October 2015 ushers in more changes across NHS


Just six months after a raft of new arrangements for health and care services in England came into effect, 1 October saw the introduction of a few more.

Here we provide a comprehensive list of what they are and where to find further information and guidance.


Nursing agency spend

Annual ceilings on the amount individual trusts can spend on nursing agency staff came into effect, following new rules introduced by Monitor and the NHS Trust Development Authority (TDA) in September.

From 19 October 2015, trusts subject to this agency spending rule will also have to secure nursing agency staff via framework agreements approved by Monitor and TDA.

Information: Access Nursing agency rules from Monitor’s website.

Guidance: Visit NHS Employers’ agency workers web pages for practical advice on reducing agency spend.

Public health


Public health commissioning responsibilities for children aged 0-5, including the health visitor service, have now transferred from NHS England to local authorities. Funding for the 0-5 budget will sit within the overall ring-fenced public health budget. 

Information: Discover more about this on the NHS England website.

To note: Our representation to the Treasury calls for the government to reverse cuts to the public health grant and protect spending on public health and prevention. Discover more.

Tobacco, e-cigarettes and smoking

It is now illegal for retailers to sell e-cigarettes or e-liquids to someone under 18; for adults to buy (or try to buy) tobacco products or e-cigarettes for someone under 18; to smoke in private vehicles carrying someone under 18.

Information: Find out more about changes to the law on the Department of Health website.


Female genital mutilation

GPs and mental health trusts are now required to record incidences of female genital mutilation (FGM), following the introduction on the Female Genital Mutilation Enhanced Data set. Collection and submission of the new data set became mandatory for all acute trusts on 1 July 2015.

Information: Head to the Health and Social Care Information Centre's website for everything you need to know.

FGM mandatory reporting duty

From 31 October 2015, healthcare professionals must report to the police any cases of FGM in girls under 18 that they come across in their work.

Guidance: Resources explaining healthcare professionals' duty can be found on the Department of Health website.

Coordinated care

NHS number

The Health and Social Care (Safety and Quality) Act 2015 imposes new duties to use the NHS number as a consistent identifier and share information with other organisations directly involved in a patient’s care and treatment. These new regulations came into force on 1 October 2015.

Information: Further details can be found in the NHS Standard Contract 2015/16.

Waiting times

Referral to treatment

The updated referral to treatment (RTT) consultant-led waiting times rules suit take effect, reflecting that there will be no provision to pause or suspend an RTT waiting time clock under any circumstances. The new rules are ushered in by the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) (No.2) Regulations 2015.

Information and guidance: Visit NHS England's website to access the updated RTT Rules Suite.

Primary care

GMS contract 2015/16

The global sum payment per weighted patient, under the general medical services contract 2015/16, will increase from today to reflect the reduction in seniority payments and reinvestment of funding into GMS global sum. The global sum covers the costs of running a general practice, including some essential GP services.

Information: Head to NHS Employers' general medical services web section for all you need to know.


Electronic discharge summaries

Discharge summaries are now to be provided only by secure email or electronic transfer, rather than  secure fax. This requirement will apply to all NHS trusts, foundation trusts all acute providers.

Guidance: Comprehensive guidance can be found on NHS England's website.

SMS services

Local general practices or other clinical service providers assume responsibility for procuring SMS services. The cost of this service will be the clinical service provider’s responsibility. This follows the Department of Health's withdrawal of central funding for NHSmail SMS and fax services for all organisations on 31 March 2015. 

Between April and September 2015, NHS England supported a replacement SMS service for primary care organisations using the current NHSmail SMS service.

Information: Further information can be found on NHS England's website, alongside a set of FAQs.

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