NHS England are seeking changes to the Health and Social Care Act, including the competition rules affecting CCGs, who can sit on their boards and how closely they can work with trusts.

Londonwide LMCs has submitted initial comments to the Parliamentary Health Committee currently considering this, and want your feedback to inform our substantive responses to both the scrutiny Inquiry, and NHS England's consultation.

We know how busy you are but would be really grateful if you could find the time to give us your thoughts.

You can see the NHS England consultation document here: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/02/nhs-legislation-engagement-document.pdf 

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* 1. Which LMC area are you based in?

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* 2. PROMOTING COLLABORATION (p5) : Do you have any comment on NHS England proposals to: remove the Competition and Markets Authority’s functions to review mergers involving NHS foundation trusts; remove NHS Improvement’s powers to enforce competition; and to remove the need for contested National Tariff provisions or licence conditions to be referred to the CMA?

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* 3. BETTER VALUE FOR THE NHS (p7): Do you have any comment on NHS England proposals to reduce procurement rules including revoking section 75 of the Health and Social Care Act 2012 and allowing NHS commissioners more freedom to determine when to appoint and when to follow a procurement process is needed, subject to a new and as yet undefined "best value test"?

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* 4. INCREASING THE FLEXIBILITY OF NATIONAL PAYMENT SYSTEMS (p9): Do you have any comment on NHS England proposals to increase the flexibility of the national NHS payments "tariff" system and  to amend it to include prices for ‘section 7A’ public health services commissioned by NHS England or CCGs on behalf of the Secretary of State, eg screening new-born babies’ hearing as part of their mothers’ maternity care?

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* 5. INTEGRATING CARE PROVISION (p11): Do you have any comment on NHS England proposals to establish new NHS trusts to deliver integrated care, and the assumptions therein regarding future bodies and roles?

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* 6. MANAGING THE NHS'S RESOURCES BETTER (p13): Do you have any comment on NHS England proposals that: there should be targeted powers to direct mergers or acquisitions involving NHS foundation trusts in specific circumstances where there is clear patient benefit; and it should be possible to set annual capital spending limits for NHS foundation trusts?

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* 7. EVERY PART OF THE NHS WORKING TOGETHER (p16): Do you have any comment on NHS England proposals that: CCGs and NHS providers be able to create joint decision-making committees (membership yet to be shared but only possibly including primary care representation) to support integrated care systems (ICSs); the nurse and secondary care doctor on CCG governing bodies be able to come from local providers; and that there should be greater flexibility for CCGs and NHS providers to make joint appointments covering commissioning and provision responsibilities?

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* 8. SHARED RESPONSIBILITY FOR THE NHS (p19): Do you have any comment on NHS England proposals that NHS commissioners and providers should have a shared duty to promote the ‘triple aim’ of better health for everyone, better care for all patients and to use NHS resources efficiently, as opposed to a quadruple aim including the wellbeing of staff?

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* 9. PLANNING OUR SERVICES TOGETHER (p20): Do you have any comment on NHS England proposals that it should be easier for NHS England and CCGs to work together to commission care, in the absence of details regarding the impact of such pooled budgets and which elements of primary care budgets might be affected.?

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* 10. JOINED-UP NATIONAL LEADERSHIP (p23): Do you have any comment on NHS England proposals that the Secretary of State should have power to transfer, or require delegation of, Arms Length Body (ALB) functions to other ALBs, and create new functions of ALBs, with appropriate safeguards?

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* 11. Would you be willing to discuss your answers?

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