centre for public scrutiny

The Health and Social Care Act 2012 will bring about some significant changes to the way that health services are held to account. The bulk of the Act will come into force in April 2013.

Until 2013

Until this time, the powers for councils with social care responsibilities to hold NHS and social care services to account and to review matters relating to the health of local people remain unchanged. These powers are exercised by elected local authority councillors sitting on overview and scrutiny committees, while Local Involvement Networks (LINks) have other roles, such as the right to "enter and view" health facilities to inspect them on behalf of patients. LINks are designed to enable individuals and groups in communities to give their views about services in ways that suit them. Local councils have a duty to ensure that a LINk is established in their area through contractual arrangements with independent Host organisations that help to set up and support the LINk.

Alongside overview and scrutiny committees and LINks, NHS Foundation Trusts have elected public governors whose role is to influence the Board of Directors and the strategic direction of the Trust, providing a voice for the public membership of the Foundation Trust. There are also staff and partner governors to represent the views of a wide range of stakeholders in the direction of the Foundation Trust.

There are also non-executive Directors on FT Boards and the Boards of Primary Care Trusts and NHS Hospital Trusts who have a role to hold the executive Directors to account and contribute to the strategic direction of the Trust. In Foundation Trusts, non-executive Directors are appointed by the governors. In other Trusts, they are appointed by the independent Appointments Commission through a process of public advertisement and appointment.

Post 2013

From next April, Local Involvement Networks will be replaced by Local HealthWatch, a network of local bodies co-ordinated at national level by HealthWatch England. The Care Quality Commission will have an overarching responsibility for the activities of HealthWatch.

Health scrutiny powers will remain, although there will be some alterations to the mechanics of how it operates, and further regulations are expected to be laid in Parliament in autumn 2012.