Secretary of State power to direct NHS England
The Secretary of State had responsibility for ensuring that NHS England, Monitor and the TDA were effectively carrying out their functions and retained ultimate responsibility for securing provision of services through the exercise of their functions, through powers such as those to set objectives for commissioners (for example by setting the mandate under section 13A of the NHS Act 2006), and to intervene in the event of significant failure (under section 13Z2 of the NHS Act 2006).
	As explained above, the Act abolishes Monitor and the TDA and transfers their functions to NHS England. In recognition of the expanded powers and responsibilities of NHS England, the Act introduces an additional accountability mechanism to support the Secretary of State in his or her democratic oversight of NHS England.
	The Act amends the NHS Act 2006 by inserting new sections 13ZC, 13ZD, 13ZE, and 13ZF which provide the Secretary of State with powers to give directions to NHS England in relation to its functions. Such directions apply only to functions of NHS England and sit alongside the pre-existing accountability mechanisms and processes for ensuring NHS England fulfil its duties to promote a comprehensive health service. The Secretary of State will be able to use these powers to ensure that NHS England continues to work effectively with other parts of the system for which the Secretary of State has responsibility including social care and public health, to support integration and tackle broader priorities such as health inequalities.
	NHS England will remain an Arm’s Length Body and will therefore continue to exercise the majority of its functions as it does now. The Mandate will remain the primary mechanism through which the Secretary of State will set out the priorities that NHS England should be seeking to achieve. The Framework Agreement between DHSC and NHS England will continue to set the parameters within which NHS England should operate and how DHSC and NHS England will interact with each other. The power supplements these mechanisms by giving the Secretary of State the ability, where he or she deems it appropriate, to set direction and to intervene in relation to NHS England’s functions. Directions could be issued on specific matters or on a standing basis. This will be done in a transparent way. Any directions made by the Secretary of State on NHS England’s functions under section 13ZC must be made in the public interest, in writing, and published.