Organisation objective

• Governance
• Statutory item

Executive summary

This paper is for the Board’s information only, to provide an overview of the All Age Continuing Care Directions 2024 (Directions) issued to NHS England in August 2024 by the Secretary of State for Health and Social Care. These Directions have been issued under section 254(1) and 304(9), (10) and (12) of the Health and Social Care Act 2012 (the 2012 Act) and sections 13ZC and 272(7) and (8) of the National Health Service Act 2006 (the 2006 Act).

The purpose of the Directions (Purpose) is to require NHS England to establish an All Age Continuing Care (AACC) information system to collect and analyse data regarding the end-to-end commissioning of AACC services provided to children, young people and adults. This includes the initial checklist through to assessment, and the commissioning and monitoring of individual care packages, regular and ad-hoc care packages and eligibility reviews, and eligibility disputes (the AACC data set).

These Directions revoke and replace the NHS Continuing Health Care Data Set collected under the NHS Continuing Healthcare Directions 2022

Action required

The Board is asked to note the new Directions and the information provided in this Paper regarding their purpose, effect, and requirements.

Background

1. Under section 254 of the 2012 Act, the Secretary of State (SoS) may direct NHS England to establish and operate a system for the collection or analysis of information. These are functions exercisable in relation to the development or operation of information systems in connection with the provision of health services or of adult social care in England. Under section 13ZC of the 2006 Act, the SoS may give NHS England directions as to the exercise of any of its functions. The Directions are issued by the SoS to NHS England under these provisions and are functions which have been transferred to NHS England from NHS Digital under the Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.

Purpose of the Direction

2. The purpose of these Directions is to require NHS England to establish an All Age Continuing Care (AACC) information system to collect and analyse data regarding the end-to-end commissioning of AACC services provided to children, young people and adults. This includes the initial checklist through to assessment, and the commissioning and monitoring of individual care packages, regular and ad-hoc care packages and eligibility reviews, and eligibility disputes (referred to as the AACC data set).

3. The AACC data set is a patient level, output based, secondary uses data set which aims to deliver robust, comprehensive, nationally consistent and comparable person-based information for children, young people and adults who are in contact with continuing care services, as defined in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care and The National Framework for Children and Young People’s Continuing Care. The AACC data will be collected from Integrated Care Boards in England and/or their system suppliers (ICB’s.)

4. As a secondary uses data set it intends to re-use operational and financial data and is used to inform service improvements and monitor service performance, patient experience, and outcomes.

5. The Directions revoke and replace the NHS Continuing Health Care Data Set (the CHC data set) collected under the NHS Continuing Healthcare Directions 2022* and which applied to persons aged 18 or over only. The AACC data set has been expanded to include the data of patients under the age of 18 who are receiving continuing care under the National Framework for Children and Young People’s Continuing Care. The CHC data set will continue to be collected under the Directions until the AACC data set collection is opened in April 2025

Effect and requirements of the Direction

6. From 16 August 2024, the date of signature of the Directions, NHS England has a legal duty to comply with the Directions, which require it to establish and operate such systems for the collection and analysis of information as set out in, and in accordance with the accompanying Requirements Specfication. This includes linkage to other data lawfully held by NHS England as described in the Requirements Specifications and such other analysis as the SoS may require or as NHS England determines is necessary, to achieve the Purpose.

7. These functions are to be exercised in accordance with the Requirements Specifications. Also in accordance with the service levels, support and monitoring requirements, and the reporting and governance requirements notified by the SoS in writing to NHS England. The exercise by NHS England of the functions set out in the Directions is also subject to the statutory guidance issued by the SoS to NHS England under section 274A of the 2012 Act: NHS England’s protection of patient data, 23 May 2023. This is guidance that NHS England has a duty to have regard to when discharging its functions under these Directions.

Approval of acceptance of Directions and publication

8. The National Director of Transformation and National Medical Director approved acceptance of the Directions on behalf of the Accounting Officer as set out in the NHS England Scheme of Delegation. The Directions have been published on the NHS England website.

Annex 1

• All Age Continuing Care Directions 2024
• All Age Continuing Care Directions 2024 Requirements Specification

* NHS Continuing Healthcare Directions 2022. The Directions were given by NHS England to the Health and Social Care Information Centre (NHS Digital) on 9 March 2022. NHS Digital was abolished, and its functions transferred to NHS England, with effect from 1 February 2023, by the Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023 (S.I. 2023/98). By virtue of regulation 3(1), the Directions are treated as if contained in a direction given by the Secretary of State to NHS England.

Publication reference: public board paper (BM/24/38(Pu)