The Health and Social Care Act establishes a new super-regulator, bringing together the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission. It will also improve the regulation of healthcare professionals and introduce the Health in Pregnancy Grant of £190. The Act was passed after the House of Commons agreed to a number of amendments.
There was cross-party support for a measure to strengthen the protection of vulnerable people using residential care by ensuring that any independent sector care home that provides accommodation together with nursing or personal care on behalf of a local authority is subject to the Human Rights Act.
The Government also agreed to a duty on the new regulator to conduct periodic reviews of care commissioned by primary care trusts or local -authorities. The Care Quality Commission will take over all regulatory duties from the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission by April 2009. Cynthia Bower, chief executive of West Midlands SHA was announced as its first chief executive.
Care Quality Commission
The Act covers the setting up of the new regulator for health and social care to which it will bring a more integrated approach. It will have tougher powers, backed by fines, to inspect, investigate and intervene where hospitals or other healthcare facilities are failing to meet hygiene standards. The provisions include enabling legislation for the registration processes for organisations delivering services and for the registration on service managers. It also covers the enabling elements of a code of practice for healthcare associated infections
Professional Regulation
Change to standard of proof
This includes changes in the standard of proof in malpractice cases from a criminal to a civil standard. This will not mean that all cases are decided on the balance of probabilities; the standard of proof will be proportionate to the seriousness of the case. Striking off clinicians will be a final option that requires the strictest burden of proof.
Revaluation process
The Act will introduce a process of revalidating the professional registration of all doctors. This will occur every five years in a process that will involve an appraisal process to confirm they have met the standards expected.
Regulation of Social Workers
The Act also covers enabling legislation for the regulation of social workers including the training of approved mental health professionals
Public Health Protection
This section covers issues around detaining individuals on the basis of the risk of them infecting others, knowingly or unknowingly or spreading the results of contamination, not necessarily caused by infection alone. It allows justices of the peace to restrict movement of people or objects and isolate premises which are considered contaminated but stops short of enforced treatment for infected individuals.
Health in Pregnancy grant
This section enables the awarding of a grant to pregnant women to support their additional health needs in the last months of pregnancy. The award is linked to a requirement to seek maternal health advice from a health professional.
Miscellaneous Provisions
- A duty on PCTs to ensure that they have arrangements in place to monitor and improve the quality of care.
- The devolution of the global sum for pharmaceutical services to PCTs in England
- Extension of CNST to non NHS providers of NHS services
- Enabling legislation so that the parents of all children weighed and measured in the national child measurement programme will automatically received this information and that it can be used in anonymised form as part of the national reporting scheme. (Previously, parents could refuse permission for their children's information to be included in the anonymised data)
- The extension of the use of direct payments to people who lack mental capacity by paying this to a person who will manage it on the person's behalf.
- Redefinition of ordinary residence for the purposes of the National Assistance Act so that local authorities where a person is resident in a care setting now have financial responsibility for them.
- Setting up the statutory basis for the National Information Governance Board.
- Abolition of the National Biological Standards Board with movement of their powers to the Health Protection Agency.
