New law puts children at the heart of NHS integrated care

The Health and Care Act 2022, given Royal Assent today, will fundamentally change the way services are planned and delivered by the NHS, local authorities, and other key agencies.

Following crucial government amendments in the House of Lords, the new law will put the needs of babies, children and young people at the heart of these reforms.

The changes to the Act have been spearheaded by the Children and Young People’s Health Policy Influencing Group (HPIG). Led by the National Children’s Bureau and Council for Disabled Children, HPIG is a membership organisation with over 70 leading voluntary organisations, Royal Colleges, and professional associations.  

Children must be a priority in the new NHS structures

The most significant change relates to the expectations of the 42 Integrated Care Boards (ICBs) that are replacing Clinical Commissioning Groups across the country from 1 July. Following a powerful intervention by members of the House of Lord, ICBs will now be required by the Act to set out the steps it will take to address the needs of children and young people under the age of 25 in their five-year forward plans. Children and young people are one of only two groups singled out by the primary legislation in this way.

Further positive changes include new statutory guidance, being produced by NHS England, that will require ICBs to nominate an executive children’s lead, responsible for ensuring the ICB sets out clearly the steps it will take to address the needs of those aged 0-25. ICBs will be required to consult with local leaders as they draw up their plans, and they should closely involve children and families themselves.

Finally, and crucially, ICBs will also be required to report annually on how well they are delivering their duty to safeguard children. This is one of the single most important responsibilities that they hold and it will have to be delegated to an executive lead, as ICBs will be lead partners in local child safeguarding arrangements, together with the police and local authorities.

Taken together, we believe these steps will put the needs of babies, children and young people at the heart of integrated health and care services.

Steps to improve information sharing to better support children and keep them safe

In response to the work of the Health Policy Influencing Group and members of the House of Lords, the government has acknowledged the serious challenges with sharing relevant information about children. It has equally recognised the potential benefits of a single consistent identifier that would bring together disparate records about an individual child.

To address this, an amendment was made to the Act that will require the government to lay a report before Parliament within a year setting out:

  • The Government’s policy on a consistent identifier for children and its approach to improving information sharing more generally;
  • How this can be achieved across health, children’s social care, police, and education settings; and
  • The cross-government actions that will be taken to implement the policy set out in the report.

We warmly welcome the government’s commitment and will work with the Department for Education, Department for Health and Social Care and other departments to support this work.

Next steps

The changes set out in the Health and Care Act are taking place at a time of major policy change for children. The rollout of Family Hubs and the Start for Life vision, proposals in the SEND green paper, and the Independent Review of Children’s Social Care, will all rely on strong multi-agency working. There will be a huge job to link these pieces of work together and provide a consistent narrative to emerging local systems.

But for the moment, we should take time to thank all those who helped make this legislation possible and we look forward to working closely with colleagues across the children’s sector and government on the guidance that will inform effective implementation of the Health and Care Act 2022.