Mandate and financial directions to NHS England
Under Section 13A of the NHS Act 2006, the Secretary of State has a duty to lay in Parliament and publish a mandate to NHS England before the beginning of each new financial year. The mandate must include objectives that NHS England has a duty to seek to meet and must also specify the limits on capital and revenue resource use that the Secretary of State has set for the purposes of section 223D of the NHS Act 2006.
	The mandate may also set out the matters the Secretary of State will take into account when assessing progress against the objectives and may include requirements that NHS England must comply with in order to meet the objectives. Requirements in the mandate only have effect if regulations provide for them to do so.
	NHS England has a legal duty, under section 13T of NHS Act 2006, to set out in its business plan how it intends to meet objectives in the mandate. The Secretary of State also has a duty to keep NHS England’s performance against the mandate under review. Having considered NHS England’s own annual report, under section 13U of the NHS Act 2006, the Secretary of State must then lay in Parliament and publish an annual assessment of its overall performance during the financial year – including performance against the mandate.
	The mandate remains the primary statutory mechanism for government to set objectives and requirements for the new NHS England. However, this Act makes the mandate duty more flexible, so that a mandate can be revised at any time, ensuring there is always a mandate in place, and will remain in force until it is revised by a new mandate. This flexibility strengthens the ability of the mandate to set longer-term direction for the NHS, where appropriate, and ensure that each mandate can fully reflect the most up to date strategic priorities and associated government funding commitments for the NHS even where it is impractical for these to be determined in line with the annual financial cycle. Within this context, however, the mandate will continuously include objectives on cancer that are expressed in terms of outcomes, and these objectives will have a priority over other objectives in the mandate that relate specifically to cancer. There continues to be a legal duty, under section 13A(8) of the NHS Act 2006, for the Secretary of State to consult NHS England, Healthwatch England (representing patients) and any other persons that the Secretary of State considers appropriate before setting objectives in a mandate. Every mandate will also continue to be laid in Parliament. NHS England will not be required to revise its own business plan should the mandate be revised during the period the plan applies but will need to set out in its annual report the extent to which, in that year, it met any objectives or requirements specified in the mandate for the relevant year.
	The Secretary of State will continue, under section 13U of the NHS Act 2006, to have a duty to keep performance against the mandate under review and continue to lay in Parliament and publish an assessment of NHS England’s overall performance against any mandate in force on an annual basis.
	As a consequence of removing the statutory link between the mandate and the annual financial cycle, NHS England’s annual limits on capital and revenue resource use can be set through financial directions from the Secretary of State. Such directions will be published and laid in Parliament to ensure continued transparency to Parliament for the financial allocations within which NHS England is expected to deliver mandate objectives and requirements, as well as its wider functions. The Act requires NHS England to exercise its functions with a view to ensuring that, in respect of each financial year, it does not exceed such limits specified in a direction by the Secretary of State.