Health and Care Bill 2021
On 6 July 2021 the Health and Care Bill was introduced to parliament, which builds on the proposals for legislative change set out in NHSEI’s Long Term Plan. The Bill streamlines and updates the legal framework for health and care to allow the system to be less bureaucratic and more integrated. An Integrated Care Board and an Integrated Care Partnership will be established in each area of England which will be responsible for bringing together local NHS organisations, local government, and public health, to deliver joined up care for its local population. The legislation will allow NHS England to arrange for its functions to be delegated or jointly delivered with ICS Bodies.
Health and Care Bill: Health Services Safety Investigations Body - establish the Health Services Safety Investigations Body (HSSIB) as an independent statutory body with the function of investigating incidents that occur in England during the provision of health care services which have, or may have, implications for the safety of patients.
Health and Care Bill: information - includes provision of data collection under a direction from the Secretary of State to NHS Digital to collect private healthcare data.
Roles and responsibilities at a National level
Ministers and the Department
The Secretary of State (SoS) will remain ultimately accountable for the NHS in England. However, instead of directly managing service providers and commissioners, the Secretary of State will set priorities for the NHS through a mandate for the NHS England.
Public Health England is the national body overseeing the public health system and will be accountable to the Secretary of State.
NHS England was formed by the Health and Social Care Act. NHS England provides the top-level commissioning and managerial guidance for the NHS in England, and will be responsible for authorising and overseeing Integrated Care Services (ICSs)), who in turn will be responsible for commissioning local health services. NHS England is responsible for allocating resources and commissioning certain services such as primary care services and specialised services (Dermatology specialised services) which have their own budgets.
NHS Trust Development Authority (NDTA)
The NTDA was established as a special health authority in April 2013. It holds responsibility for the performance management of NHS trusts and supports them in their bid to become foundation trusts, the assurance of clinical quality, governance and risk in NHS trusts.
Care Quality Commission (CQC)
CQC will continue to inspect your service against essential standards of safety and quality. It will carry out inspections in response to information that it receives about a provider, which will come through ICSs and local HealthWatch and HealthWatch England as well as through existing channels, such as patient and service user feedback and complaints. Patients will be able to access more information about how dermatology services are performing, which will help them to choose the treatment that they need from a range of different providers (including from charity or independent sector providers, social enterprises). It will maintain its inspectorate role of all care services.
National Institute for Health and Care Excellence (NICE)
NICE will continue to provide independent advice and guidance to the NHS, and will maintain its role of assessing the clinical and financial viability of treatment and services but will extend its role to include social care.
NHS Digital is the central point for data and information collected from the NHS and social care organisations in England.
Roles and responsibilities at a local level:
Local authorities are responsible for improving the health of their local populations by pulling together all of the work done by the NHS, social care, housing, environmental health, leisure and transport services. Local authorities are required to appoint a Director of Public Health and publish annual reports to chart local progress in health improvement. It is therefore important that you forge relationships with them to influence how your local dermatology services are developed.
Integrated Care Services (Formerly Clinical Commissioning groups (CCGs))
Integrated care is about giving people the support they need, joined up across local councils, the NHS, and other partners. It removes traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services. In the past, these divisions have meant that too many people experienced disjointed care.
Integrated care systems (ICSs) are new partnerships between the organisations that meet health and care needs across an area, to coordinate services and to plan in a way that improves population health and reduces inequalities between different groups.
You will therefore need to familiarise themselves with who your local ICSs are, in order to build effective professional working relationships.
Health and Wellbeing Boards (Part of local authorities)
Health and Wellbeing Boards have a duty to encourage integrated commissioning between health, social care and public health by bring together representatives from each of these areas. They provide a forum across these groups to discuss the future shape of services, building on their assessments of local health and care needs. Their tasks include developing joint health and wellbeing strategies to inform local commissioning plans. Representation on these Boards include: one local elected representative, a representative of both the CCG and the Local Healthwatch, a local authority director for adult social services and children’s services and a director of public health. These representatives are able to influence and challenge commissioning decisions and promote integrated health and care. These boards report to the local authority’s Health Overview and Scrutiny Committee.
Healthwatch are the independent national champion for people who use health and social care services. Local Healthwatch acts as a point of contact for individuals, community groups and voluntary organisations dealing with health and social care services. Along with the Health and Wellbeing Boards, Healthwatch England and Local Healthwatch will give patients a stronger voice by making patient involvement an integral part of the commissioning process. The BAD has developed some guidance about how dermatology departments can proactively involve and engage with their patients.
National Quality Board
The National Quality Board (NQB) was formed in 2009 to champion the quality agenda, secure system alignment and drive quality improvement across the health care, social care and public health system. The NQB’s current core priorities include supporting system transformation and the integration of care and outcomes, understanding and addressing unwarranted variation and inequalities, and supporting learning and recovery from the COVID-19 pandemic.
Quality Surveillance Group
Quality Surveillance Groups (QSGs) bring together different parts of the health and care system, to share intelligence about risks to quality.
The health and care system has evolved significantly during the three years since the QSG model was last reviewed. Relationships between organisations have matured and developed. The National Quality Board (NQB) has therefore undertaken a further review of the QSG model, to understand how QSGs are operating across the country, to refresh their purpose and identify where they could be supported to be more effective.