Section 75 arrangements: an opportunity to boost integration

The Department of Health and Social Care has launched a consultation on the use of section 75 of the NHS Act 2006 which enables NHS bodies and local authorities to enter into partnership arrangements to deliver integrated health and social care services.

Section 75 arrangements provide the legal mechanism for pooling budgets and combining resources between the NHS (NHS England, Integrated Care Boards and NHS trusts and foundation trusts) and local authorities to carry out health and care related functions.

Widening the scope of functions and organisations

The consultation specifically considers widening the scope of section 75 to include previously excluded functions, such as the full range of primary care services and expanding the scope of the organisations that can be part of section 75 arrangements to include social care providers, voluntary, community, faith, and social enterprise (VCFSE) providers and wider providers such as housing providers.

The expansion of section 75 arrangements was one of recommendations made by the Hewitt review under the theme of simplifying and broadening delegation and pooled budget arrangements. It was also a commitment made in 2022 in the DHSC’s Integration white paper to simplify integrated commissioning along with pooling and aligning budgets to support more joined-up care that wraps around patient needs.

The consultation

Specifically, the DHSC is seeking views on five areas:

  • whether the scope of section 75 should be widened to include additional health-related functions of local authorities and NHS bodies
  • whether the scope of section 75 should be widened to include additional public health functions delegated to local authorities and NHS bodies by the Secretary of State
  • whether it should consider widening the scope of organisations that can enter into arrangements under section 75
  • any perceived barriers to pooling of budgets, and consider whether and if so, how the provisions within the regulations could be simplified to facilitate easier use and reduce the administrative burden on NHS bodies and local authorities
  • how it could strengthen and/or simplify the governance of section 75 arrangements to further support the commissioning of integrated care services

You can respond to the consultation here and by 31 October when it closes.

More partnership working

The expansion of the arrangements possible under section 75 would be a key enabler to integrating health and social care. The inclusion of public health services could take this even further and provide a mechanism for contracting for prevention and population health (as opposed to illness).

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