National Health Service Act 2006 (c. 41)

(The document as of February, 2008)

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

(3) Subject to any directions of the Secretary of State excluding specified descriptions of activity, the activities authorised by this section include--

(a) public appeals or collections,

(b) competitions,

(d) bazaars,

(e) sales of produce or other goods, and

(f) other similar activities.

(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 section 224 or 226, 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.

Chapter 5 Formation of companies

223 Public-private partnerships

(1) The Secretary of State 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 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 within the meaning of the Companies Act 1985 (c. 6).

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

Chapter 6 Finance

Strategic Health Authorities and Special Health Authorities

224 Means of meeting expenditure of Strategic Health Authorities out of public funds

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

(2) Where the Secretary of State has made an initial determination of the amount ("the initial amount") to be allotted for any year to a Strategic Health Authority under subsection (1), he may increase the initial amount by a further sum if it appears to him that over a period notified to the Strategic Health Authority--

(a) it satisfied any objectives notified to it as objectives to be met in performing its functions, or

(b) it performed well against any criteria notified to it as criteria relevant to the satisfactory performance of its functions (whether or not the method of measuring its performance against those criteria was also notified to it).

(3) "Notified" means specified or referred to in a notice given to the Strategic Health Authority by the Secretary of State.

(4) In making any increase under subsection (2), the Secretary of State may (whether by directions under subsection (9) or otherwise) impose any conditions he considers appropriate on the application or retention by the Strategic Health Authority of the sum in question.

(5) Subsection (6) applies where--

(a) the Secretary of State has, under subsection (2), increased by any sum the amount to be allotted for any year to a Strategic Health Authority,

(b) the Secretary of State has notified the Strategic Health Authority of the allotment, and

(c) it subsequently appears to the Secretary of State that the Strategic Health Authority has failed (wholly or in part) to satisfy any conditions imposed in making that increase.

(6) Where this subsection applies, the Secretary of State may reduce--

(a) the allotment made to that Strategic Health Authority for that year, or

(b) when he has made an initial determination of the amount ("the initial amount") to be allotted for any subsequent year to the Strategic Health Authority under subsection (1), the initial amount,

by an amount not exceeding the sum mentioned in subsection (5)(a).

(7) An amount is allotted to a Strategic 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.

(8) The Secretary of State may, subject to subsection (6), make an allotment under this section increasing or reducing an allotment previously so made; and the reference to a determination in subsection (2) includes a determination made with a view to increasing or reducing an allotment previously so made.

(9) The Secretary of State may give directions to a Strategic 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.

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

225 Means of meeting expenditure of Special Health Authorities out of public funds

(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.

226 Financial duties of Strategic Health Authorities and Special Health Authorities

(1) Each Strategic 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 224(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.

(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 Strategic Health Authority or Special Health Authority as appear to be requisite to secure that the Authority complies with the duty under subsection (1) or (2).

(4) To the extent to which--

(a) any expenditure is defrayed by a Strategic Health Authority or Special Health Authority as trustee or on behalf of a Strategic Health Authority or Special Health Authority by special trustees, or

(b) any sums are received by a Strategic Health Authority or 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 Strategic Health Authority or 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 Strategic Health Authority or 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 specified Strategic Health Authority or specified Special Health Authority,

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

(i) expenditure within subsection (1) of a specified Strategic Health Authority, or

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

(i) by a Strategic Health Authority under section 224, or

(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 Strategic Health Authority or Special Health Authority and to which financial year's expenditure they must be attributed.

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

227 Resource limits for Strategic Health Authorities and Special Health Authorities

(1) Each Strategic Health Authority and each 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 Strategic Health Authority or Special Health Authority certain uses of resources must be attributed,

(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 subsections (1) and (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.

Primary Care Trusts

228 Public funding of Primary Care Trusts

(1) The Secretary of State must, in respect of each financial year, pay to each Primary Care Trust--

(a) sums equal to its pharmaceutical services expenditure, and

(b) sums not exceeding the amount allotted by the Secretary of State to the Primary Care Trust for that year towards meeting the Primary Care Trust's main expenditure in that year.

(2) In determining the amount to be allotted for any year to a Primary Care Trust under subsection (1)(b) (or in varying the amount under subsection (9)), the Secretary of State may take into account, in whatever way he considers appropriate--

(a) the Primary Care Trust's pharmaceutical services expenditure, and

(b) expenditure which would have been the Primary Care Trust's pharmaceutical services expenditure but for an order under section 234(2) (special arrangements as to payment of remuneration),

during any period he considers appropriate (or such elements of that expenditure as he considers appropriate).

(3) Where the Secretary of State has made an initial determination of the amount ("the initial amount") to be allotted for any year to a Primary Care Trust under subsection (1)(b), he may increase the initial amount by a further sum if it appears to him that over a period notified to the Primary Care Trust--

(a) it satisfied any objectives notified to it as objectives to be met in performing its functions, or

(4) "Notified" means specified or referred to in a notice given to the Primary Care Trust by the Secretary of State.

(5) In making any increase under subsection (3), the Secretary of State may (whether by directions under subsection (10) or otherwise) impose any conditions he considers appropriate on the application or retention by the Primary Care Trust of the sum in question.

(6) Subsection (7) applies where--

(a) the Secretary of State has, under subsection (3), increased by any sum the amount to be allotted for any year to a Primary Care Trust,

(b) the Secretary of State has notified the Primary Care Trust of the allotment, and

(c) it subsequently appears to the Secretary of State that the Primary Care Trust has failed (wholly or in part) to satisfy any conditions imposed in making that increase.

(7) Where this subsection applies, the Secretary of State may reduce--

(a) the allotment made to the Primary Care Trust for that year, or

(b) when he has made an initial determination of the amount ("the initial amount") to be allotted for any subsequent year to the Primary Care Trust under subsection (1)(b), the initial amount,

by an amount not exceeding the sum mentioned in subsection (6)(a).

(8) An amount is allotted to a Primary Care Trust for a year under this section when the Primary Care Trust is notified by the Secretary of State that the amount is allotted to it for that year.

(9) The Secretary of State may make an allotment under this section increasing or reducing (subject to subsection (7)) an allotment previously so made; and the reference to a determination in subsection (3) includes a determination made with a view to increasing or reducing an allotment previously so made.

(10) The Secretary of State may give directions to a Primary Care Trust 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.

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

(12) "Pharmaceutical services expenditure" and "main expenditure" are defined in Schedule 14.

229 Financial duties of Primary Care Trusts

(1) Each Primary Care Trust 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 (not including its pharmaceutical services expenditure) does not exceed the aggregate of--

(a) the amount allotted to it for that year under section 228(1)(b),

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

(2) The Secretary of State may give such directions to a Primary Care Trust as appear to be requisite to secure that it complies with the duty under subsection (1).

(3) To the extent to which--

(a) any expenditure is defrayed by a Primary Care Trust as trustee or on behalf of a Primary Care Trust by special trustees, or

(b) any sums are received by a Primary Care Trust as trustee or under section 222,

that expenditure and, subject to subsection (5) those sums, must be disregarded for the purposes of this section.

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

(5) Of the sums received by a Primary Care Trust under section 222 so much only as accrues to the Primary Care Trust after defraying any expenses incurred in obtaining them must be disregarded under subsection (3).

(6) Subject to subsection (3), 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 specified Primary Care Trust,

(b) whether specified expenditure must, or must not, be treated for those purposes as expenditure within subsection (1) of a specified Primary Care Trust, or

(c) the extent to which, and the circumstances in which, sums received by a Primary Care Trust under section 228 but not yet spent must be treated for the purposes of this section as part of the expenditure of the Primary Care Trust and to which financial year's expenditure they must be attributed.

(7) "Specified" means of a description specified in the directions.

230 Resource limits for Primary Care Trusts

(1) Each Primary Care Trust 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) no account may be taken of any use of resources for the purpose of a Primary Care Trust's pharmaceutical services expenditure.

(3) But in specifying an amount for a Primary Care Trust under subsection (1) (or in varying the amount under subsection (5)), the Secretary of State may take into account (in whatever way he considers appropriate)--

(a) any such use of resources, and

(b) the use of any resources which would have been for the purpose of the Primary Care Trust's pharmaceutical services expenditure but for an order under section 234(2) (special arrangements as to payment of remuneration),

during any period he considers appropriate (or such elements of such uses of resources as he considers appropriate).

(4) 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 Primary Care Trust certain uses of resources must be attributed,

(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) Subsections (3) to (5) of section 229 apply in relation to the duty under subsection (1) of this section as they apply in relation to the duty under subsection (1) 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.

(7) The Secretary of State may give such directions to a Primary Care Trust as appear to be requisite to secure that it complies with the duty under subsection (1).

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

231 Further provision about the expenditure of Primary Care Trusts

Schedule 14 makes further provision about the expenditure of Primary Care Trusts.

Accounts and audit

232 Accounts and audit

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

Allowances and remuneration

233 Allowances for members of certain bodies

(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.

234 Special arrangement as to payment of remuneration

(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 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.

(4) If the Secretary of State by order so provides with respect to remuneration in respect of such pharmaceutical services or such local pharmaceutical services as may be specified in the order--

(a) an NHS trust or an NHS foundation trust determined in accordance with the order has the function of paying sums so determined to a Primary Care Trust so determined in respect of the whole or any part of that remuneration, and

(b) subsection (3) does not apply with respect to the whole or that part of the remuneration.

235 Superannuation of officers of certain hospitals

(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.

236 Payments for certain medical examinations

(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) the Secretary of State 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 as part of his duty as an officer of a Primary Care Trust, NHS trust, Special Health Authority, NHS foundation trust or Local Health Board.

(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.

Part 12 Public involvement and scrutiny

Chapter 1 Patients' Forums

237 Establishment of Patients' Forums

(1) The Patients' Forums established by the Secretary of State continue in existence, and he must establish a Patients' Forum--

(a) for each NHS trust all or most of whose hospitals, establishments and facilities are situated in England,

(b) for each Primary Care Trust, and

(2) The members of each Patients' Forum must be appointed by the Commission for Patient and Public Involvement in Health.

(3) A Patients' Forum must--

(a) monitor and review the range and operation of services provided by, or under arrangements made by, the trust for which it is established,

(b) obtain the views of patients and their carers about those matters and report on those views to the trust,

(c) provide advice, and make reports and recommendations, about matters relating to the range and operation of those services to the trust,

(d) make available to patients and their carers advice and information about those services,

(e) in prescribed circumstances, perform any prescribed function of the trust with respect to the provision of a service affording assistance to patients and their families and carers,

(f) carry out such other functions as may be prescribed.

(4) In providing advice or making recommendations under subsection (3)(c), a Patients' Forum must have regard to the views of patients and their carers.

(5) If, in the course of exercising its functions, a Patients' Forum becomes aware of any matter which in its view--

(a) should be considered by a relevant overview and scrutiny committee, or

(b) should be brought to the attention of the Commission for Patient and Public Involvement in Health,

the Forum may refer that matter to the committee, or to the Commission.

(6) Subsection (5) does not affect the power of a Patients' Forum to make such other representations or referrals as it considers appropriate, to such persons or bodies as it considers appropriate, about matters arising in the course of it exercising its functions.

(7) Patients' Forums must in prescribed circumstances--

(a) co-operate with each other in the exercise of their functions,

(b) exercise functions jointly with one or more other Forums.

(8) References in subsection (3) to services are references to--

(a) services provided as part of the health service in England,

(b) services provided in England in pursuance of section 75 arrangements in relation to the exercise of health-related functions of a local authority, and

(c) services provided elsewhere (and not as part of the health service in England) in pursuance of section 75 arrangements with a local authority in England.

(9) In this section--

"carer", in relation to a patient, means a person who provides care for the patient, but who is not employed to do so by any body in the exercise of its functions under any enactment,
"patient" includes a person who receives services provided in pursuance of section 75 arrangements in relation to the exercise of health-related functions of a local authority,
"relevant overview and scrutiny committee", in relation to a Patients' Forum, means any overview and scrutiny committee in relation to which the Primary Care Trust, NHS trust or NHS foundation trust for which the Forum is established is a local NHS body by virtue of regulations made under section 244(3) (including that provision as read with section 245(5) and as applied by section 247(2)),
"section 75 arrangements" means arrangements under regulations under section 75.

238 Additional functions of PCT Patients' Forums

(1) A Patients' Forum established for a Primary Care Trust (a "PCT Patients' Forum") has the following additional functions--

(a) providing independent advocacy services to persons in the Primary Care Trust's area or persons to whom services have been provided by, or under arrangements with, the Primary Care Trust,

(b) making available to patients and their carers advice and information about the making of complaints in relation to services provided by or under arrangements with the Primary Care Trust, and

(c) representing to persons and bodies which exercise functions in relation to the area of the Primary Care Trust (including, in particular, any relevant overview and scrutiny committee) the views of members of the public in the Primary Care Trust's area about matters affecting their health.

(2) In subsection (1), references to services have the meaning given by section 237(8).

(3) It is also the function of a PCT Patients' Forum--

(a) to promote the involvement of members of the public in the area of the Primary Care Trust in consultations or processes leading (or potentially leading) to decisions by those mentioned in subsection (4), or the formulation of policies by them, which would or might affect (whether directly or not) the health of those members of the public,

(b) to make available advice and information to such members of the public about such involvement,

(c) to advise those mentioned in subsection (4) about how to encourage such involvement (including, in the case of bodies mentioned in subsection (4) to which section 242 applies, advising them how to comply with the requirements of that section in relation to the area of the Primary Care Trust), and

(d) to monitor how successful those mentioned in subsection (4) are at achieving such involvement.

(4) Those referred to in subsection (3) are--

(a) Strategic Health Authorities whose areas include any part of the area of the Primary Care Trust,

(b) the Primary Care Trust itself,

(d) other public bodies, and

(e) others providing services to the public or a section of the public.

(5) In this section--

"carer" and "patient" have the meaning given by section 237,
"independent advocacy services" means services provided under section 248,
"relevant overview and scrutiny committee" has the meaning given by section 237.

239 Entry and inspection of premises

(1) The Secretary of State may make regulations requiring--

(a) Strategic Health Authorities,

(b) Primary Care Trusts,

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