A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

ForewordThe Health and Social Care Act 2012 (the Act)makes changes to the way health care isregulated, including expanding Monitor’s role bygiving us a number of additional responsibilities.As part of these changes we are given a newmain duty to protect and promote the interestsof people who use health care services bypromoting the provision of services which iseconomic, efficient and effective, and maintainsor improves the quality of the services.As the foundation of our new role, the Act requires that Monitor issue licences for providers ofNHS services and also gives Monitor powers to enforce this licence. These powers enableMonitor to investigate potential breaches of the licence and then to either impose requirements onNHS service providers where we find actual breaches, or accept undertakings from the provider,to make sure they return to compliance. The requirements we can impose range from obligingproviders to take steps to restore compliance, requiring providers to restore the position beforethe breach or obliging them to pay a financial penalty. In exceptional circumstances, we can alsoconsider revoking a licence.Some of the enforcement powers of the Act can also be exercised against those who are notlicence holders - such as those operating without a licence when required to hold one, and thosein breach of a requirement to provide Monitor with information. The Act separately gives Monitorconcurrent powers with the Office of Fair Trading to apply competition law in the health caresector in England.This document sets out guidance on how we will exercise our enforcement powers. As examples,this guidance will apply to:complaints from a commissioner that a provider has acted unreasonably in refusing tosupply a service as a Commissioner Requested Service, in breach of its licence;complaints that a provider is not charging in line with the national tariff as required by itslicence;complaints that a provider has acted anti-competitively in breach of its licence and/orcompetition law;investigations into whether an NHS foundation trust may be in breach of its licenceconditions about governance; andfailures, by those obliged to do so, to provide information to Monitor.In this document we explain when we may formally investigate potential breaches, the processeswe are likely to follow, and the factors that we may consider when deciding what requirements toimpose should Monitor find a breach of the provider licence.Page 3 of 50