Key Facts

• Amendment 12 and 13 clarify the duties of integrated care boards regarding medical and ophthalmic services.
• These amendments replicate the existing language used for clinical commissioning groups.
• The amendments address concerns about changes in policy but assure that no such changes are intended.
• Clause 15 substitutes a new section 3 into the National Health Service Act 2006.
• The clause requires ICBs to commission hospital and other health services for those persons for whom they are responsible.
• It includes duties such as arranging hospital accommodation, nursing, ambulance services, dental services, diagnosis, care, treatment, aftercare of people suffering illness, injury or disability.
• Clause 16 gives effect to schedule 3, allowing ICBs to take over responsibility for primary medical services.
• Schedule 3 includes provisions for the transfer of primary medical, dental, and ophthalmic service responsibilities from NHS England to ICBs.
• The amendments would prevent ICBs from entering into or renewing contracts with private and third-sector organizations for primary medical services.
• Around 70% of GP services are provided on the general medical services contracting model.
• A little more than a quarter of services are on the personal medical services terms.
• A small but growing number of APMS contracts allow bespoke contracting with private companies.
• The largest provider of GP services in England is wholly owned by a US megacorporation and has 500,000 patients.
• The mean payment to an APMS provider is 11% greater than that to a GMS provider.
• If the model grows to be dominant, it would cost £1.5 billion across the country.
• The minister reassures Karin Smyth about the direction of APMS model.
• Flexibility in primary care provision is crucial for dealing with challenges such as practice closures and ensuring continuity of service.
• NHS England will assess which ICBs are sufficiently developed to take on additional commissioning responsibilities.
• Clause 18 amends section 12ZA of the NHS Act 2006.
• The amendment allows for more flexible commissioning arrangements between commissioners and providers.
• It aims to improve patient care through tailored service provision.
• Government providing £2 billion for elective recovery funding.
• Amendment would require ICBs to ensure patients access services within maximum waiting times, according to rights established in the NHS constitution.
• The NHS constitution includes both statutory and non-statutory waiting time standards.
• Established by NHS England in 2013, there are 15 Academic Health Science Networks (AHSNs) covering distinct geographic regions.
• Each AHSN is responsible for improving health and generating economic growth within its specific population region.
• AHSNs act as catalysts to bring together people, resources, and organisations quickly to facilitate change in health and social care.
• The amendment relates to the role of ICBs and ICPs in innovation.
• Edward Argar acknowledges the importance of vaccine development as an example of effective collaboration.
• AHSN is described as a non-statutory entity, though valuable.
• Other bodies relevant for research include NIHR, UK Research and Innovation, and various research charities.
• The total number of NHS medical consultants and GPs has risen by 40% over the past 15 years.
• Clinical academic numbers have decreased from 7.5% to 4.2% of the workforce, with only 0.4% being clinical academic GPs.
• Less than 0.1% of nursing, midwifery and allied health professions staff are clinical academics.
• In England, 36% of healthcare academic staff are over the age of 50, and 9% are over the age of 60.
• The amendments aim to send a signal that research should be central to the mission of integrated care boards.
• Amendment 8 seeks to foster a culture where investment in developing people's skills is prioritised.
• The UK life sciences sector is world-leading, evidenced by its role during the pandemic.
• Amendments 7 and 8 relate to ICBs' duties regarding education, training, and research.
• The Government believes ICBs should work closely with higher education institutions but does not see a need for mandated details in the statute.
• HEE works closely with educational providers nationally through regional boards.
• The Domestic Abuse Commissioner has the power to obtain information from public bodies.
• Integrated Care Boards are within scope of the commissioner's powers under the Act.
• The Health and Social Care system plays a crucial role in preventing and tackling domestic abuse.
• The clause inserts new sections into the NHS Act 2006 related to ICBs.
• Proposed sections detail duties such as acting in line with the NHS constitution, improving service quality, reducing inequalities, involving patients and carers, promoting innovation, research, education, and integration of health and social care services.
• The triple aim duty requires ICBs to consider the impact on people's health, service quality, and sustainable use of resources when making decisions.
• The Health and Care Bill sets out 12 duties for ICBs.
• In 2018-19, the National Institute for Health Research clinical research network produced £2.7 billion in gross value added through clinical research activities.
• For every patient recruited on to a commercial trial between 2016 and 2018, the NHS in England received more than £9,000.
• Clause 19 sets down the prescribed functions of an integrated care board that can be exercised jointly with the local health board in Wales.
• The private sector has a lesser role in providing health and social care services in Wales compared to England.
• In 2019, 13,500 people from Wales accessed GP services in England while 21,000 people from England accessed GP services in Wales.
• The ICB model aims for enhanced integration and partnership-working.
• ICBs have an obligation to consult health and wellbeing boards.
• Discussions with the Welsh Government continue regarding consultation adequacy.
• Private providers will not serve on ICBs or joint committees.
• Amendments aim to require ICSs to consider children's needs in their integrated care strategies.
• Analysis by YoungMinds found that 77% of sustainability and transformation partnerships failed to sufficiently consider children’s needs.
• The speaker suggests extending the age range from nought to 25 years to include services for pregnant mothers.
• The creation of ICBs and ICPs represents a significant opportunity to improve service planning and provision.
• Amendment 54 intends to ensure that children and young people's needs are represented on the ICP.
• Guidance is being developed with NHS England, Department for Education, and stakeholders including the National Children’s Bureau.
• Amendment 83 is grouped with amendment 47.
• The Bill aims to integrate health and social care but falls short of solving the issue comprehensively.
• The vaccine roll-out exemplifies successful collaboration between local government and NHS.
• Wales has a strategy focusing on wellbeing that moves away from market thinking in healthcare delivery.
• The amendment proposes a safeguard to ensure accountability and balance.
• If the relationship breaks down, the integrated care board must make a public statement within 30 days and provide reasons with evidence within 60 days.
• There is an equivalent provision in NHS England for responsibilities at a national level.
• Amendments 47 and 83 address the relationship between ICPs and ICBs.
• Amendment 47 would require a procedure for resolving disputes between ICPs and ICBs.
• Amendment 83 proposes additional requirements for public statements when deviating from integrated care strategies.
• Clause 20 introduces the integrated care partnership (ICP).
• ICP is a joint committee between the integrated care board and local authorities.
• The clause mandates establishment of ICPs to promote health and care integration.
• Clause 21 places a duty on NHS England to ensure that its expenditure, together with that of integrated care boards (ICBs), does not exceed the sums received in a year.
• The historic settlement for the NHS will see its budget rise by £33.9 billion by 2023-24.
• Clause 22 could be commenced at a later date and would expand the duty on NHS England to include expenditure of ICBs, English NHS trusts, and foundation trusts.
• The clauses in question are 21 to 24, dealing with 'Integrated care system: financial controls'.
• Financial directors commend the idea of working together under shared control.
• The Bill aims to allow NHS England to control aggregate spending but lacks clear direction and definitions of roles and responsibilities.
• ICS chairs' advertised pay range is £50,000 to £80,000 for three days a week.
• Local systems receive resource envelopes at the start of each year.
• Overspends within the system are resolved through offsetting savings or support from NHS England.
• The Department of Health and Social Care can provide cash support in extreme cases.
• Clause 23 of the Health and Care Bill provides for NHS England to set overall system financial objectives.
• The amendment by the hon. Member for Ellesmere Port and Neston aims to ensure transparency and protection against unrealistic efficiency savings targets.
• Funding settlements are based on a weighted capitation formula considering factors like demography, morbidity, and deprivation.
• The amendment to Clause 23 is withdrawn without pressing for a vote.
• Further consideration of the Bill is adjourned until Tuesday 21 September.