The National Health Service (General Medical Services Contracts) (Scotland) Regulations 2004

• (b) on 1st January 2005,

whichever is the earlier.

• (4) An arrangement made in accordance with sub-paragraph (2) shall, for so long as it continues, relieve the contractor of—

• (a) its obligations to provide out of hours services pursuant to regulation 30 or 31; and

• (b) all liabilities under the contract in respect of those services.

• (5) The person referred to in this sub-paragraph is any person who holds a general medical services contract or section 17C agreement with the Health Board which includes the provision of out of hours services.

• (6) A contractor may make more than one out of hours arrangement and may do so (for example) with difference contractors or providers of primary medical services and in respect of different patients, different times and different parts of its practice area.

• (7) A contractor may retain responsibility for, or make separate out of hours arrangements in respect of, the provision to any patients of maternity medical services during the out of hours period which the contractor is required to provide pursuant to regulation 30 or 31 and any separate out of hours arrangements it makes may encompass all or any part of the maternity medical services it provides.

• (8) Nothing in this paragraph prevents a contractor from retaining or resuming its obligations in relation to named patients.

Application for approval of an out of hours arrangement

2

• (1) An application to the Health Board for approval of an out of hours arrangement shall be made in writing and shall state—

• (a) the name and address of the proposed transferee out of hours service provider;

• (b) the periods during which the contractor’s obligations under the contract are to be transferred;

• (c) how the proposed transferee out of hours service provider intends to meet the contractor’s obligations during the periods specified under paragraph (b);

• (d) the arrangements for the transfer of the contractor’s obligations under the contract to and from the transferee out of hours service provider at the beginning and end of the periods specified under paragraph (b);

• (e) whether the proposed arrangement includes the contractor’s obligations in respect of maternity medical services; and

• (f) how long the proposed arrangements are intended to last and the circumstances in which the contractor’s obligations under the contract during the periods specified under paragraph (b) would revert to it.

• (2) The Health Board shall determine the application before the end of the period of 28 days beginning with the day on which the Health Board received it.

• (3) The Health Board shall grant approval to a proposed out of hours arrangement if it is satisfied—

• (a) having regard to the overall provision of primary medical services provided in the out of hours period in its area, that the arrangement is reasonable and will contribute to the efficient provision of such services in the area;

• (b) having regard, in particular, to the interests of the contractor’s patients, that the arrangement is reasonable;

• (c) having regard, in particular, to all reasonably foreseeable circumstances, that the arrangement is practicable and will work satisfactorily;

• (d) that it will be clear to the contractor’s patients how to seek primary medical services during the out of hours period;

• (e) where maternity medical services are to be provided under the out of hours arrangement, that they will be performed by a medical practitioner who has such medical experience and training as are necessary to enable the medical practitioner properly to perform such services; and

• (f) that if the arrangement comes to an end, the contractor has in place proper arrangements for the immediate resumption of the contractor’s responsibilities,

and shall not refuse to grant approval without first consulting the area medical committee (if any) for its area.

• (4) The Health Board shall give notice to the contractor of its determination and, where it refuses an application, it shall send the contractor a statement in writing of the reasons for its determination.

• (5) A contractor which wishes to refer the matter in accordance with the NHS dispute resolution procedure must do so before the end of the period of 30 days beginning with the day on which the Health Board’s notification under sub-paragraph (4) was sent.

Effect of approval of an arrangement with a transferee out of hours service provider

3

Where the Health Board has approved an out of hours arrangement with a transferee out of hours service provider, the Health Board and the transferee out of hours service provider shall be deemed to have agreed a variation of their contract which has the effect of including in it, from the date on which the out of hours arrangement commences, and for so long as that arrangement continues, the services covered by that arrangement and paragraph 94(1) of Schedule 5 shall not apply.

Review of approval

4

• (1) Where it appears to the Health Board that it may no longer be satisfied of any of the matters referred to in paragraph 2(3), it may give notice to the contractor that it proposes to review its approval of the out of hours arrangement.

• (2) On any review under sub-paragraph (1), the Health Board shall allow the contractor a period of 30 days, beginning with the day on which it sent the notice, within which to make representations in writing to the Health Board.

• (3) After considering any representations made in accordance with sub-paragraph (2), the Health Board may determine to—

• (a) continue its approval;

• (b) withdraw its approval following a period of notice; or

• (c) if it appears to it that it is necessary in the interests of the contractor’s patients, withdraw its approval immediately.

• (4) Except in the case of an immediate withdrawal of approval, the Health Board shall not withdraw its approval without first consulting the area medical committee for its area.

• (5) Where the Health Board determines to withdraw its approval immediately, it shall notify the area medical committee (if any) for its area.

• (6) The Health Board shall give notice to the contractor of its determination under sub-paragraph (3).

• (7) Where the Health Board withdraws its approval, whether immediately or on notice, it shall include with the notice a statement in writing of the reasons for its determination.

• (8) A contractor which wishes to refer the matter in accordance with the NHS dispute resolution procedure must do so before the end of the period of 30 days beginning with the day on which the Health Board’s notification under sub-paragraph (6) was sent.

• (9) Where the Health Board determines to withdraw its approval following a period of notice, the withdrawal shall take effect at the end of the period of two months beginning with—

• (a) the date on which the notice referred to in sub-paragraph (6) was sent; or

• (b) where there has been a dispute which has been referred under the NHS dispute resolution procedure and the dispute is determined in favour of withdrawal, the date on which the contractor receives notice of the determination.

• (10) Where the Health Board determines to withdraw its approval immediately, the withdrawal shall take effect on the day on which the notice referred to in sub-paragraph (6) is received by the contractor.

Immediate withdrawal of approval other than following review

5

• (1) The Health Board shall withdraw its approval of an out of hours arrangement immediately—

• (a) in the case of an arrangement with a person referred to in paragraph 1(5), if the person with whom it is made ceases to hold a contract or section 17C agreement for the provision of primary medical services with the Health Board which includes the provision of out of hours services; or

• (b) where, without any review having taken place under paragraph 4, it appears to the Health Board that it is necessary in the interests of the contractor’s patients to withdraw its approval immediately.

• (2) The Health Board shall give notice to the contractor of a withdrawal of approval under sub-paragraph (1)(a) or (b) and shall include with the notice a statement in writing of the reasons for its determination.

• (3) An immediate withdrawal of approval under sub-paragraph (1) shall take effect on the day on which the notice referred to in sub-paragraph (2) is received by the contractor.

• (4) The Health Board shall notify the area medical committee for its area of a withdrawal of approval under sub-paragraph (1)(b).

• (5) A contractor which wishes to refer a withdrawal of approval under sub-paragraph (1)(b) in accordance with the NHS dispute resolution procedure must do so before the end of the period of 30 days beginning with the day on which the Health Board’s notification under sub paragraph (2) was sent.

Termination of an out of hours arrangement

6

The contractor shall terminate an out of hours arrangement with effect from the date of the taking effect of the withdrawal of the Health Board’s approval of that arrangement under paragraph 4 or 5.

SCHEDULE 7

CLOSURE NOTICE

SCHEDULE 8 — INFORMATION TO BE INCLUDED IN PRACTICE LEAFLETS

A practice leaflet shall include—

1

The name of the contractor.

2

In the case of a contract with a partnership—

• (a) whether or not it is a limited partnership; and

• (b) the names of all the partners and, in the case of a limited partnership, their status as a general or limited partner.

3

In the case of a contract with a company—

• (a) the names of the directors, the company secretary and the shareholders of that company; and

• (b) the address of the company’s registered office.

4

The full name of each person performing services under the contract.

5

In the case of each health care professional performing services under the contract the health care professional’s professional qualifications.

6

Whether the contractor undertakes the teaching or training of health care professionals or persons intending to become health care professionals.

7

The contractor’s practice area, by reference to a sketch diagram, plan or postcode.

8

The address of each of the practice premises.

9

The contractor’s telephone and fax numbers and the address of the contractor’s website (if any).

10

Whether the practice premises have suitable access for all disabled patients and, if not, the alternative arrangements for providing services to such patients.

11

How to register as a patient.

12

The right of patients to express a preference of practitioner in accordance with paragraph 18 of Schedule 5 and the means of expressing such a preference.

13

The services available under the contract.

14

The opening hours of the practice premises and the method of obtaining access to services throughout the core hours.

15

The criteria for home visits and the method of obtaining such a visit.

16

The consultations available to patients under paragraphs 5 and 6 of Schedule 5.

17

The arrangements for services in the out of hours period (whether or not provided by the contractor) and how the patient may contact such services.

18

If the services in paragraph 17 are not provided by the contractor, the fact that the Health Board referred to in paragraph 28 is responsible for commissioning the services.

19

The telephone number of NHS 24 and details of the NHS 24 website.

20

The method by which patients are to obtain repeat prescriptions.

21

If the contractor is a dispensing contractor the arrangements for dispensing prescriptions.

22

How patients may make a complaint or comment on the provision of service.

23

The rights and responsibilities of the patient, including keeping appointments.

24

The action that may be taken where a patient is violent or abusive to the contractor, the contractor’s staff, persons present on the practice premises or in the place where treatment is provided under the contract or other persons specified in paragraph 21(2) of Schedule 5.

25

Details of who has access to patient information (including information from which the identity of the individual can be ascertained) and the patient’s rights in relation to disclosure of such information.

26

The name, address and telephone number of the Health Board which is a party to the contract and from whom details of primary medical services in the area may be obtained.

Signed

Malcolm Chisholm — A member of the Scottish Executive — 10th March 2004

Explanatory note

(This note is not part of the Regulations)

These Regulations set out, for Scotland, the framework for general medical services contracts under section 17J of the National Health Service (Scotland) Act 1978 (“the Act”).

Part 2 of the Regulations prescribes the conditions which, in accordance with section 17L(1) of the Act, must be met by a contractor before the Health Board may enter into a general medical services contract with it.

Part 3 of the Regulations prescribes the procedure for pre-contract dispute resolution, in accordance with section 17O(1) of the Act.

Part 4 of the Regulations sets out the procedures, in accordance with section 17O(2) of the Act, by which a contractor may elect to be regarded as a health service body for any purposes of section 17A of the Act and modifies section 17A in relation to such a person.

Part 5 of (and Schedules 1 to 5, 7 and 8 to) the Regulations prescribe the terms which, in accordance with sections 17K and 17N of the Act, must be included in a general medical services contract (in addition to those contained in the Act). It includes, in regulation 15, a description of the services which must be provided to patients under general medical services contracts pursuant to section 17K of the Act.

The prescribed terms include terms relating to—

• (a) the type and duration of the contract (regulations 12 to 14);

• (b) the services to be provided (regulations 15, 16 and 18 to 20 and Schedule 1), the manner in which they are to be provided (Part 1 of Schedule 5) and the procedures for opting out of additional and out of hours services (regulation 17 and Schedule 2);

• (c) the issuing of medical certificates (regulation 21 and Schedule 3);

• (d) finance, fees and charges (regulations 22 to 24 and Schedule 4);

• (e) patient registration and removal, lists closures and assignments (Schedule 5, Part 2 and Schedule 7);

• (f) prescribing and dispensing (Schedule 5, Part 3);

• (g) the conditions to be met by those who perform services or are employed or engaged by the contractor (Schedule 5, Part 4);

• (h) patient records, the provision of information and rights of entry (Schedule 5, Part 5 and Schedule 8);

• (i) complaints (Schedule 5, Part 6);

• (j) procedures for dispute resolution (Schedule 5, Part 7); and

• (k) procedures for variation and termination of contracts (Schedule 5, Part 8).

Part 6 of the Regulations prescribes functions for area medical committees.

Part 7 of the Regulations and Schedule 6 make transitional provision.

Footnotes

[^f00001]: 1978 c. 29. Section 17A(6) was inserted by the National Health Service and Community Care Act 1990 (c. 18) (“the 1990 Act”), section 30; sections 17K, 17L, 17N and 170 were inserted by the Primary Medical Services (Scotland) Act 2004 (asp 1), section 4; section 28 was amended by the National Health Service (Amendment) Act 1986 (c. 66), section 3(4) and the 1990 Act, Schedule 9, paragraph 19(8); section 105(7) was amended by the Health Services Act 1980 (c. 53), Schedule 5, paragraph 5, paragraph 5 and by the Health Services Act 1983 (c. 4`), Schedule 7, paragraph 24. Section 108(1) defines “prescribed” and “regulations”. The functions of the Secretary of State were transferred to the Scottish Ministers by virtue of section 53 of the Scotland Act 1998 (c. 46).

[^f00002]: 1978 c. 29.

[^f00003]: 2004 asp 1.

[^f00004]: S.I. 2003/1250.

[^f00005]: Section 27 was amended by the National Health Service and Community Care Act 1990 (c. 19), Schedule 9 the Medicinal Products: Prescription by Nurses etc. Act 1992 (c. 28), section 3, the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 44, the Health and Social Care Act 2001 (c. 15), section 44 and S.I. 2003/1590.

[^f00006]: 1983 c. 54; section 11(4) was amended by the National Health Service (Primary Care) Act 1997 (c. 46), section 35(4) and type=start time=1185534232738Schedule 2type=end time=1185534232738, paragraph 61(2).

[^f00007]: 2001 asp 8.

[^f00008]: Section 17J was inserted by the 2004 Act section 4.

[^f00009]: 1977 c. 49.

[^f00010]: S.I. 1978/1907.

[^f00011]: Section 17M was inserted by the 2004 Act, section 4. The directions in respect of the financial year 2004–05 will be given before 31st March 2004 and will be available on http://www.show.scot.nhs.uk

[^f00012]: 1998/5 as amended by S.I. 1998/669 and S.S.I. 2000/23.

[^f00013]: S.I. 1972/1265 (N.I. 14).

[^f00014]: S.I. 1991/194 (N.I.1).

[^f00015]: Section 17L(5) was inserted by the 2004 Act, section 4.

[^f00016]: Section 17A(2) was inserted by the National Health Service and Community Care Act 1990 (c. 19), section 30 and amended by the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 102(2), the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 36, the Health Act 1999 (c. 8), Schedule 4, paragraph 46 and S.I. 1991/195.

[^f00017]: 1995 c. 36.

[^f00018]: 1968 c. 67.

[^f00019]: 1907 c. 24.

[^f00020]: Section 29(8) was substituted by the Health Act 1999 (c. 8), section 58(1) and amended by the Community Care and Health (Scotland) Act 2002 (asp 5), Schedule 2, paragraph 2 and the 2004 Act, section 5(3).

[^f00021]: 1977 c. 49. Section 16BA was inserted by the National Health Service Reform and Health Care Professions Act 2002 (c. 17) section 6.

[^f00022]: Section 29B(2) was inserted by the Health Act 1999 (c. 8), section 58 and amended by the Community Care and Health (Scotland) Act 2002 (asp 5), schedule 2, paragraph 2 and the 2004 Act, section 5(3).

[^f00023]: 1983 c. 54; section 2 was amended by S.I. 1996/1591 and 2002/3135.

[^f00024]: Section 17J was inserted by the 2004 Act, section 4.

[^f00025]: Section 17A(3) was inserted by the National Health Service and Community Care Act 1990 (c. 19), section 30 and amended by the Health Act 1999 (c. 8), Schedule 3, paragraph 46(b) and Schedule 4.

[^f00026]: 2003 c. 43.

[^f00027]: 1990 c. 19.

[^f00028]: S.1. 2002/253.

[^f00029]: S.I. 1995/414 as amended by S.I. 1996/840 and 1504, 1997/696, 1998/2224 and 3031 and S.S.I. 1999/57, 2001/70, 2002/111 and 153, 2003/296.

[^f00030]: 1968 c. 67.

[^f00031]: Section 69 was amended by the Statute Law (Repeals) Act 1993 (c. 50) and the Pharmacists (Fitness to Practise) Act 1997 (c. 19), Schedule 4, paragraph 5.

[^f00032]: S.I. 1997/1830 as amended by S.I. 1997/2044, 1998/108, 1178 and 2081, 1999/1044 and 3463, 2000/1917, 2889 and 3231, 2001/2777, 2889 and 3942, 2002/549 and 2469 and 2003/696.

[^f00033]: 1977 c. 49. Section 16A was inserted by the Health Act 1999 (c. 8), section 2(1).

[^f00034]: Section 17P was inserted by section 5(2) of the 2004 Act.

[^f00035]: 1954 c. 61.

[^f00036]: S.1. 1976/1213 (N.1. 22).

[^f00037]: Section 17C was inserted by the National Health Service (Primary Care) Act 1997 (c. 46), section 21(2) and was amended by the 2004 Act, section 2(2).

[^f00038]: Section 17N was inserted into the Act by section 4 of the 2004 Act.

[^f00039]: Section 29 was substituted by the Health Act 1999 (c. 8), section 58(1) and amended by the Community Care and Health (Scotland) Act 2002 asp 5, schedule 1, paragraph 2(4) and by the 2004 Act, schedule, paragraph 1(12) and (13).

[^f00040]: 1995 c. 46.

[^f00041]: 1933 c. 12, as amended by the Criminal Justice Act 1988 (c 33), section 170, Schedule 15, paragraph 8 and Schedule 16, paragraph 16 and the Sexual Offences Act 1956 (c. 69), sections 48 and 51 and Schedules 3 and 4; and as modified by the Criminal Justice Act 1988, section 170(1), Schedule 15, paragraph 9.

[^f00042]: 1986 c. 45. Schedule 4A was inserted by section 257 of and Schedule 20 to the Enterprise Act 2002 (c. 40).

[^f00043]: 1990 c. 40.

[^f00044]: 1986 c. 46 as amended by the Insolvency Act 2000 (2000 c. 39).

[^f00045]: S.I. 1986/1032 (N.I.6).

[^f00046]: 1986 c. 45.

[^f00047]: S.I. 2004/291.

[^f00048]: Section 17L was inserted by the 2004 Act, section 4.

[^f00049]: Section 17A was inserted by the National Health Service and Community Care Act 1990 (c. 19), section 30 and amended by the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 102(2), the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 36, the Health Act 1999 (c. 8), Schedule 4, paragraph 46 and S.I. 1991/195.

[^f00050]: Section 17K was inserted by the 2004 Act, section 4.

[^f00051]: World Health Organisation, 1992 ISBN 92 4 1544 198 (v.1) NLM Classification WB 15.

[^f00052]: S.I. 1976/615. Regulation 2 was amended by S.I. 1982/699, type=start time=11855343673171992/247type=end time=1185534367317, 1994/2975, 1995/987 and type=start time=11855344248182000/590type=end time=1185534424818.

[^f00053]: Section 17M was inserted into the Act by section 4 of the 2004 Act.

[^f00054]: S.I. 1995/416.

[^f00055]: S.I. 1995/416. Regulation 35 was amended by S.I. 1998/1600, 1999/749 and S.S.I. 1995/54 and 2000/111.

[^f00056]: David Hall and David Elliman, January 2003, Oxford University Press, ISBN 0-19-85188-X.

[^f00057]: 1865 c. 73.

[^f00058]: 1917 c. 51.

[^f00059]: 1939 c. 83.

[^f00060]: 1939 c. 82.

[^f00061]: 1942 c. 26.

[^f00062]: 1947 c. 19.

[^f00063]: 1992 c. 5.

[^f00064]: 1992 c. 4.

[^f00065]: 1998 c. 14.

[^f00066]: 1988 c. 7. Section 13 was amended by the Social Security Act 1990 (c. 27), Schedule 5, paragraph 8(11)(a), and the Social Security (Consequential Provisions) Act 1992 (c. 6), Schedule 1, paragraph 94.

[^f00067]: 1965 c. 49. Section 21 was amended by the Nurses, Midwives and Health Visitors Act 1979 (c. 36), Schedule 6, paragraphs 12 and 13.

[^f00068]: 1983 c. 20. Section 142 was amended by S.I. 1999/1820.

[^f00069]: 1995 c. 46.

[^f00070]: 1988 c. 36.

[^f00071]: 1985 c. 17.

[^f00072]: 1983 c. 2.

[^f00073]: 1978 c. 29.

[^f00074]: 1992 c. 14.

[^f00075]: 1978 c. 29. Section 57 was substituted by the Health and Medicines Act 1988 (c. 49), section 7 and amended by the National Health Service and Community Care Act 1990 (c. 19), Schedule 9, paragraph 19.

[^f00076]: 1988 c. 52. Section 158 was amended by S.I. 1995/889, Article 3.

[^f00077]: Section 26(1) was amended by the Health and Social Security Act 1984 (c. 48), Schedule 1, paragraph 1 and the Health and Medicines Act 1988 (c. 49), section 13(4).

[^f00078]: Section 26(1E) was inserted by the Health and Medicines Act 1988 (c. 49), section 13(4).

[^f00079]: 1995 c. 36.

[^f00080]: 2000 asp 4

[^f00081]: 1971 c. 38.

[^f00082]: Schedule 4 was amended by S.I. 2003/1432.

[^f00083]: Section 17N was inserted by the 2004 Act, section 4.

[^f00084]: Article 3B was inserted into the POM Order by S.I. 2003/696.

[^f00085]: 1968 c. 67.

[^f00086]: 1972 c. 68.

[^f00087]: O.J. L 311, 28.11.2001, p. 67.

[^f00088]: S.S.I. 2001/430, as amended by S.S.I. 2002/100 and 2003/130 and 295.

[^f00089]: S S.I. 2003/ 460.

[^f00090]: 1968 c. 67.

[^f00091]: 1983 c. 54. Section 41A was inserted by S.I. 2000/1803.

[^f00092]: Section 15 was amended by the National Health Service (Primary Care) Act 1997 (c. 46) (“the 1997 Act”), Schedule 1, Part 1, paragraph 61(9); section 15A was inserted by S.I. 2000/3041; section 21 was amended by the 1997 Act, Schedule 1, Part 1, paragraph 61(5) and by S.I. 1996/1591 and 2002/3135.

[^f00093]: This document is published jointly by the General Practitioners Committee of the British Medical Association and the NHS Confederation. It is available on the Department of Health’s website at www.doh.gov.uk/gmscontract/supportingdoc. htm or a copy may be obtained by writing to the NHS Confederation, 1 Warwick Road, London SW1E 5ER.

[^f00094]: Section 17M was inserted by the 2004 Act, section 4.

[^f00095]: The current guidance is the GP Registrar Scheme Vocational Guide for General Medical practice—the UK Guide 2000 published by the Department of Health and available on their website at www.doh.gov.uk/medicaltrainingintheuk or by writing to the Department of Health, P.O. Box 777, London SE1 6XH.

[^f00096]: Copies of NHS Circular PCA(M) (2001)17 may be obtained in writing from the Scottish Executive Health Department, Primary Care Division, St Andrew’s House, Regent Road, Edinburgh, EH1 3DG.

[^f00097]: RFA V.1 is published on Scottish Health On the Web (SHOW) at the following link:http://www.show.scot.nhs.uk/publications/me/gpcomputerrecords/rfav1.pdf.

[^f00098]: Section 2C was inserted by the 2004 Act, section 1(2).

[^f00099]: 1986 c. 45.

[^f00100]: Section 17L was inserted by the 2004 Act, section 4.

[^f00101]: 1995 c. 36.

[^f00102]: 1994 c. 39.

[^f00103]: 1970 c. 42; section 1 was amended by the Local Government Act 1972 (c. 70), section 195 and by the Local Government (Wales) Act 1994 (c. 19), Schedule 10, paragraph 7.

[^f00104]: Section 17A was inserted by the National Health Service and Community Care Act 1990 (c. 19), section 30.

[^f00105]: Section 17L was inserted by the 2004 Act, section 4.

[^f00106]: 1995 c. 46.

[^f00107]: 1933 c. 12 as amended by the Criminal Justice Act 1988 (c. 33), section 170, Schedule 15, paragraph 8 and Schedule 16, paragraph 16; the Sexual Offences Act 1956 (c. 69), sections 48 and 51 and Schedules 3 and 4 and as modified by he Criminal Justice Act 1988, section 170(1), Schedule 15, paragraph 9.

[^f00108]: 1986 c. 45. Schedule 4A was inserted by section 257 of and Schedule 2 to the Enterprise Act 2002 (c. 40).

[^f00109]: Schedule B1 was inserted by section 248 of and Schedule 16 to the Enterprise Act 2002.

[^f00110]: 1990 c. 40.

[^f00111]: 1986 c. 46 as amended by the Insolvency Act 2000 (2000 c. 39).

[^f00112]: S.1. 1986/1032 (N.1.6).

[^f00113]: S.I. 2004/291.