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NHS Reform and Health Care Professions Act 2002: guidance to primary care trusts and strategic health authorities

  • Last modified date:
    15 December 2010

Guidance and reference for major legislative, and organisational, changes resulting from the passage of the NHS Reform and Health Care Professions Act 2002.

NHS Reform and Health Care Professions Act 2002 Commencement Orders

The following commencement orders have been made by the Secretary of State*, which will enable many of the provisions of the NHS Reform and Health Care Professions Act to be brought into operation:

* A further commencement order (SI 2002/2532) has been made by the National Assembly for Wales bringing various provisions in the Act into effect for Wales from 10th October 2002.

The first commencement order S.I. 2002 / 2202 covers various provisions of the NHS Reform Act, which come into effect on various dates from 27 August 2002 to 1 April 2003, but not from 1 October. Among the areas it covers are the powers to make directions relating to the functions of StHAs and PCTs, and the Council for the Regulation of Health Care Professionals.

The second commencement order S.I. 2002 / 2478 covers provisions of the NHS Reform Act, which came into force on 1 October 2002. These include the change of name of English Health Authorities to Strategic Health Authorities, the introduction of PCTs throughout England, the shift of family health service functions to PCTs, certain provisions related to Personal Medical Services, Local Representative Committees, and the funding of StHAs and PCTs.

The third commencement order S.I. 2002 / 3190 covers provisions of the NHS Reform Act, which came into force on 1 January 2003. It covers the establishment of The Commission for Patient and Public Involvement in Health; an amendment to section 7 of the Health & Social care Act 2001, concerning health related functions of the Overview & Scrutiny Committees; and certain consequential amendments and repeals.

These are available online from the HMSO website or in hardcopy, as priced documents, from HMSO

The National Health Service Reform and Health Care Professions Act 2002 (Supplementary, Consequential etc. Provisions) Regulations 2002 (SI 2002/2469)

These Regulations came into force on 1 October 2002. They contain details of amendments necessary to primary and secondary legislation as a result of the change of name of English Health Authorities to Strategic Health Authorities, and the reallocation of many former Health Authority functions to Primary Care Trusts. These amendments are additional to those contained in Schedules 1 and 2 to the 2002 Act.

These Regulations are available on Her Majesty's Stationery Office website and in hardcopy as a priced document from HMSO.

Statutory Instrument 2003 No. 1617 The Strategic Health Authorities (Consultation on Changes) Regulations 2003

The Strategic Health Authorities (Consultation on Changes) Regulations 2003 will come into force on the 18th July 2003. These Regulations set out the consultation requirements which must be complied with before the Secretary of State may make an order which varies the area of, abolishes, establishes or changes the name of a Strategic Health Authority.

Secretary of State Directions

In addition to changes to primary and secondary legislation, it is also necessary to make consequential amendments to certain extant sets of Secretary of State directions. A general direction has been issued establishing a default position that all references in directions to Health Authorities are to be read as references to Strategic Health Authorities. Where this is not the policy intention and the reference is intended to be to Primary Care Trusts, then there will need to be amending directions to that effect. In some cases, the relevant amending directions will have been made before 1 October. In other cases, Solicitors have advised that, pending such amendments, StHAs can delegate any functions conferred by the directions to Primary Care Trusts using their powers in section 17A of the NHS Act 1977 (as amended by the NHS Reform and Health Care Professions Act 2002). Where directions relate to the exercise of a function, which has been delegated to PCTs under The National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements)(England) Regulations 2002 (see below), then those directions should also automatically be read as referring to the body to whom the function has been delegated so far as is necessary or expedient (this is the effect of section 128(1A) of the NHS Act 1977).

The National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements)(England) Regulations 2002 (S.I. 2002/2375)

These Regulations came into force on 1 October. They contain details of Secretary of State functions, which have been delegated to be exercisable by Strategic Health Authorities or Primary Care Trusts. They also give details of Strategic Health Authority functions that may not be delegated to Primary Care Trusts and set out some StHA functions (in relation to pilot schemes), which must be delegated to PCTs.

These regulations are available on Her Majesty's Stationery Office website or in hardcopy, as a priced document, from HMSO.

Changes to drug charging process

From 1st October, PCTs have had responsibility for unified allocations. This responsibility includes drugs bill costs associated with all GP (and nurse) prescribing within the present Strategic Health Authorities or PCTs. The following guidance document highlights changes to Prescription Pricing Authority financial reports and the drug charging process in 2002/03:

Pharmaceutical services

Primary Care Trusts are reminded that from 1 October 2002, in addition to the responsibilities they already have for local pharmaceutical services, they will have responsibility for all aspects of the NHS (Pharmaceutical Services) Regulations 1992.

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Public Health (Control of Disease) Act 1984 responsibilities

Dr Pat Troop, Deputy Chief Medical Officer, has written to Regional Directors of Public Health asking them to draw the attention of local authorities, with responsibilities under the Public Health (Control of Disease) Act 1984, to changes that affect them. Her letter also asks that information collected by medical inspectors under the Immigration Act should in future be passed to Primary Care Trusts.

Recognition of Local Representative Committees

From 1 October 2002, the recognition of Local Representative Committees (LRCs) is devolved to Primary Care Trusts. From that date LRCs no longer have to conform to the boundary of a single Primary Care Trust. Instead, LRCs will be able to establish themselves at the level of a single PCT area, or more than one whole PCT area, - profession by profession and area by area - and apply to the relevant PCT or PCTs for recognition in accordance with sections 44 and 45 of the NHS Act 1977.

Transitional arrangements to ensure continuity are in paragraphs 5 and 25 - 26 of Schedule 12 to The National Health Service Reform and Health Care Professions Act 2002 (Supplementary, Consequential etc. Provisions) Regulations 2002 (see also above).

General Ophthalmic Services

From 1 October 2002, PCTs have responsibility for administering the General Ophthalmic Services (GOS) and spectacle voucher schemes. The schemes themselves are unchanged. GOS practitioners who were previously on the Health Authority list should automatically be allocated to the PCT list (or lists) for the locality where they have their practice(s) or in the case of mobile practices, the localities where they carry out their domiciliary visits and have their administrative base.

Primary care practitioner list management

StHAs and PCTs were required to make special transitional arrangements for primary care list management and disciplinary arrangements because of the NHS reorganisation that took place on 1 October 2002. The arrangements are set out in Schedule 12 of the The National Health Service Reform and Health Care Professions Act 2002 (Supplementary, Consequential etc. Provisions) Regulations 2002 (see also above).

NHS Local Improvement Finance Trust (LIFT): public-private-partnerships (Section 96C of the 1977 Act)

Those PCTs with NHS LIFT schemes approved by the Secretary of State have the power to take a shareholding in local LIFT companies. The power to do this is delegated to PCTs in Part 2 of Schedule 1 to the National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements) (England) Regulations 2002 (S.I. 2002/2375) subject to the limitation set out in regulation 8(3) of those Regulations.

Personal Medical Services

The roles and responsibilities of organisations involved within PMS have changed considerably to underpin Shifting the Balance of Power. Further guidance on these changes is available at the link below.

Out Of Hours - PCT role in accreditation

GPs are currently responsible for ensuring the availability of care to their patients throughout each day. Under new arrangements GPs will be able to delegate responsibility for out of hours care to accredited service providers. Regulations to underpin the new accreditation system were made in October 2002 and came into effect from 1 November 2002.

Similar changes are being introduced in February 2003 for PMS pilot providers NHS (Out of Hours Provision of Personal Medical Services and Miscellaneous Amendments) (England) Regulations 2003 (SI 2003/26), and associated amendments to the PMS Implementation Directions).

Guidance on the roles and responsibilities of those engaged in the delivery of out of hours services was issued in June 2002. This guidance is currently being revised and will be issued shortly. The Quality Standards that those engaged in the delivery of out-of-hours services are required to meet by 2004 are set out in the Out of Hours section of this website.

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