Health and Care Act 2022

Health and Care Act 2022
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Title	Health and Care Act 2022
Enacted by	Parliament of the United Kingdom
Long title	An Act to make provision about health and social care integrated care systems, NHS commissioning, and public health; and for connected purposes.
Year	2022
Citation	2022 c. __
Territorial extent	England and Wales
Royal assent	2022

Health and Care Act 2022 The Health and Care Act 2022 is primary legislation enacted by the Parliament of the United Kingdom to reform aspects of the National Health Service commissioning, establish statutory integrated care systems, and revise public health and social care arrangements. It follows a sequence of reforms after the Health and Social Care Act 2012, building on policy initiatives from the Department of Health and Social Care, and intersects with administrations such as the Department for Levelling Up, Housing and Communities, the Cabinet Office, and devolved bodies including the Scottish Government, the Welsh Government, and the Northern Ireland Executive.

Background and legislative history

The Act originated in policy proposals advanced under the Theresa May ministry, refined during the Boris Johnson ministry, and introduced as a bill in the House of Commons of the United Kingdom by ministers from the Department of Health and Social Care. Its passage followed debates in the House of Lords involving peers from the Labour Party (UK), the Conservative Party (UK), the Liberal Democrats (UK), and crossbenchers linked to the King's Speech legislative programme. The bill was considered alongside inquiries and reports from bodies such as the National Audit Office, the King's Fund, and the Nuffield Trust. Key parliamentary stages included committee scrutiny in the Health and Social Care Select Committee and amendments debated in the Public Bill Committee.

Key provisions

Major provisions establish statutory integrated care systems replacing some functions of clinical commissioning groups, modify NHS commissioning arrangements with implications for NHS England and NHS Improvement, and create duties for local partners such as local authorities and NHS trusts. The Act addresses workforce and accountability by conferring powers on regulators like the Care Quality Commission and reshaping arrangements that interact with bodies including the General Medical Council, the Nursing and Midwifery Council, and the Health and Safety Executive. It includes measures on public health responsibilities that connect to frameworks from the World Health Organization and obligations under international instruments such as the International Health Regulations (2005). Provisions also touch procurement rules influenced by precedents from the Competition and Markets Authority and financial controls reflecting guidance from the Treasury (United Kingdom).

Organization and governance changes

The Act mandates structural changes: statutory integrated care boards and integrated care partnerships replace aspects of clinical commissioning groups and coordinate with NHS foundation trusts and ambulance trusts. Governance duties are reallocated between NHS England commissioners, boards chaired by appointed leaders, and partner organizations including local enterprise partnerships and Health Education England. Corporate governance intersects with regulatory regimes overseen by the Care Quality Commission and audit oversight from the National Audit Office. The Act amends duties of entities such as clinical commissioning group chairs and redefines provider collaboratives similar in function to consortia studied by the Institute for Fiscal Studies.

Implementation and timeline

Implementation was staged: initial commencement orders and transitional arrangements were made following Royal Assent, coordinating with milestones set by NHS England and guidance from the Department of Health and Social Care. The roll-out involved mapping existing clinical commissioning groups into new integrated care boards across sustainability and transformation partnerships influenced by pilot programmes from the NHS Long Term Plan. Workforce, funding transfers, and data-sharing protocols required parallel integration with systems used by organisations like NHS Digital and contractual frameworks monitored by the Crown Commercial Service. Timetables aligned with fiscal cycles overseen by the HM Treasury.

Impact and responses

Responses encompassed commentaries from think tanks such as the King's Fund, the Nuffield Trust, and the Health Foundation, stakeholder input from the British Medical Association, the Royal College of Nursing, and patient groups including Healthwatch. Opinions varied: supporters in the Conservative Party (UK) framed the Act as strengthening local partnerships; critics from the Labour Party (UK) and the Trade Union Congress raised concerns about accountability and resource allocation. Regulatory bodies including the Care Quality Commission signalled new inspection priorities, while health economists at the Institute for Fiscal Studies and the Office for Budget Responsibility modelled fiscal and service impacts. International observers from the Organisation for Economic Co-operation and Development noted implications for comparative health system performance.

Legal challenges and amendments

Following enactment, legal and judicial review challenges were lodged by interest groups and local authorities invoking administrative law precedents from the Supreme Court of the United Kingdom and judgments referencing cases heard in the Court of Appeal of England and Wales. Amendments were considered in parliamentary sessions and through secondary legislation to clarify duties and procurement interactions, with statutory instruments laid before the House of Commons and the House of Lords. Oversight by the Parliamentary and Health Service Ombudsman and assessments by the National Audit Office informed subsequent ministerial adjustments and guidance updates.

Category:United Kingdom legislation Category:National Health Service