What Legislation Relates to Health and Social Care?

Health and social care services in the UK operate within a framework defined by numerous laws. These Acts and Regulations guide how care is provided, ensure safety standards are met, and protect the rights of people using services. For anyone working in or interacting with the sector, having a grasp of this legal background is necessary for providing safe, ethical, and lawful care.

This body of law covers a vast range of activities. It sets out how services like hospitals and care homes are regulated to maintain quality. It defines procedures for handling sensitive personal information to protect confidentiality. Specific laws address workplace safety, the rights of individuals who may lack capacity to make decisions, and the management of medicines. Other legislation focuses on equality, safeguarding vulnerable groups, and the specific needs of children or those with conditions like autism.

The laws establish responsibilities for different organisations, from NHS bodies and local authorities to individual care providers. They also outline the rights individuals have when receiving care and support, such as the right to be treated with dignity, the right to consent to treatment, and the right to safe care. This guide will explore some of the key pieces of legislation that shape the delivery of health and social care across the United Kingdom, providing insight into the rules that govern this important sector.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

This law is central to how health and adult social care services are regulated in England. It sets out the fundamental standards of quality and safety that providers must meet. The Care Quality Commission (CQC) uses these standards to check services. The CQC is the independent regulator of health and adult social care in England.

The regulations cover aspects like:

• Person-centred care: Treatment and care should meet individual needs and preferences. People using services should be involved in decisions about their care.
• Dignity and respect: People must be treated with dignity and respect at all times.
• Consent: Care and treatment can only be given with valid consent. Providers must follow the Mental Capacity Act 2005 if someone lacks capacity to consent.
• Safety: People must be protected from abuse and avoidable harm. Providers need systems to assess risks and keep people safe.
• Safeguarding: Providers must have procedures to protect people from abuse and neglect. This involves working with local authorities on safeguarding matters.
• Food and drink: People must have enough to eat and drink to stay healthy.
• Premises and equipment: The places where care is provided must be clean, suitable, and properly maintained. Equipment must be safe and used correctly.
• Complaints: Providers must have an effective system for handling complaints. People should know how to complain, and complaints should be investigated properly.
• Good governance: Providers must have systems to check the quality and safety of care. They need to manage risks effectively and learn when things go wrong.
• Staffing: Providers must have enough suitably qualified, competent, and experienced staff to meet people’s needs. Staff must receive appropriate support and training.
• Fit and proper persons: Individuals directing or providing regulated services must be fit and proper to do so. This includes checks on character and competence.
• Duty of candour: Providers must be open and honest when something goes wrong with care or treatment that causes harm.

The CQC inspects providers against these standards. It has powers to take action if providers fail to meet them. Actions can range from issuing warning notices to prosecution or closing a service.

The Care Act 2014

This Act reformed the law relating to adult social care in England. It brought together different pieces of older legislation into a single framework. It focuses on wellbeing and meeting needs.

Key parts of the Care Act include:

• Promoting wellbeing: Local authorities have a general duty to promote individual wellbeing when carrying out their care and support functions. Wellbeing includes aspects like personal dignity, physical health, mental health, protection from abuse, control over day-to-day life, participation in work or education, social relationships, and suitable accommodation.
• Assessment: Local authorities must assess anyone who appears to need care and support, regardless of their income or eligibility for state-funded care. Assessments must consider the person’s needs, desired outcomes, and impact on wellbeing. Carers also have rights to assessment.
• National eligibility criteria: The Act introduced a national minimum threshold for eligibility for care and support. Local authorities must meet needs that reach this threshold. Needs are eligible if they arise from a physical or mental impairment or illness and mean the adult cannot achieve specified outcomes (like managing nutrition or maintaining personal hygiene), which affects their wellbeing.
• Care planning: If someone is eligible for support, the local authority must work with them to create a care and support plan. This plan sets out the needs identified and how they will be met. People have a right to a personal budget, showing the cost of their care and allowing them more control over how it is spent.
• Safeguarding adults: The Act placed adult safeguarding on a statutory footing for the first time. It requires local authorities to make enquiries if they suspect an adult with care needs is experiencing, or at risk of, abuse or neglect. It sets up Safeguarding Adults Boards (SABs) in each local authority area to coordinate safeguarding work.
• Integration and cooperation: The Act contains duties for local authorities and other bodies, like the NHS, to cooperate to promote wellbeing and integrate services.
• Information and advice: Local authorities must provide information and advice about care and support services in their area. This should cover types of care, providers, and how to access services.
• Transition for young people: It includes provisions to help young people with care needs transition smoothly into adult care services.

The Care Act aims to make care and support clearer, fairer, and more personalised.

The Health and Safety at Work etc. Act 1974

This is the main piece of UK legislation covering occupational health and safety. It applies to all workplaces, including health and social care settings like hospitals, care homes, and people’s own homes where care is delivered.

The Act sets out general duties:

• Employers’ duties: Employers must protect the health, safety, and welfare of their employees and others affected by their work activities (e.g., patients, service users, visitors). This includes providing safe systems of work, safe equipment, adequate training, and a safe working environment. They must carry out risk assessments.
• Employees’ duties: Employees must take reasonable care of their own health and safety and that of others who might be affected by their actions at work. They must cooperate with their employer on health and safety matters.
• Self-employed duties: Self-employed people have duties towards themselves and others affected by their work.

Specific regulations under this Act address particular risks, such as manual handling (Manual Handling Operations Regulations 1992) and hazardous substances (Control of Substances Hazardous to Health Regulations 2002 – COSHH). In care settings, this involves managing risks like moving and handling people, slips and trips, challenging behaviour, infections, and stress. The Health and Safety Executive (HSE) enforces this Act.

The Mental Capacity Act 2005 (MCA)

This Act provides a legal framework for acting and making decisions on behalf of adults who lack the mental capacity to make specific decisions for themselves. It applies in England and Wales.

The MCA is based on five statutory principles:

1. Assume a person has capacity unless proven otherwise.
2. Do not treat someone as unable to make a decision unless all practicable steps to help them have been tried without success.
3. Do not treat someone as unable to make a decision just because they make an unwise decision.
4. Actions taken or decisions made for someone lacking capacity must be in their best interests.
5. Before acting, consider if the purpose can be achieved in a way that is less restrictive of the person’s rights and freedom.

The Act defines lacking capacity: a person cannot make a decision if they cannot understand information relevant to it, retain that information, use or weigh it, or communicate their decision. This assessment is decision-specific and time-specific.

It allows people to plan ahead for a time when they might lack capacity through Lasting Powers of Attorney (LPA) or Advance Decisions to Refuse Treatment (ADRT).

It also created the Deprivation of Liberty Safeguards (DoLS). These safeguards provide legal procedures for authorising the deprivation of liberty for people who lack capacity to consent to their care arrangements in hospitals or care homes, where this is necessary for their care or treatment and in their best interests. The Liberty Protection Safeguards (LPS) are intended to replace DoLS but their implementation has been delayed.

The Mental Health Act 1983 (as amended)

This Act covers the assessment, treatment, and rights of people with a ‘mental disorder’. It applies mainly in England and Wales. The Act allows for compulsory detention (sectioning) in hospital, treatment, and guardianship for individuals who need it for their own health or safety, or for the protection of others.

Key aspects include:

• Criteria for detention: Strict criteria must be met for someone to be detained under the Act, related to the presence of a mental disorder and risks.
• Different sections: Various sections of the Act allow for detention for different lengths of time and purposes (e.g., Section 2 for assessment, Section 3 for treatment).
• Consent to treatment: The Act has rules about when treatment can be given without the person’s consent, particularly when detained.
• Safeguards: It includes safeguards like the right to appeal detention to the Mental Health Tribunal and access to independent mental health advocates (IMHAs).
• Community Treatment Orders (CTOs): These allow some patients to be discharged from hospital but remain liable to recall if needed, subject to conditions.

The Act aims to balance the need to treat people with mental disorders with protecting their rights and liberties. Reforms are often discussed to modernise the Act.

The Data Protection Act 2018 (DPA 2018) and UK GDPR

These laws regulate how organisations process personal data. Personal data is information that relates to an identified or identifiable individual. In health and social care, this includes sensitive information like medical records, care plans, and contact details.

Key principles require that personal data is:

• Processed lawfully, fairly, and transparently.
• Collected for specified, explicit, and legitimate purposes.
• Adequate, relevant, and limited to what is necessary.
• Accurate and kept up to date.
• Kept for no longer than necessary.
• Processed securely, protecting against unauthorised access or loss.

Organisations must demonstrate compliance (accountability). Health and social care providers must have clear policies on handling data, training for staff, and security measures.

Individuals have rights regarding their data, including the right to access it, correct inaccuracies, request erasure, and object to processing. There are specific rules for processing ‘special category data’, which includes health data, requiring additional justification. The Information Commissioner’s Office (ICO) enforces data protection law.

The Equality Act 2010

This Act legally protects people from discrimination in the workplace and wider society. It consolidated previous anti-discrimination laws. It applies to services and public functions, including health and social care.

It identifies nine protected characteristics:

• Age
• Disability
• Gender reassignment
• Marriage and civil partnership
• Pregnancy and maternity
• Race
• Religion or belief
• Sex
• Sexual orientation

The Act prohibits direct discrimination (treating someone less favourably because of a protected characteristic), indirect discrimination (a policy or practice applying to everyone disadvantages people with a protected characteristic), harassment, and victimisation.

It places a Public Sector Equality Duty on public bodies, including NHS organisations and local authorities. They must have due regard to the need to eliminate discrimination, advance equality of opportunity, and foster good relations between different groups when carrying out their functions. This requires active consideration of equality issues in service design and delivery. Health and care providers must make reasonable adjustments for disabled people to avoid them being substantially disadvantaged when accessing services.

The Children Acts 1989 and 2004

These Acts form the main legal framework for child protection and welfare in England and Wales.

The Children Act 1989 established principles like:

• The child’s welfare is paramount.
• Parental responsibility.
• The duty of local authorities to provide services for children in need and protect children at risk of harm.

The Children Act 2004 aimed to improve children’s wellbeing and cooperation between agencies following the Victoria Climbié inquiry. It established:

• The role of the Children’s Commissioner.
• Duties on agencies (like health bodies, police, local authorities) to cooperate to improve children’s wellbeing (the ‘duty to cooperate’).
• Local Safeguarding Children Boards (LSCBs) – now replaced by multi-agency safeguarding arrangements – to coordinate local child protection work.

These Acts require professionals working with children and families, including in health settings, to be aware of their responsibilities regarding safeguarding and promoting child welfare.

Safeguarding Vulnerable Groups Act 2006

This Act was introduced to help prevent unsuitable people from working with children or vulnerable adults. It established the Vetting and Barring Scheme, managed by the Disclosure and Barring Service (DBS).

Key functions include:

• Maintaining lists of individuals barred from working with children and/or vulnerable adults.
• Processing requests for criminal record checks (DBS checks). Employers in regulated activities (like health and social care) must check if potential employees are barred and obtain appropriate DBS certificates.

This Act is a key part of safe recruitment practices in the sector.

Human Rights Act 1998

This Act incorporates rights set out in the European Convention on Human Rights (ECHR) into domestic UK law. Public authorities, including NHS trusts, local authorities, and care providers delivering services on their behalf, must respect these rights.

Relevant rights in health and social care include:

• Right to life (Article 2)
• Prohibition of torture, inhuman or degrading treatment (Article 3)
• Right to liberty and security (Article 5)
• Right to respect for private and family life (Article 8)
• Freedom of thought, conscience, and religion (Article 9)
• Freedom of expression (Article 10)
• Prohibition of discrimination in the enjoyment of Convention rights (Article 14)

The Act means that people using services can challenge decisions or treatment that breach their human rights in UK courts. It requires services to be delivered in ways that uphold dignity, autonomy, and respect.

Health and Care Act 2022

This recent Act introduces significant changes to the structure and operation of health and care services in England. Its main aims include:

• Establishing Integrated Care Systems (ICSs) across England on a statutory basis. ICSs bring together NHS organisations, local authorities, and others to plan and deliver joined-up health and care services. Each ICS has an Integrated Care Board (ICB) responsible for NHS budgets and commissioning, and an Integrated Care Partnership (ICP) to develop a wider health and care strategy.
• Promoting collaboration and reducing bureaucracy.
• Improving accountability and enhancing public confidence.
• Addressing health inequalities.
• Giving the Secretary of State for Health and Social Care more powers of direction over the NHS.
• Introducing changes to CQC’s regulatory powers and processes.

This Act continues the drive towards greater integration between health and social care.

Medicines Act 1968

This Act provides the basis for the licensing system for medicines in the UK. It controls the manufacture, distribution, sale, and supply of medicinal products for human and veterinary use. Although significantly amended over time, its core principles remain.

Key aspects relevant to health and social care:

• Licensing: Medicines generally require a marketing authorisation (product licence) before they can be sold or supplied. This ensures they meet standards of safety, quality, and efficacy.
• Classification: It establishes categories for medicines, influencing how they can be sold or supplied:
  • Prescription Only Medicines (POMs): Must be prescribed by an appropriate practitioner.
  • Pharmacy Medicines (P): Can be sold without prescription but only from a pharmacy, under pharmacist supervision.
  • General Sales List (GSL): Can be sold in general retail outlets without pharmacist supervision.
• Supply and Administration: The Act sets rules around who can prescribe, dispense, supply, and administer medicines. In care settings, procedures must align with these rules, ensuring staff are competent and authorised for any medicine-related tasks they perform.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for regulating medicines under this Act.

Misuse of Drugs Act 1971

This Act is the main law controlling dangerous or harmful drugs, often referred to as ‘controlled drugs’. It aims to prevent the non-medical use of these substances. It classifies controlled drugs into Classes A, B, and C, based on perceived harm, which dictates the penalties for unlawful activities.

In health and social care:

• Legitimate Use: The Act allows for the lawful possession, supply, and administration of controlled drugs for medical purposes (e.g., strong painkillers like morphine).
• Strict Controls: Due to their potential for harm and misuse, strict legal requirements govern the prescribing, storing, administering, recording, and destruction of controlled drugs in hospitals, pharmacies, and care homes. Specific regulations under the Act detail these requirements.
• Authorisation: Only authorised individuals (doctors, dentists, certain nurses) can prescribe or supply controlled drugs. Staff administering controlled drugs must follow precise procedures and maintain accurate records.

Failure to comply with the Act and its associated regulations (like the Misuse of Drugs Regulations 2001 and the Misuse of Drugs (Safe Custody) Regulations 1973) can lead to serious legal consequences.

Control of Substances Hazardous to Health Regulations 2002 (COSHH)

These regulations require employers to control substances that are hazardous to health. They fall under the umbrella of the Health and Safety at Work etc. Act 1974 but are specific to hazardous substances.

In health and social care settings, hazardous substances can include:

• Bodily fluids (blood, saliva, urine)
• Disinfectants and cleaning chemicals
• Certain medications (e.g., cytotoxic drugs)
• Medical gases

COSHH requires employers to:

• Assess risks: Identify hazardous substances and the risks they pose to employees and others (like service users).
• Prevent or control exposure: Implement measures to prevent exposure or, if not possible, adequately control it. This might involve using protective equipment (gloves, aprons), safe handling procedures, or proper ventilation.
• Maintain control measures: Ensure control measures are used and maintained correctly.
• Provide information and training: Inform employees about the risks and precautions.
• Monitor exposure (if necessary): Check exposure levels in certain situations.
• Carry out health surveillance (if necessary): Monitor employees’ health where appropriate.

Compliance with COSHH is vital for preventing illness and injury from exposure to harmful substances in care environments.

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR)

RIDDOR requires employers, the self-employed, and people in control of work premises to report certain serious workplace accidents, occupational diseases, and specified dangerous occurrences (near misses) to the Health and Safety Executive (HSE).

In health and social care, reportable incidents could include:

• Deaths: Fatal accidents arising out of work activities.
• Specified injuries: Fractures (other than fingers/toes), amputations, serious burns, loss of sight, crush injuries causing internal organ damage, serious head injuries, or incidents causing unconsciousness or requiring resuscitation or hospital admission for over 24 hours.
• Occupational diseases: Conditions likely caused or worsened by work, such as work-related dermatitis, asthma, or certain infections (e.g., tuberculosis if likely contracted through occupational exposure).
• Dangerous occurrences: Incidents with the potential to cause harm, like the collapse of lifting equipment, explosions, or accidental release of hazardous substances.
• Injuries to non-workers: Injuries to patients, service users, or visitors resulting from a work activity, where they are taken directly from the scene to hospital for treatment.

Reporting under RIDDOR helps the HSE and local authorities monitor workplace risks and investigate serious incidents. It also alerts providers to potential failures in safety management.

The Public Health (Control of Disease) Act 1984

This Act gives powers to local authorities and health officials to prevent and control the spread of infectious diseases. It allows for measures like requiring information from individuals, ordering medical examinations, or, in rare circumstances, imposing restrictions on movement or isolation.

Its relevance became very apparent during the COVID-19 pandemic, although specific pandemic legislation was also enacted (like the Coronavirus Act 2020, much of which has now expired). The core principles of managing communicable disease risks remain important. Health and social care providers play a key role by:

• Implementing infection prevention and control measures.
• Notifying relevant authorities (UK Health Security Agency – UKHSA, formerly Public Health England) of specific infectious diseases (Notifiable Diseases).
• Cooperating with public health officials during outbreak investigations.

Food Safety Act 1990

This Act provides the framework for food safety legislation in Great Britain. It ensures that food supplied is safe to eat and is what consumers expect. It applies to any setting where food is provided, including hospitals, care homes, and day centres.

Key requirements include:

• Safety: Not supplying food that is harmful to health or unfit for human consumption.
• Quality: Not supplying food that is not of the nature, substance, or quality demanded by the purchaser.
• Labelling/Presentation: Not misleading consumers through labelling, advertising, or presentation.

Under this Act, specific regulations like the Food Hygiene (England) Regulations 2013 set out detailed hygiene requirements for food businesses. Health and social care providers serving food must register as food businesses and comply with hygiene rules covering premises, equipment, personal hygiene of staff, and safe food handling practices (cooking, chilling, cross-contamination prevention). Environmental Health Officers enforce this legislation.

Autism Act 2009

This Act is specific to England and Wales and is the first ever disability-specific law in the UK. It focuses on improving services for adults with autism.

Key provisions:

• National Strategy: Required the government to produce and regularly review a strategy for meeting the needs of autistic adults. Current strategy is “Fulfilling and Rewarding Lives”.
• Statutory Guidance: Required the government to issue guidance to local authorities and NHS bodies on implementing the strategy and meeting needs. This guidance covers areas like diagnosis, assessment, care planning, transition support, training for staff, and local service development.

While the Act itself is quite short, the resulting strategy and statutory guidance place duties on local authorities and the NHS to consider the needs of autistic adults when commissioning and providing services. It aims to improve access to diagnosis, support, and understanding within health and social care.

Regulatory Reform (Fire Safety) Order 2005

This Order applies in England and Wales and simplifies, rationalises, and consolidates previous fire safety legislation. It applies to virtually all non-domestic premises, including hospitals, care homes, and clinics.

Key aspects:

• Responsible Person: It places responsibility for fire safety on the ‘Responsible Person’ – typically the employer, owner, or person in control of the premises.
• Fire Risk Assessment: The Responsible Person must carry out a suitable and sufficient fire risk assessment to identify fire hazards and people at risk.
• Fire Safety Measures: Based on the assessment, the Responsible Person must implement appropriate fire safety measures. This includes:
  • Minimising fire risks.
  • Providing means of escape (fire doors, clear routes, emergency lighting).
  • Installing fire detection and warning systems.
  • Providing fire-fighting equipment.
  • Establishing emergency procedures (including evacuation plans, especially crucial in settings with vulnerable residents).
  • Providing staff training and information.
• Record Keeping: Records of the risk assessment and fire safety measures must be kept.

Fire and Rescue Authorities enforce the Order and inspect premises to ensure compliance. Given the vulnerability of many people using health and social care services, fire safety is a critical consideration.

Okay, let’s add further important pieces of legislation impacting health and social care in the UK.

National Health Service Act 2006

This Act consolidated much of the previous legislation relating to the National Health Service (NHS) in England. While it has been significantly amended, particularly by the Health and Social Care Act 2012 and the Health and Care Act 2022, it still provides a core legislative basis for the NHS.

Key elements originally established or confirmed by this Act include:

• Secretary of State’s Duty: Sets out the general duty of the Secretary of State for Health and Social Care to promote a comprehensive health service in England.
• NHS Constitution: Although the Constitution itself is separate, the Act underpins the legal rights and pledges contained within it.
• Commissioning: Originally detailed the roles of Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) in commissioning services (these bodies were later abolished and replaced, currently by Integrated Care Boards – ICBs).
• Provision of Services: Covered the establishment and functions of NHS Trusts and NHS Foundation Trusts, which provide hospital, community, and mental health services.

Understanding this Act helps appreciate the historical legal structure of the NHS in England, upon which later reforms have been built.

Children and Families Act 2014

This Act introduced wide-ranging reforms, particularly concerning children and young people with Special Educational Needs and Disabilities (SEND) in England. It also covers aspects like adoption, fostering, and family justice.

Key provisions relevant to health and social care:

• SEND Reforms: Replaced ‘Statements of Special Educational Needs’ with integrated Education, Health and Care Plans (EHCPs) for children and young people up to age 25. EHCPs require joint assessment and planning between education, health, and social care services to meet the individual’s needs.
• Local Offer: Requires local authorities to publish a ‘Local Offer’ detailing the support available for children and young people with SEND in their area, including relevant health and social care services.
• Joint Commissioning: Places duties on local authorities and health bodies (Clinical Commissioning Groups, now ICBs) to jointly commission services for children and young people with SEND.
• Personal Budgets: Gives young people and parents of children with an EHCP the right to request a personal budget to manage some of the funding for their support.
• Young Carers: Includes provisions requiring local authorities to assess the needs of young carers and consider their wellbeing.

This Act reinforces the need for integrated working between health, social care, and education professionals to support children and young people with additional needs.

Social Services and Well-being (Wales) Act 2014

This Act is the primary legislation governing social care in Wales, similar in scope to the Care Act 2014 in England. It reformed Welsh social services law, focusing on people’s well-being and giving them a stronger voice and control.

Core principles and duties include:

• Well-being: Places a duty on local authorities and Local Health Boards to promote the well-being of people needing care and support, and their carers. Well-being is broadly defined, similar to the Care Act.
• Assessment: Establishes rights to assessment for adults, children, and carers based on apparent need. Assessments must focus on the person’s desired outcomes.
• National Eligibility Criteria: Sets a national minimum threshold for accessing care and support.
• Meeting Needs: Local authorities must meet eligible needs identified through assessment. Care and support plans detail how needs will be met.
• Cooperation and Partnership: Emphasises cooperation between local authorities, health boards, and other bodies through statutory Regional Partnership Boards.
• Safeguarding: Creates a unified safeguarding framework for adults and children through National Independent Safeguarding Boards and Regional Safeguarding Boards.
• Social Services Workforce: Includes provisions related to the regulation and development of the social care workforce in Wales.
• Information, Advice, and Assistance (IAA): Requires local authorities to provide accessible IAA services.

This Act defines the modern approach to social care delivery and regulation within Wales.

Abortion Act 1967 (as amended)

This Act regulates abortion in Great Britain (England, Wales, and Scotland; Northern Ireland has separate legislation following decriminalisation in 2019). It provides the legal framework under which abortions can be performed.

Key points:

• Legality: Abortion remains a criminal offence, but the Act provides exceptions. An abortion is lawful if two registered medical practitioners agree in good faith that specific grounds are met.
• Grounds: The most common ground is that continuing the pregnancy would involve greater risk to the physical or mental health of the pregnant woman or her existing children than terminating it (provided the gestation is not over 24 weeks). Other grounds relate to grave permanent injury, risk to life, or substantial risk of the child being seriously handicapped.
• Location: Abortions must generally be carried out in an NHS hospital or an approved independent sector clinic. Recent changes allow for early medical abortion pills to be taken at home.
• Conscientious Objection: Allows healthcare professionals to refuse to participate in treatment under the Act if they have a conscientious objection (unless necessary to save the woman’s life or prevent grave permanent injury).

Healthcare providers involved in abortion services must strictly adhere to the Act’s requirements regarding grounds, practitioner agreement, location, and notification.

Common Law Duty of Confidentiality

Alongside statutory laws like the Data Protection Act 2018 and UK GDPR, there exists a common law duty of confidentiality. This means that when someone shares personal information in confidence (like a patient telling a doctor or nurse their medical history), the person receiving it has a legal duty not to disclose it without consent, unless specific circumstances apply.

Key aspects:

• Basis: Arises from the relationship of trust where sensitive information is shared.
• Scope: Applies to information that is confidential in nature and shared in circumstances implying confidentiality.
• Disclosure: Disclosure is permitted:
  • With the individual’s explicit consent.
  • When required by law (e.g., court order, reporting certain infectious diseases).
  • When necessary in the public interest (e.g., to prevent serious harm to others) – this is a high bar and must be carefully justified.
  • For limited purposes within the healthcare team (‘implied consent’ for direct care, though explicit consent is better).
• Overlap with DPA/GDPR: While related, the common law duty can sometimes offer broader protection or apply in slightly different ways. Both must be respected.

This duty is fundamental to the trust between healthcare professionals and the people they care for. Breaching it can lead to legal action and professional misconduct findings.

Public Services (Social Value) Act 2012

This Act requires public bodies in England (and some in Wales) to consider how the services they commission and procure might improve the economic, social, and environmental well-being of the relevant area. This applies to bodies commissioning health and social care services, like local authorities and ICBs.

Impact on health and social care:

• Commissioning: When planning services, commissioners must think about how they can secure wider social value beyond the core service outcomes.
• Procurement: During the process of buying services from providers, commissioners must consider social value criteria, not just price and quality.
• Examples: Social value might include providers creating jobs for local people, offering training opportunities, supporting community initiatives, or using environmentally sustainable practices.

This Act encourages commissioners and providers to think more broadly about the impact of health and social care spending on the community.

These additional pieces of legislation contribute further layers to the regulatory environment, covering specific services like abortion, fundamental NHS structure, social value in commissioning, specific needs like SEND, the Welsh context, and the bedrock principle of common law confidentiality.

Final Thoughts

These laws form a complex web that defines how health and social care should operate in the UK. They set expectations for providers, outline the rights of people using services, and establish systems for regulation and oversight. Staff working in the sector need a good understanding of the legislation relevant to their roles to provide safe, legal, and ethical care.