The Health and Social Care Act 2012 is an important piece of health sector legislation in the United Kingdom.
This E RADAR boardroom briefing explains the new legal framework and opportunities for organisations already working in primary care, including service users and suppliers.
The Health and Social Care Act aims to safeguard the future of the National Health Service (NHS) by enabling the organisation to change to meet the challenges it faces.
The Act puts Clinical Commissioning Groups (CCGs) at the centre of commissioning NHS services locally, frees up providers to innovate, empowers patients and gives a new focus to public health.
The overall approach was originally designed to direct funds straight from the Department of Health into GP practices and Primary Care. However, many critics raised concerns over local practices handling the £80 billion spend. The new Act therefore introduced CCGs to help manage this process better.
Government remains committed to the NHS’s founding principles. However, there is a broad consensus that standing still will not protect the NHS. Modernisation is therefore essential for three main reasons:
1. Rising demand and treatment costs
The pressures on the NHS are increasing, in keeping with health systems across the world. Demand is growing rapidly as the population ages and long-term conditions become more common; more sophisticated and expensive treatment options are becoming available. The cost of medicines is growing by over £600 m per year.
2. Need for improvement
At its best, the NHS is world-leading, but there are important areas where the NHS falls behind those of other major European countries. If the UK had cancer survival rates at the average in Europe, the country would save 5,000 lives a year.
3. State of the public finances
Whilst the Government has protected the NHS budget, this is still among the tightest funding settlements the NHS has ever faced. Simply doing the same things in the same way will no longer be affordable in future.
Key legislative changes
The provisions in the Health and Social Care Act 2012 are designed to meet these challenges, by making the NHS more responsive, efficient and accountable.They draw on the evidence and experience of 20 years of NHS reform.
Clinically led commissioning (Part 1)
The Health and Social Care Act 2012 puts clinicians in charge of shaping services, enabling NHS funding to be spent more effectively. Previously clinicians in many areas were frustrated by negotiating with primary care trusts to get the right services for their patients. Supported by the NHS Commissioning Board, new clinical commissioning groups will now directly commission services for their populations.
Provider regulation to support innovative services (Parts 3 and 4)
The Health and Social Care Act 2012 enshrines a fair-playing field in legislation for the first time. This will enable patients to be able to choose services which best meet their needs, including from charity or independent sector providers, as long as they meet NHS costs. Providers, including NHS foundation trusts, will be free to innovate to deliver quality services. Monitor will be established as a specialist regulator to protect patients' interests.
Greater voice for patients (Part 5)
The Health and Social Care Act 2012 establishes new Healthwatch patient organisations locally and nationally to drive patient involvement across the NHS.
New focus for public health (Parts 1 and 2)
The Health and Social Care Act 2012 provides the underpinnings for Public Health England, a new body to drive improvements in the public’s health.
Greater accountability locally and nationally (Parts 1 and 5)
The Health and Social Care Act 2012 sets out clear roles and responsibilities, whilst keeping Ministers’ ultimate responsibility for the NHS. It limits political micromanagement and gives local authorities a new role to join up local services.
Streamlined arms-length bodies (Parts 7-10)
The Health and Social Care Act 2012 removes unnecessary tiers of management, releasing resources to the frontline. It also places the National Institute for Healthcare Excellence NICE and the Information Centre in primary legislation
An information standard is defined in the Health and Social Care Act 2012 as: 'a document containing standards that relate to the processing of information'.
Using information standards means that data can be understood across the sector, and used for planning and monitoring as well as for good patient care. The Standardisation Committee for Care Information (SCCI) assures the quality of information standards. Visit the full list of current information standards and collections.
Supervision and enforcement