Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how many reviews of transactions involving (a) the creation of subsidiaries and (b) material changes to existing subsidiaries are being undertaken by NHS Improvement where the proposal is considered to be material as at 29 June 2021.

The National Health Service has had a long-standing ability to create subsidiary companies under the National Health Service Act 2006. NHS foundation trusts can establish subsidiaries with approval undertaken through the statutory powers and duties of NHS England and NHS Improvement. NHS trusts may only establish subsidiaries with approval of the Secretary of State. The review of proposals under the existing Addendum to the transactions guidance for trusts forming or changing a subsidiary involving the creation of subsidiaries and material changes, including those that are considered significant to existing subsidiaries, has been paused to allow both NHS England and NHS Improvement and the sector to focus on supporting the recovery of services

NHS England and NHS Improvement made a small number of exemptions to this principle, where there were exceptional circumstances. Over the last 12 months, NHS trusts and foundation trusts have reported four proposals to create new subsidiaries and six proposals to make material changes to existing subsidiaries. Updated guidance is due to be published later in 2021/22.

There have been a number of recent discussions involving Departmental officials and NHS England and NHS Improvement on the proposals for a review of the guidance covering the creation of subsidiaries or material changes to existing subsidiaries.