The Health and Care Act 2022 came into force on 1st July 2022.  

The main aim of the act is to transform how NHS England is organised, focussing on improving health and care services and tackling health inequalities through better health and care integration.  

The Act also served as a mechanism to amend other legislation and introduce a range of other changes, such as the CQC assessment and review of local authority adult social care, a cap on care costs and mandatory training requirements around learning disability and autism. 

This briefing explains the key changes that are likely to directly impact social care professionals and practitioners in their day-to-day practice.

Transforming NHS England 

Integrated Care Systems (ICSs) have been established. These are geographically based, strategic partnerships whose members include providers and commissioners of the NHS, local authorities and other local partners. Their role is to plan, coordinate and commission health and social care services that meet the needs and priorities of their locality.  

Integrated Care Systems consist of two bodies, each with a different role in meeting the objectives of the overall System.  

1. Integrated Care Boards (ICBs); and
2. Integrated Care Partnerships (ICPs).  

CCG’s have been abolished under the Act and most of the functions previously undertaken by them will become the responsibility of ICB’s. This includes, but is not limited to things like NHS Continuing Healthcare, NHS-funded Nursing Care, joint packages of care etc.  

Health services that provide care, support and treatment to people will sit under the ICB. This includes GP’s, community nurses, dentists, NHS equipment services etc. All the following, specific and focused groups will form part of the ICB: 

• Health and Wellbeing Boards 
• Place-Based Partnerships 
• Primary Care Networks 

You should no longer be using the terminology ‘CCG’, as this is no longer accurate. 

While ICB’s are practice based, ICPs have a role to ensure that the services being commissioned by the NHS in their area are of a high quality and reflect the specific needs of the local population. To do this, ICP’s must function at a local level and work with key local stakeholders and residents, to inform relevant joint strategic needs assessments and ensure the right commissioning decisions are made.

CQC Assessment, Review and Monitoring of Local Authorities and Integrated Care Systems 

Local Authorities

From April 2023, the CQC will review, assess and report on local authority adult social care. These reviews will specifically focus on how well the local authority is meeting its duties under Part One of the Care Act 2014. 

The CQC is currently developing its methodology and anticipates that by September 2022 a first draft of the process will be available. 

Integrated Care Systems

NHS England will make sure all committees and systems are accountable for their operational and financial performance.  

In addition to the role of NHS England, the Care Quality Commission (CQC) will also review the ICS. This review will consider how well partners are integrating and working together across the system.   

Working Together 

The duty to co-operate

The duty to co-operate is set out in both the Care Act 2014 and the NHS Act 2006. The duty remains, but the Health and Care Act 2022 has now given powers to the Secretary of State to issue specific guidance setting out what the co-operation duty should look like in practice. When this guidance is developed and issued, it is intended to give organisations greater clarity about what the duty to cooperate means in practice. 

Information sharing and data gathering 

The Act includes provisions to address data gaps and to improve the quality, flow, and collection of data across health and social care.  

In particular, the Act gives powers to share anonymous information between services and to standardise how data is collected, stored and processed. 

There is also a new requirement for NHS Digital to obtain a range of data from adult social care services relating to their activities and service users. This will ensure that the whole needs of a local population are analysed and understood, not just healthcare needs.

Social Care Practice Issues 

Removal of delayed discharge from hospital

The Act repeals the legal requirement for adult social care needs assessments to take place while an individual is in hospital and allows assessments to take place after discharge.  

The Act also repeals the system of discharge notices and associated financial penalties set out in the Care Act 2014. 

Cap on care costs for charging purposes

Legislation to allow for a cap on care costs was already in place in the Care Act 2014 but implementation was postponed. The Health and Care Act 2022 amends the measures set out in the Care Act 2014 about how much a person should contribute to the cost of their personal care over a lifetime. 

Regulations are expected to be in place within some local authorities in January 2023 and for all other local authorities by October 2023. The final guidance is expected this year.

Mental health services 

The Act requires that Mental health services are prioritised and ICB’s will have to evidence their spending on mental health services. 

Adult social care providers payment  

Previously, the Secretary of State was able to provide financial assistance to bodies that provide health and care services, or those connected with health and social care provision, but this was restricted to non-profit-making bodies. The Act extends this power to the private sector providers. 

New NHS safeguarding body 

The Local Authority remains the responsible organisation for safeguarding but the Act establishes a new body, the Health Service Safety Investigation Body (HSSIB), to conduct investigations into incidents that occur during the provision of health care services.  

New criminal offences 

The Act introduces new criminal offences relating to virginity testing and hymenoplasty (the reconstruction of the hymen with or without consent). This includes carrying out hymenoplasty and aiding and abetting someone in carrying out hymenoplasty.  

This is part of the government’s Violence against Women and Girls Strategy and in England and Wales can be punishable by up to 5 years in prison and/or a fine. 

Mandatory learning disability and autism training 

The Act amends the Health and Social Care Act 2008 to require all providers of health, care and support to ensure that all staff receive training on learning disability and autism. This is seen as an important part of reducing health inequalities for those groups of people. 

A code of practice will be issued about the training, and how the involvement of people with learning disability and autism and their carers will be achieved.

Further Information and Reading

To read more about the Health and Care Act 2022, see: 

Health and Care Act 2022 (primary legislation) 

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

The Health and Care Act (Kings Fund resource to help inform and make sense of the legislation) 

Get in touch

If you have enjoyed this briefing, wish to provide feedback or make a suggestion for a future topic of interest you can email the author directly using sally.gillies@trixonline.co.uk