Key Facts

• The NHS payment system involves over £100 billion of taxpayers’ money, rising to 40% of the Government’s annual spend.
• Clause 66 is important for understanding how and where NHS funding is spent effectively and efficiently.
• The Minister expects the scheme to be published in the course of 2022.
• The Bill aims to change the NHS payment system by April 2022.
• There are concerns about the impact of removing competition incentives from the system.
• Providers have until 2022 to adjust their practices following new guidelines.
• Amendment 100 was discussed without being pressed.
• Amendment 84 aims to ensure equal pricing for private providers in the NHS payment scheme.
• The Committee voted on amendment 84 with Ayes 4, Noes 8.
• Amendment 93 would enable dying people to have conversations about their holistic needs and preferences.
• The amendment aims to ensure that new bodies consider these conversations when making decisions about service procurement.
• Evidence supports earlier access to palliative care, communication, reducing conflict, and helping families understand what is ahead.
• Reports indicate cancer care being 'rationed' in Nottingham due to workforce shortages.
• Marie Curie survey found that 76% of carers said their loved ones did not get all the necessary care and support during the pandemic.
• By 2040, the number of people needing palliative care is projected to increase by 42% due to an ageing population.
• Amendment 93 would require regulations under the power of patient choice to offer conversations about holistic needs and preferences.
• NHS long-term plan commits to more personalised care at end-of-life.
• CQC’s review led to the establishment of a ministerial oversight group for advance care planning.
• Clause 67 reinserts patient choice rights under the new healthcare model.
• Schedule 11 provides details for resolving breaches of patient choice requirements by ICBs.
• NHS England will have powers to enforce patient choice following the merger with NHS Improvement.
• Amendment 99 requires formal competitive tendering for services specified in subsection (1)(a) and (b).
• Amendment 96 includes provisions to continue commissioning NHS services without re-tendering processes.
• New clause 12 establishes the NHS as the preferred provider of NHS contracts, with competitive tenders required if the NHS cannot fulfill terms.
• Justin Madders criticizes the Lansley Act's requirements for compulsory competitive tendering.
• The National Audit Office report highlights issues with decision documentation and risk management in emergency procurements.
• Amendment 99 sets a baseline that no contract under this clause can be awarded to anyone other than a relevant authority unless a formal competitive tendering process has been followed.
• There are concerns about cronyism, transparency, and value for money due to lack of robust procurement rules.
• The Health Service Journal reports issues with subcontractors in the NHS.
• Dr Chaand Nagpaul emphasizes the importance of the NHS as the preferred provider based on evidence and accountability.
• McCabe's amendments aim to make the NHS the default provider, reduce reliance on private providers over three years, and ensure transparency in contract awarding.
• The Health and Social Care Act 2012 (Lansley reforms) is seen as a disaster that led to public waste and missed opportunities for pandemic preparedness.
• There are concerns about the lack of clarity regarding what will replace section 75 of the NHS Act 2006.
• The MP suggests operationalizing political interference or accountability in the NHS due to large amounts of money consumed by parts of the public sector.
• The government's proposal allows for a more flexible procurement process for healthcare services.
• Current competition and procurement rules are seen as barriers to integrating care, disrupting collaborations, and causing legal costs without adding value.
• The new regime will focus on tailored criteria such as integration, collaboration, patient choice, and tackling inequalities.
• Non-healthcare services will continue to fall under the Public Contract Regulations 2015 or a future Cabinet Office procurement regime.
• Amendment proposed to clause 68 seeks to include requirements about regulations for service provision.
• Proposes that integrated care boards must conduct public consultations before commencing formal procurement processes.
• Requires providers to pay staff at least NHS rates and publish reports annually on contract distribution.
• The clause inserts proposed new section 12ZB into the NHS Act 2006.
• The government intends for regulations to be produced under section 12ZB, but has not specified a timeline.
• The proposals have gained widespread support with 79% agreement from respondents.
• Clause 69 aims to remove specific healthcare procurement rules under the Health and Social Care Act 2012.
• Clauses 70-73 are aimed at promoting collaboration within NHS, removing Monitor's competition functions, and adjusting CMA’s role in reviewing mergers.
• The clauses will make amendments to allow NHS England to set its own license conditions for providers without external oversight.
• Clauses 74, 75, and 76 repeal the three-year time limit on special health authorities.
• Clause 74 removes the process of extending lifespan every three years for special health authorities like NHS Counter Fraud Authority.
• The changes aim to ensure flexibility in the arm's length body landscape for a world-class healthcare system.
• Local education and training boards (LETBs) are being abolished.
• Health Education England (HEE) will take over LETB functions directly.
• HEE will continue to have responsibility for workforce planning and engagement with regional people boards, integrated care boards, and NHS England regional directorates.
• A report on assessing and meeting healthcare workforce needs will be published.
• Amendment 98 aims to improve clause 78 of the Bill.
• It mandates social care needs assessments within two weeks of discharge or before hospital discharge.
• Integrated care boards must agree processes and report on failures.
• Local authorities will bear additional costs fully during assessments.
• The Secretary of State must publish an annual report on assessment effectiveness, including readmission rates.
• The MP's family members were part of the discharge to assess programme.
• Families are suddenly becoming carers overnight due to lack of care services post-discharge.
• Some people are told they need assessed care but there is none available for several weeks.
• Amendment would require local authorities to conduct social needs assessments within two weeks post-discharge.
• Existing legislation mandates NHS to meet health needs while local authorities assess adult social care needs.
• New statutory guidance is being developed for co-operation in discharge procedures.
• Clause repeals legislative barriers to the discharge to assess model.
• Local authorities and NHS developed innovative ways during the pandemic.
• Guidance will be produced with health and social care partners setting out how statutory duty in the NHS Act 2006 applies to discharge.