[^key-1ed6bb140516fad71f8355f9d04b8c06]: Pt. 3 Ch. 4 (ss. 114A-114F) substituted for Pt. 3 Ch. 4 (ss. 115-127) (1.7.2022 but only for the insertion of ss. 114C, 114D for specified purposes, 1.4.2023 in so far as not already in force) by Health and Care Act 2022 (c. 31), s. 186(6), Sch. 10 para. 3; S.I. 2022/734, reg. 2(b) (with regs. 13, 29, 30); S.I. 2023/371, reg. 2(d)

[^key-319af3f4bf3b34b45845cd10ef0d8895]: S. 304(5)(g) substituted (1.7.2022 for specified purposes, 1.4.2023 in so far as not already in force) by Health and Care Act 2022 (c. 31), s. 186(6), Sch. 10 para. 4; S.I. 2022/734, reg. 2(b) (with regs. 13, 29, 30); S.I. 2023/371, reg. 2(d)

[^key-afed82ca7a0a2a837e13d2a2732946fe]: S. 87A inserted (1.4.2023) by Health and Care Act 2022 (c. 31), ss. 51(2), 186(6); S.I. 2023/371, reg. 2(c)

[^key-a3969e73605e557bc59561fd7586cfdf]: S. 296A inserted (1.4.2023) by The Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023 (S.I. 2023/368), reg. 1(2), Sch. 1 para. 12(3) (with reg. 7)

[^key-74efb1f518ff9c30d058444043f0a303]: S. 290(3)(ca) omitted (1.4.2023) by virtue of The Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023 (S.I. 2023/368), reg. 1(2), Sch. 1 para. 12(2) (with reg. 7)

[^key-b377a07c37aec5cb63bd3b748bb3ebd1]: S. 54 omitted (1.10.2023) by virtue of Health and Care Act 2022 (c. 31), ss. 169(6), 186(6); S.I. 2023/1035, reg. 2(b)

[^key-ced1d83d3dca245683d839d4f5deddee]: Sch. 9 omitted (1.1.2024) by virtue of Health and Care Act 2022 (c. 31), ss. 80(2), 186(6); S.I. 2023/1431, reg. 3(c) (with reg. 5)

[^key-02c3693b4d8d52bfe9fe722de9e2ac08]: Ss. 75-78 omitted (1.1.2024) by virtue of Health and Care Act 2022 (c. 31), ss. 80(2), 186(6); S.I. 2023/1431, reg. 3(c) (with reg. 5)

[^key-a801d651e613ebc66855d10596be0fad]: Act: power to amend conferred (24.5.2024 for specified purposes, 1.1.2025 in so far as not already in force) by Digital Markets, Competition and Consumers Act 2024 (c. 13), ss. 138(2)-(7), 339(2)(c); S.I. 2024/1226, regs. 1(2), 2(1)(2) (with Sch. para. 10, 20)

[^M_F_d10edacd-2859-41dc-d4cf-6cf6c74d1c67]: S 251ZA cross-heading inserted (19.6.2025 for specified purposes) by Data (Use and Access) Act 2025 (c. 18), s. 142(1)(2)(h), Sch. 15 para. 6

[^key-e0d6fd2cacb4682f0cc57a1b527fb4a8]: Ss. 251ZB-251ZE and cross-heading inserted (19.6.2025 for specified purposes, 5.2.2026 in so far as not already in force) by Data (Use and Access) Act 2025 (c. 18), s. 142(1)(2)(h), Sch. 15 para. 8; S.I. 2026/82, reg. 2(z15)

[^key-347aaabf96d8ca6d09b53e5f63e51810]: Ss. 251, 251ZA substituted for s. 251 (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(3), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-919cace9f83248d5852edfd63b7feb23]: S. 250(2)-(2B) substituted for s. 250(2) (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(2)(a), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-0ab56517908468c5c1f4380bee2666e0]: S. 250(6)-(6D) substituted for s. 250(6) (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(2)(d), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-96cd9116e6551879fa43ae49a688509e]: Word in s. 250(3) substituted (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(2)(b), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-719efca3a6ee56a1e8eb7548e41425d6]: S. 250(5) omitted (7.7.2025) by virtue of Health and Care Act 2022 (c. 31), ss. 95(2)(c), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-e76bb049b4300d0e81854fc8b28391b5]: Words in s. 250(7) inserted (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(2)(e)(i), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-d2a447a55e8409ee1d229007134e8f72]: Words in s. 250(7) omitted (7.7.2025) by virtue of Health and Care Act 2022 (c. 31), ss. 95(2)(e)(ii), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-ec00b1ac1156899053d0a22de3003b9b]: S. 251C(6A) inserted (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(4)(a), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-77f86a682c93395afa5c490fabb04634]: S. 251C(7) substituted (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(4)(b), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^key-c17aa212a9ae322843cb3dd93d11dee0]: S. 304(5)(ja) inserted (7.7.2025) by Health and Care Act 2022 (c. 31), ss. 95(5), 186(6); S.I. 2025/807, reg. 2 (with reg. 3)

[^M_F_f222c31c-0daa-457a-f386-3a0f0da3714d]: Words in s. 253(3) substituted (1.2.2023 for specified purposes) by The Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023 (S.I. 2023/98), reg. 1(2)(3), Sch. para. 17(5)(e) (with reg. 3)

Secretary of State's duty to promote comprehensive health service

Power of clinical commissioning groups as to commissioning certain health services

Financial arrangements for the Board

Fluoridation of water supplies: transitional provision

New Special Health Authorities

Co-operation with bodies exercising functions in relation to public health

Voting

Acquisitions

Procedure etc.

Requests, rights of entry and referrals

Amendments consequential on section 190

Persons eligible to enter into general dental services contracts

Control of entry on pharmaceutical lists

Additional functions

Special notices of births and deaths

Provision of information by Registrar General: Wales

Power to make consequential provision

Arrangements between the Board and Northern Ireland Ministers

Provision of statistical information by Statistics Board

Financial provision

262A

In exercising any function ... of publishing or otherwise disseminating information obtained in connection with the exercise of its relevant data functions, NHS England must have regard to any advice given to it by the committee appointed by the Health Research Authority under paragraph 8(1) of Schedule 7 to the Care Act 2014 (committee to advise in connection with information dissemination etc).

CHAPTER 1A — Continuity of Information

251A

(1) The Secretary of State must by regulations specify a description of consistent identifier for the purposes of this section.

(2) “Consistent identifier” means any identifier (such as, for example, a number or code used for identification purposes) that—

(a) relates to an individual, and

(b) forms part of a set of similar identifiers that is of general application.

(3) Subsection (4) applies if—

(a) a relevant health or adult social care commissioner or provider (“the relevant person”) processes information about an individual, and

(b) the individual is one to whom a consistent identifier of the description specified under subsection (1) relates.

(4) If this subsection applies the relevant person must include the consistent identifier in the information processed (but this is subject to subsections (5) to (8)).

(5) Subsection (4) applies only so far as the relevant person considers that the inclusion is—

(a) likely to facilitate the provision to the individual of health services or adult social care in England, and

(b) in the individual's best interests.

(6) The relevant person need not comply with subsection (4) if the relevant person reasonably considers that one or more of the following criteria apply—

(a) the relevant person does not know the consistent identifier and is not reasonably able to learn it;

(b) the individual objects, or would be likely to object, to the inclusion of the consistent identifier in the information;

(c) the information concerns, or is connected with, the provision of health services or adult social care by an anonymous access provider;

(d) for any other reason the relevant person is not reasonably able, or should not be required, to comply with subsection (4).

(7) This section does not permit the relevant person to do anything which, but for this section, would be inconsistent with—

(a) any provision of the data protection legislation, or

(b) a common law duty of care or confidence.

(8) This section does not require the relevant person to do anything which the relevant person is required to do by or under provision included in a contract by virtue of any provision of the National Health Service Act 2006 (and, accordingly, any such requirement is to be treated as arising under the contract, and not under this section).

(9) In this section, “the data protection legislation” has the same meaning as in the Data Protection Act 2018 (see section 3 of that Act).

251C

(1) This section applies for the purposes of sections 251A and 251B and this section.

(2) “Relevant health or adult social care commissioner or provider” means—

(a) any public body so far as it exercises functions in connection with the provision of health services, or of adult social care in England, and

(b) any person (other than a public body) so far as the person provides such services or care—

(i) pursuant to arrangements made with a public body exercising functions in connection with the provision of the services or care, and

(ii) otherwise than as a member or officer of a body or an employee of a person,

but this is subject to subsection (3).

(3) The Secretary of State may by regulations provide for a person to be excluded from the definition of “relevant health or adult social care commissioner or provider”, whether generally or in particular cases.

(4) Regulations under subsection (3) may, in particular, provide for a person to be excluded in relation to the exercise of particular functions or the exercise of functions in relation to particular descriptions of person, premises or institution.

(5) A reference to an inclusion or a disclosure being likely to facilitate the provision to an individual of health services or adult social care in England is to its being likely to facilitate that provision directly (rather than by means of a clinical trial, a study, an audit, or any other indirect means).

(6) “Anonymous access provider” means a relevant health or adult social care commissioner or provider (whether “the relevant person” under section 251A(3)(a) or 251B(1) or another person) whose services or care are, or may be, received by individuals anonymously due to the nature of the services or care.

(6A) “Health services” means services which must or may be provided as part of the health service in England; and for that purpose “the health service” has the same meaning as in the National Health Service Act 2006 (see section 275(1) of that Act).

(7) “Adult social care” and “public body” have the same meaning as in section 250; and “processes” and “processed” are to be read in accordance with the meaning of “processing” in that section.

Regulations, orders and directions

Power to make consequential provision

251B

(1) This section applies in relation to information about an individual that is held by a relevant health or adult social care commissioner or provider (“the relevant person”).

(2) The relevant person must ensure that the information is disclosed to—

(a) persons working for the relevant person, and

(b) any other relevant health or adult social care commissioner or provider with whom the relevant person communicates about the individual,

but this is subject to subsections (3) to (6).

(3) Subsection (2) applies only so far as the relevant person considers that the disclosure is—

(a) likely to facilitate the provision to the individual of health services or adult social care in England, and

(b) in the individual's best interests.

(4) The relevant person need not comply with subsection (2) if the relevant person reasonably considers that one or more of the following apply—

(a) the individual objects, or would be likely to object, to the disclosure of the information;

(b) the information concerns, or is connected with, the provision of health services or adult social care by an anonymous access provider;

(c) for any other reason the relevant person is not reasonably able, or should not be required, to comply with subsection (2).

(5) This section does not permit the relevant person to do anything which, but for this section, would be inconsistent with—

(a) any provision of the data protection legislation, or

(b) a common law duty of care or confidence.

(6) This section does not require the relevant person to do anything which the relevant person is required to do under a common law duty of care (and, accordingly, any such requirement is to be treated as arising under that common law duty and not under this section).

(7) In this section, “the data protection legislation” has the same meaning as in the Data Protection Act 2018 (see section 3 of that Act).

The Alcohol Education and Research Council

Financial provision

Commencement: consultation with Scottish Ministers

Short title

The NHS payment scheme

114A

(1) NHS England must publish a document, to be known as “the NHS payment scheme”, containing rules for determining the price that is to be payable by a commissioner—

(a) for the provision of health care services for the purposes of the NHS;

(b) for the provision of services in pursuance of arrangements made by NHS England or an integrated care board in the exercise of any public health functions of the Secretary of State, within the meaning of the National Health Service Act 2006, by virtue of any provision of that Act.

(2) The commissioner and the provider of services mentioned in subsection (1) must comply with rules under that subsection.

(3) Rules under subsection (1) may, in particular—

(a) specify prices;

(b) specify amounts, formulae or other matters on the basis of which prices are to be determined;

(d) make different provision for different services or provision for some services but not others;

(e) make different provision for the same service by reference to different circumstances or areas, different descriptions of provider, or other factors relevant to the provision of the service or the arrangements for its provision;

(f) confer a discretion on the commissioner of a service or on NHS England.

(4) Rules under subsection (1) may allow or require a price to be agreed between the commissioner and the provider of a service.

(5) Rules made by virtue of subsection (4) may—

(a) make provision about how the price is to be agreed;

(b) allow the agreement to make any provision that could be made by rules by virtue of subsection (3);

(c) provide for the publication by the commissioner, the provider or NHS England of information relevant to the agreement.

(6) For the purpose of securing that the prices payable for the provision of services mentioned in subsection (1)(a) or (b) result in a fair level of pay for providers of those services, NHS England must, in exercising functions under subsection (1), have regard to—

(a) differences in the costs incurred in providing those services to persons of different descriptions, and

(b) differences between providers with respect to the range of those services that they provide.

(7) The NHS payment scheme may contain rules relating to the making of payments to the provider of a service for the provision of that service.

(8) The NHS payment scheme may contain guidance as to the application of rules under subsection (1).

(9) A commissioner of a service mentioned in subsection (1) must have regard to any such guidance.

(10) The NHS payment scheme has effect for the period specified in the NHS payment scheme or, where a new edition of the NHS payment scheme takes effect before the end of that period, until that new edition takes effect.

The NHS payment scheme: enforcement

114B

Where the commissioner of a service fails to comply with rules contained in the NHS payment scheme, NHS England may direct the commissioner to take steps specified in the direction, within a period specified in the direction—

(a) to secure that the failure does not continue or recur, or

(b) to secure that the position is (so far as practicable) restored to what it would have been if the failure was not occurring or had not occurred.

The NHS payment scheme: impact assessment and consultation

114C

(1) Before publishing the NHS payment scheme, NHS England must—

(a) carry out an assessment of the likely impact of the proposed scheme, or

(b) publish a statement setting out its reasons for concluding that such assessment is not needed.

(2) Before publishing the NHS payment scheme, NHS England must consult the following—

(a) each integrated care board;

(b) each relevant provider;

(3) NHS England must give those persons a notice—

(a) describing the proposed NHS payment scheme,

(b) setting out any impact assessment carried out under subsection (1)(a), and

(c) specifying when the period within which representations may be made about the proposed NHS payment scheme (“the consultation period”) will come to an end.

(4) The consultation period is the period of 28 days beginning with the day after that on which the notice is published.

(5) NHS England must publish the notice given under subsection (3).

(6) If, having consulted under this section—

(a) NHS England decides to make amendments of the proposed NHS payment scheme that are, in its opinion, significant, and

(b) it would, in NHS England’s opinion, be unfair to make the amendments without further consultation,

NHS England must consult again under this section.

(7) Subsection (6) does not apply where section 114D applies.

(8) In this section “relevant provider” means—

(a) a licence holder, or

(b) another person, of a prescribed description, that provides—

(i) health care services for the purposes of the NHS, or

(ii) services in pursuance of arrangements made by NHS England or an integrated care board by virtue of section 7A or 7B of the National Health Service Act 2006 (Secretary of State’s public health functions).

Objections to proposed NHS payment scheme

114D

(1) This section applies where—

(a) within the consultation period under section 114C, NHS England receives objections to the proposed NHS payment scheme from one or more integrated care boards or relevant providers, and

(b) either or both of the following apply—

(i) the objection percentage for integrated care boards exceeds the prescribed percentage;

(ii) the objection percentage for relevant providers exceeds the prescribed percentage.

(2) In subsection (1)(b) the “objection percentage” is the proportion (expressed as a percentage) of integrated care boards or (as the case may be) relevant providers that objected.

(3) NHS England must consult such persons as appear to NHS England to be representative of the integrated care boards or relevant providers from whom objections were received.

(4) If, having complied with subsection (3)—

(a) NHS England decides to make amendments of the proposed NHS payment scheme that are, in its opinion, significant, and

(b) it would, in NHS England’s opinion, be unfair to make the amendments without further consultation,

NHS England must consult again under section 114C.

(5) If, having complied with subsection (3), NHS England decides not to amend the proposed NHS payment scheme, it may publish the scheme but, before doing so, must—

(a) publish a notice stating that decision and setting out the reasons for it, and

(b) send a copy of the notice to—

(i) the persons consulted under subsection (3), and

(ii) the integrated care boards or relevant providers from whom objections were received.

114E

(1) NHS England may amend the NHS payment scheme during the period for which it has effect, provided that, in the opinion of NHS England, the amendments are not so significant as to require publication of a new edition of the NHS payment scheme.

(2) In deciding whether the amendments are so significant as to require the publication of a new edition of the NHS payment scheme, NHS England must have regard to—

(a) the proportion of integrated care boards that would be affected by the proposed amendments;

(b) the proportion of relevant providers that would be affected by the proposed amendments;

(c) the impact that the proposed amendments would have on integrated care boards and relevant providers that would be affected by them;

(d) whether any integrated care boards or relevant providers would be disproportionately affected by the proposed amendments;

(e) the amount of any increase or decrease in prices that would result from the proposed amendments.

(3) If NHS England amends the NHS payment scheme, it must publish the NHS payment scheme as amended.

(4) Before amending the NHS payment scheme, NHS England must, in accordance with subsections (5) to (7), consult the following about the proposed amendments—

(a) any integrated care boards that would be affected by the proposed amendments;

(b) any relevant providers that would be affected by the proposed amendments;

(5) NHS England must publish a notice specifying—

(a) the proposed amendments, and

(b) when the period within which representations may be made about the proposed amendments (“the consultation period”) will come to an end.

(6) The consultation period is the period of 28 days beginning with the day after that on which the notice is published.

(7) NHS England must send a copy of the notice to each of the persons to be consulted under subsection (4).

Interpretation

114F

In this Chapter—

“commissioner”, in relation to a service, means the person who arranges for the provision of the service;

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Health and Social Care Act 2012

Secretary of State's duty to promote comprehensive health service

Power of clinical commissioning groups as to commissioning certain health services

Financial arrangements for the Board

Fluoridation of water supplies: transitional provision

New Special Health Authorities

Co-operation with bodies exercising functions in relation to public health

Voting

Acquisitions

Procedure etc.

Requests, rights of entry and referrals

Requests, rights of entry and referrals

Amendments consequential on section 190

Persons eligible to enter into general dental services contracts

Control of entry on pharmaceutical lists

Power to regulate social workers etc. in England

Additional functions

Special notices of births and deaths

Provision of information by Registrar General: Wales

Provision of information by Registrar General: Wales

Power to make consequential provision

Arrangements between the Board and Northern Ireland Ministers

Provision of statistical information by Statistics Board

Financial provision

Financial provision

262A

CHAPTER 1A — Continuity of Information

251A

251C

Regulations, orders and directions

Power to make consequential provision

251B

The Alcohol Education and Research Council

Financial provision

Commencement: consultation with Scottish Ministers

Short title

The NHS payment scheme

114A

The NHS payment scheme: enforcement

114B

The NHS payment scheme: impact assessment and consultation

114C

Objections to proposed NHS payment scheme

114D

114E

Interpretation

114F