Part 1: Health Service in England: Integration, Collaboration and Other Changes NHS Trusts Section 52: NHS Trusts: wider effect of decisions
This provision, which is inserted into the NHS Act 2006 as the new section 26A, sets out a new duty on English NHS Trusts, which also applies to the other "relevant bodies". The "relevant bodies" are integrated care boards (new section 14Z43), NHS England (new section 13NA) and NHS Foundation Trusts (new section 63A).
	This duty has been described operationally as the "triple aim" duty.
	The duty applies to NHS Trusts established under section 25 of the NHS Act 2006, the effect of which is that it only applies to NHS Trusts in England, and not Wales.
	Subsection (1) provides that Trusts will be under a duty, in making a decision about the carrying out of their functions, to have regard to all likely effects of their decisions on three areas: the health and well-being of the people of England (paragraph (a)), the quality of services provided or arranged by relevant bodies (paragraph (b)) and the efficiency and sustainability of resources used by the relevant bodies (paragraph (c)).
	The reference in the subsection to "all" likely effects means that Trusts will have to consider, under paragraphs (b) and (c), the effects of the decision both on its own quality of services and resource use and those of other relevant bodies.
	Subsection (2) excludes decisions relating to services provided to a particular individual (e.g. individual clinical decisions or highly specialist commissioning decisions concerning an individual patient) from this duty. Under subsections (b) and (c), it also specifies that when complying with the Triple Aim duty, the relevant bodies must consider inequalities in health and well-being and the benefits obtained from services when considering the effects of their decisions on the areas in subsections (1)(a) and (b).
	Subsection (3) provides that Trusts must have regard to guidance on the discharge of this duty published by NHS England (under section 13NB).