Power of Direction – Secretary of State public health functions
Section 7A of the NHS Act 2006 enables the making of arrangements for the delegated exercise of the Secretary of State’s public health functions by agreement.
	NHS England currently commissions a range of services, including national immunisation and screening programmes, under such a delegation as set out in an NHS Public Health Functions Agreement with the Secretary of State.
	However, the Secretary of State could not require NHS England, or any other NHS body, to take on a delegated public health function. This potentially could have exposed the Secretary of State to a position where they were to effectively deliver an aspect of his or her public health duties. The Act creates a power for the Secretary of State to require, via directions, NHS England (or an integrated care board) to discharge public health functions delegated by the Secretary of State.
	This is intended to provide for greater speed, agility, certainty and clarity to keep in step with challenges presented to public health, and to strengthen the Secretary of State’s ability to play the role in the system that Parliament expects.
	It is expected that the delegation of public health functions will continue to be on the basis of agreement in most circumstances. However, consistent with other changes in the Act, this bolsters the Secretary of State’s ability, via the flexibility of a direction making power, to ensure the system can respond rapidly to emerging issues as they arise, or where the additional clarity and certainty of directions is otherwise desirable. Power to give directions to NHS England as to the exercise of public health functions, once delegated, will be covered by the more general power of direction in new section 13ZC.
	To ensure transparency, the Secretary of State will need to publish any directions as soon as is practicable.