It is interesting to note that there are only three direct references in the Bill to Section 75 of the National Health Service Act 2006, this being the section dealing with partnership arrangements between local authorities and health bodies. However, each of the references promotes the interaction and integration of local authority and health service bodies’ working. The first reference can be found on page 17 of the Bill and is in regard to the duties of the NHS Commissioning Board which now has a duty to encourage integrated working. The Board “must, for the purpose of advancing the health and well being of the people of England, exercise its functions with a view to encouraging commissioning consortia to work closely with local authorities in arranging for the provision of the services”. Further, at 13J(2) the Bill states that “the duty imposed by sub-section (1) includes in particular a duty to encourage commissioning consortia to enter into arrangements with local authorities in pursuance of regulations under Section 75.”
The regulations under Section 75 of the National Health Service Act allow for the lead commissioning, pooling of funds and integrated provision of health and local authority health related functions. They also prescribe which bodies may enter into partnership arrangements and the functions which the parties may delegate. Subsidiary legislation will need amending to enable commissioning consortia to enter into such arrangements.
The next reference to Section 75 is found on page 149 of the Bill and is in regard to local authority joint strategic needs assessments in regard to health and social care. The amendment is an amendment to Section 116 of the Local Government and Public Involvement in Health Act 2007. This Act is amended to require local authorities and their partner commissioning consortia to prepare a joint health and well being strategy to meet the needs included in their assessment in regard to the health and social care of the populations for which they are responsible. Depending on the geographic coverage of a commissioning consortia, it may need to work with more than one local authority.
Further, the Bill states that in preparing a strategy the responsible “…local authority and each of its partner commissioning consortia must, in particular, consider the extent to which the health related needs could be met more effectively by the making of arrangements under Section 75 of the National Health Service Act 2006 (rather than in any other way)”. This clearly sends the message that this would always be the preferred option. The last reference to partnership arrangements comes under the heading of the Health and Wellbeing Boards and on page 152 of the Bill under the title “Duty to encourage integrated working” the Bill refers to the Health and Wellbeing Board having to, in particular, provide such advice, assistance or other support as it thinks appropriate for the purpose of encouraging the making of arrangements under Section 75 of the National Health Service Act 2006 in connection with the provision of health or social care services.
It is therefore apparent that at all times entering into agreements under s 75 of the NHS Act 2006 will be considered the preferred option for partnership arrangements between local authorities and commissioning consortia to take place and even over and above other forms of service provision. The Bill, therefore, delivers on what was proposed in the White Paper by making integrated working and partnerships between health and local authorities now duties and preferred options rather than mere choice.