a statement of special educational needs made under section 324 of the Education Act 1996(8)(statement of special educational needs); or

(e) the child requires accommodation in a care home, a children’s home or an independent hospital to meet the child’s continuing care needs.

(3) This sub-paragraph applies to a child if—

(a) the child is provided with—

(i) services which consist of or include the provision of accommodation situated in the area of another CCG or of a Local Health Board, under arrangements made by the CCG in the exercise of its commissioning functions (by itself or jointly with a local authority), or

(ii) such services under arrangements made by the local authority and immediately before those arrangements were made the CCG was responsible for the child under section 3(1A) of the 2006 Act; and

(b) the child is both—

(i) resident in that accommodation, and

(ii) would not be a person for whom the CCG is responsible under section 3(1A)(a) of the 2006 Act.

5.  A person falls within this paragraph if—

(a) the CCG has made an arrangement in the exercise of its commissioning functions (by itself or jointly with a local authority) by virtue of which immediately before attaining 18 the person was provided with services to meet his or her continuing care needs;

(b) those services consist of or include the provision of the following accommodation and services to meet the person’s continuing care needs—

(i) accommodation in a care home, a children’s home or an independent hospital situated in the area of another CCG, and

(ii) nursing and another service which is a planned service, as part of the health service to meet his or her continuing care needs;

(c) the person is resident in that accommodation and continues to need that planned service (or those planned services), and

(d) the person would not be a person for whom the CCG is responsible under section 3(1A)(a) of the 2006 Act.

6.  A person falls within this paragraph if—

(a) a Primary Care Trust has made an arrangement before the relevant date in the exercise of its functions by virtue of regulation 3 of the National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements)(England) Regulations 2002(9) by virtue of which the person was provided with services to meet his or her continuing care needs;

(b) the rights and liabilities under that arrangement are transferred to the CCG by virtue of a scheme made under section 300 of the 2012 Act (transfer schemes);

(c) the person continues to need the provision of the following accommodation and services to meet the person’s continuing care needs—

(i) accommodation in a care home or independent hospital situated in the area of another CCG, and

(ii) at least one planned service (other than a service consisting only of NHS-funded nursing care) which is connected to the provision of such accommodation (whether or not the accommodation is arranged by the CCG); and

(d) the person would not be a person for whom the CCG is responsible under section 3(1A)(a) of the 2006 Act.

7.  A child falls within this paragraph if—

(a) a Primary Care Trust has made an arrangement on or before 31st March 2013 in the exercise of its functions by virtue of regulation 3 of the National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements) (England) Regulations 2002 by virtue of which the child was provided with services to meet his or her continuing care needs;

(b) the rights and liabilities under that arrangement are transferred to the CCG by virtue of a scheme made under section 300 of the 2012 Act;

(c) the child continues to need services consisting of or including the provision of accommodation in a care home, a children’s home or an independent hospital situated in the area of another CCG and nursing and another service which is a planned service as part of the health service to meet his or her continuing care needs; and

(d) the child would not be a person for whom the CCG is responsible under section 3(1A)(a) of the 2006 Act.

8.—(1) A child falls within this paragraph if—

(a) a local authority has made an arrangement before the relevant date by virtue of which the child is provided with accommodation at a school in the area of another CCG or a Local Health Board, to which the child is admitted in accordance with a statement of special educational needs made under section 324 of the Education Act 1996;

(b) immediately before the child was accommodated at that school the child was either—

(i) provided with primary medical services by a person who is now a member of the CCG; or

(ii) usually resident in the area of the CCG and not provided with primary medical services by a person who is now a member of the CCG; and

(c) the child would not be a person for whom the CCG is responsible under section 3(1A)(a) of the 2006 Act.

(1)

2000 c. 14.

(2)

Section 130C was inserted by section 30 of the Mental Health Act 2007 (c. 12). It has been amended, in relation to Wales, by Schedule 1 to the Mental Health (Wales) Measure 2010 (nawm 7).

(3)

1989 c. 41.

(4)

The National Health Service Commissioning Board is established by section 1H of the 2006 Act as inserted by section 9(1) of the 2012 Act.

(5)

See regulation 10 of these Regulations (services to be provided by the Board for prisoners and other detainees).

(6)

Section 23A was inserted into the Children Act 1989 by section 2(1) and (4) of the Children (Leaving Care) Act 2000 (c.35).

(7)

Section 24(1A) and (1B) were inserted into the Children Act 1989 by section 139(1) of, and paragraphs 54, 60(a) and 60(b) of Schedule 3 to the Adoption and Children Act 2002 ( c.38).

(8)

1996 c. 56. Section 324 was amended by section 140(1) of, and paragraph 77(b) of Schedule 30 to, the School Standards and Framework Act 1998 (c. 31) and section 9 of the Special Educational Needs and Disability Act 2001 (c. 10).

(9)

S.I. 2002/2375 relevant amending instruments S.I. 2006/359 and S.I. 2010/2649.