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Review of arm’s length bodies to cut bureaucracy

  • Published date:
    26 July 2010
Health Secretary Andrew Lansley

Bureaucracy will be cut and the functions of several organisations will be streamlined, following a review of arm’s length bodies (ALBs), published by Health Secretary Andrew Lansley today. In total, the changes outlined in today’s report will reduce the number of health ALBs from eighteen to between eight and ten; they are expected to deliver savings of over £180m by 2014/15.

In line with the wider reforms set out in the White Paper, Equity and Excellence: Liberating the NHS, the Department of Health’s ALB sector will be transformed to cut cost and remove duplication and burdens on the NHS.

The review has assessed whether the work of each of the Department of Health’s 18 Arm’s Length Bodies’ remains essential nationally. It also looked at whether work is being duplicated or could be better carried out by a different body.
Subject to Parliamentary approval, organisations which are no longer needed will be removed from the sector, with essential work moved to other bodies. This process will increase the ability of the organisations to do their important work in the most efficient way. It is also part of the cross-Government strategy to increase accountability and transparency, and to reduce the number and cost of quangos. 

Health Secretary Andrew Lansley said:

‘In order to secure every possible means to promote greater value for money and efficiency, we have acted decisively to ensure that our ALB sector remains fit for purpose and affordable.

‘Over the years the sector has grown to the point where overlap between organisations and duplication of effort have produced a needless bureaucratic web. By making sure that the right functions are being carried out at the appropriate level, we will free up significant savings to support front-line NHS services.

‘I know that the uncertainty created by this review has been difficult for staff. The constructive support of the Chairs and Chief Executives of all the organisations has been invaluable throughout this process. We will be supporting them to carry on their essential work during and beyond the period of transition.’

In line with the efficiency savings being made across the health sector, remaining ALBs will be required to deliver their functions effectively and efficiently, taking full advantage of commercial opportunities.

The Department will work with each organisation affected by the changes over the next few months to help them through the transition process.  The form of this work will vary according to the nature and scale of the change for each organisation.

The conclusions of today’s review and outcomes for each organisation are set out below.

Notes to Editors

1. The conclusions of today’s review and outcomes for each organisation are set out below.

Arm’s Length Body: Alcohol Education and Research Council 
ALB Type: Executive Non Departmental Public Body (ENDPB) and registered charity 
Role: Administers the Alcohol Education and Research Fund 
Proposal: Abolish as an ALB and remove from the sector, while seeking to maximise the opportunities for effective cross-government policy to reduce the harm from alcohol misuse.

Arm’s Length Body: Appointments Commission 
ALB Type: ENDPB 
Role: Makes public appointments 
Proposal: Abolish as an ALB during 2012 in view of the very substantial reduction in the number of appointments required. Move remaining appointments to the Department of Health.

Arm’s Length Body: Care Quality Commission 
ALB Type: ENDPB 
Role: Regulates health and adult social care provision 
Proposal: Retain as quality inspectorate across health and social care, operating a joint licensing regime with Monitor. Host organisation for Healthwatch England. Current responsibility of assessing NHS commissioning moves to the NHS Commissioning Board. May gain functions from other organisations, e.g. HTA and HFEA.

Arm’s Length Body: Council for Healthcare Regulatory Excellence 
ALB Type: ENDPB 
Role: Oversees professional regulators
Proposal: Remove from the sector. Make a self-funding body by charging a levy on regulators. Extend role to set standards for and quality assure voluntary registers.

Arm’s Length Body: General Social Care Council 
ALB Type: ENDPB 
Role: Regulates social workers 
Proposal: Transfer the regulation of social workers to the Health Professions Council, which will be renamed to reflect its new remit.

Arm’s Length Body: Health and Social Care Information Centre
ALB Type: Special Health Authority (SpHA) 
Role: Collects and provides health and social care information 
Proposal: Retain, and put on a firmer statutory footing by establishing it in primary legislation. National repository for data collection across health care, public health and adult social care. Clearer focus on data collection, with a close working relationship with the NHS Commissioning Board.

Arm’s Length Body: Health Protection Agency 
ALB Type: ENDPB 
Role: Protects the health and wellbeing of the population 
Proposal: Abolish as a statutory organisation and transfer functions to the Secretary of State as part of the new Public Health Service.

Arm’s Length Body: Human Fertilisation and Embryology Authority  
ALB Type: ENDPB 
Role: Regulates human embryo storage, research and assisted reproduction treatment 
Proposal: Retain as a separate ALB for the time being, with the aim of transferring its functions by the end of the current Parliament. In the meantime, we will examine the practicalities (and legal implications) of how to divide the HFEA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre. 

Arm’s Length Body: Human Tissue Authority 
ALB Type: ENDPB 
Role: Regulates the removal, storage and use of human tissue and organs 
Proposal: Retain as a separate ALB for the time being, with the aim of transferring its functions by the end of the current Parliament. In the meantime, we will examine the practicalities (and legal implications) of how to divide the HTA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre. 

Arm’s Length Body: Medicines and Healthcare products Regulatory Agency 
ALB Type: Executive agency 
Role: Regulates medical devices and medicines 
Proposal: Retain, but with the expectation that it will undertake its regulatory duties in the most cost effective way.

Arm’s Length Body: Monitor 
ALB Type: ENDPB 
Role: Assesses, licences and monitors NHS Foundation Trusts 
Proposal: Retain and make an economic regulator, operating a joint licensing regime with CQC.

Arm’s Length Body: National Institute for Health and Clinical Excellence 
ALB Type: SpHA 
Role: Provides national guidance on the promotion of good health and the prevention and treatment of ill-health 
Proposal: Retain, and put on a firmer statutory footing by establishing it in primary legislation. Expand scope to include social care standards.

Arm’s Length Body: National Patient Safety Agency 
ALB Type: SpHA 
Role: Promotes patient safety and manages the National Clinical Assessment Service, the National Research Ethics Service and confidential enquiries. 
Proposal: Abolish as an ALB. Safety functions retained and transferred to the National Commissioning Board. Explore transfer of National Research and Ethics Service functions to single research regulator. National Clinical Assessment Service to become self-funding over the next two to three years.

Arm’s Length Body: National Treatment Agency for Substance Misuse 
ALB Type: SpHA 
Role: Works to increase the availability, capacity and effectiveness of drug treatment in England  
Proposal: Abolish as an ALB, and transfer functions to the Secretary of State as part of the new Public Health Service.

Arm’s Length Body: NHS Blood and Transplant 
ALB Type: SpHA 
Role: Provides blood, organs and associated services to the NHS 
Proposal: Retain, and commission an in-depth review of opportunities to make more commercially effective. Transfer Bio-Products Laboratory out of NHSBT into a Department of Health owned company. 

Arm’s Length Body: NHS Business Services Authority  
ALB Type: SpHA 
Role: Provides central services to the NHS 
Proposal: Retain in short term, and commission commercial review to identify potential for increased commercial opportunities, including potential to remove functions from the ALB sector.

Arm’s Length Body: NHS Institute for Innovation and Improvement 
ALB Type: SpHA 
Role: Supports the NHS by spreading new ways of working, new technology and leadership
Proposal: Remove from ALB sector. Move functions which will support the NHS Commissioning Board in leading for quality improvement to the Board. Review the potential for its remaining functions to be delivered through alternative commercial delivery models.

Arm’s Length Body: NHS Litigation Authority 
ALB Type: SpHA 
Role: Handles negligence claims and works to improve risk management practices in the NHS  
Proposal: Retain, and commission an industry review to identify potential opportunities for greater commercial involvement.

2. Copies of the Report of the Arm’s Length Bodies Review are available on the Department of Health website via the links below.

3. An Arm’s Length Body is an organisation working at national level, but at ‘arm’s length’ from the Department. As stand-alone national organisations sponsored by the Department of Health, arm's length bodies (ALBs) work closely with the local NHS, social care services and other ALBs to carry out specific functions. In DH, they regulate the system, improve standards, protect public welfare and support local services. ALBs vary in size but normally have boards, employ staff and publish accounts. They are accountable to the Department of Health and sometimes directly to Parliament. Most ALBs also receive substantial funding from the Department of Health.

4. This review cover the Department’s eighteen Arms Length Bodies at present. The White Paper, Equity and Excellence: Liberating the NHS, proposed the establishment of the NHS Commissioning Board. Ministers are also considering the establishment of a single research regulator. Subject to this the Human Fertilisation and Embryology Authority and the Human Tissue Authority will be abolished. The maximum number of ALBs will therefore be ten. However, following the further identification of opportunities  for commercial involvement, the NHS Business Services Authority and the NHS Litigation Authority functions within the ALB sector may be reduced or removed.  

5. For further information contact the Department of Health newsdesk on 0207 210 5221. 

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