Health and Care Act 2022 including Integrated Care Systems

On this page you will find links to resources about the Health and Care Act 2022 (HCA).

The HCA which will fundamentally change how health and social care is delivered in England received Royal Assent (the final stage to become law) on 28th April 2022. Some parts of the HCA, however, also apply in Wales and/or Scotland. Section 185 of the Act sets out which sections of the Act apply where, so should be checked when reading the Act.

Although the HCA is now (June 2022) on the statute book, it is not necessarily yet all in force. Section 186 should also be checked to ensure the section of the Act you are reading is currently in force.

The HCA is wide ranging with over 200 provisions, bringing in significant changes in the organisation and delivery of health and care services in England. It aims to dismantle many of the NHS organisational structures put in place by the Health and Social Care Act 2012 and is closely aligned to the NHS Long Term Plan and enacts into law the government policy outlined in their February 2021 White Paper Integration and Innovation: Working together to improve health and social care for all.

Among the key changes introduced by the HCA are:

• Putting Integrated Care Systems (ICSs) into statute and transferring Clinical Commissioning Groups (CCGs) duties, powers, staff and resources to ICSs.
• Repealing the requirement under s.75 if the Health and Social Care Act 2012 for services to be put out to competitive tender.
• Formally merging NHS England and NHS Improvement.
• Formally changing the name of the NHS Commissioning Board to its more commonly used name NHS England.
• Increasing the powers of the Secretary of State for Health and Care, particularly over NHS England.
• Putting a cap of £86,000 on the personal amount an individual in England will pay for care over their lifetime.
• Promoting co-operation in the provision of health services and care.
• Establishing the Health Services Safety Investigation Body.
• Creating new offences in relation to virginity testing and hymenoplasty.
• Creating new offences in relation to organ trafficking.
• Introducing mandatory training on learning disability and autism.

On the rest of this page you will find links to UK government and parliament resources; NHS and local government resources and resources from non- government bodies such as the Kings Fund; the Health Foundation and the British Medical Association.  There are also links to additional resources specifically about the new Integrated Care Systems (ICSs) and Integrated Care Boards (ICBs) towards the bottom of this page, as ICSs and ICBS are a major change introduced by the HCA. If you are aware of any additional resources you think we should add to this page, please contact us using the Contact Us tab above.

UK Government and Parliamentary Resources

Note some of these resources relate to the Health and Care Bill so changes may have been made before the Bill obtained Royal Assent.

Health and Care Act 2022

Health and Care Act 2022 (Commencement No.1) Regulation 2022

This statutory instrument (a form of secondary legislation) brings limited sections of the HCA into force from 9th May 2022.

The Health and Care Act 2022 (Consequential and Related Amendments and Transitional Provisions) Regulations 2022

This statutory instrument addresses consequential and transitional arrangements in relation to pre- HCA secondary legislation.

Westminster Government Health and Care Bill Factsheets (last updated March 2022)

Westminster Government White Paper Integration and Innovation: Working together to improve health and social care for all.

Westminster Parliament Library Briefing on Health and Care Bill (12th July 2021)

Schedule of all changes the Health and Care Act 2022 makes to existing legislation

NHS and Local Authority Resources

NHS Providers: A guide to the Health and Care Act 2022 for Trusts and Foundation Trusts

NHS England:Integrated Care Systems Guidance

NHS Digital: Integrated Care Systems Implementation

NHS Providers Media Briefing: Much to wlcome in the new Health and Care Act but lack of NHS workforce planning a major, missed opportunity 28th April 2022

NHS North East London Clinical Commissioning Group: How the NHS is organised is changing from July 2022

Local Government Association: Get in on the Act: Health and Care Act 2022 (May 2022)

Nottinghamshire County Council: Summary on Health and Care Act

Health Education England: Oliver McGowan Mandatory Training in Learning Disabilities and Autism

s.181 HCA introduces mandatory training for health and social care staff in learning disability and autism. The training should be at the right level for their role. The aim is to improve understanding of the needs of people with learning disabilities and autism, to provide better services and support leading to better outcomes.

Non-Government Resources

British Medical Journal Briefing: Ten things you need to know about the Health and Care Bill (February 2022)

British Medical Association Members’ Briefing on the Health and Care Act

Royal College of Nursing: What has the Health and Care Bill got to do with me? (April 2022)

The Kings Fund: Health and Care Act 2022

Integrated Care Systems (ICSs)

A key aim of ICSs is to break down barriers between the NHS and local authorities to and provide more integrated care and to tackle health inequalities.

This short video from NHS England provides a brief introduction to ICS

NHS England: What are Integrated Care Systems?

NHS England:Integrated Care Systems Guidance

British Medical Association Briefing : Integrated Care Systems (July 2022)

The Kings Fund: Integrated Care: Our Position (May 2022)

House of Parliament Library Briefing on Integrated Care Systems (December 2019)

House of Commons Health and Social Care Committee Report: Integrated care: organisations, partnerships and systems (May 2018)

Westminster Government Response to Health and Social Care Committee Report, (August 2018)

Nuffield Trust Briefing: Evaluating integrated care: why are evaluations not producing the results we expect? (November 2019)

Integrated Care Boards

Integrated Care Boards (ICB) were established by the Integrated Care Board (Establishment) Order 2022 with effect from 1 July 2022 as required by the HCA. Each ICB will have a constitution its Board membership and governance arrangements. ICBs will be responsible for formulating a strategy to address the health, social care and public health needs of their ICS and to support partnership working across the ICS. Boards will include as a minimum:

• Chief Executive
• Finance Executive
• Nursing Director
• Medical Director
• Independent non-executive Chair*
• Two further independent non-executives*
• Three ‘partner’ members – one from an NHS trust/foundation trust within the ICS region; one from general practice and one from a local authority.

*these independent members will ‘not normally hold roles from other health and care organisations within the ICS footprint’.

Editor’s note: It is our hope that patients, carers, non health and social employee experts, and the voluntary sector will have seats at the table as they are best placed to know how to address ‘problems’ in the system and health inequalities.

NHS England: Integrated Care Boards

NHS Providers Briefing: Integrated Care Boards

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