Question to the Department of Health and Social Care:

To ask Her Majesty's Government who is accountable under current NHS legislation for alternating or relaxing the delivery of service targets provided for in the NHS Constitution; and whether those targets have the force of a legal obligation on either the Secretary of State or NHS England.

The NHS Constitution established by the Health Act 2009 sets out access standards that patients should expect from the National Health Service in the form of rights which have a legal basis, and pledges which go beyond the legal rights. The NHS commits to seeking to achieve these pledges wherever possible. The Secretary of State for Health, NHS bodies, private and voluntary sector providers supplying NHS services, local authorities exercising public health functions, and Health Education England must all have regard to the Constitution in their decisions and actions.

The Secretary of State is required to review the NHS Constitution at least once every ten years and to review the Handbook to the Constitution, which explains its rights and pledges, every three years. Both were reviewed and updated in 2015, with changes to ambulance response time standards added to the Handbook through an addendum published in August 2017. The overall Handbook will be reviewed and updated in 2018.

Pledges in the Constitution cover a range of access standards which are reflected in the Government’s mandate to NHS England for 2017-18 and set out in NHS guidance.