Made | 22nd March 2004 | ||
Laid before Parliament | 23rd March 2004 | ||
Coming into force | 1st April 2004 |
1. | Citation, commencement, application and interpretation |
2. | Application and interpretation of this Part |
3. | Applications for inclusion in lists of patients |
4. | Acceptance of applications for inclusion in lists of patients |
5. | Removal from the list of patients at the request of the patient |
6. | Removal from the list of patients at the request of the relevant medical practitioner |
7. | Removals from the list of patients who are violent |
8. | Removals from the list of patients who have moved |
9. | Removals not reflected in the list of patients on 31st March 2004 |
10. | Applications for acceptance as a temporary resident |
11. | Acceptance of temporary residents |
12. | Termination of responsibility for temporary residents |
13. | Provision of immediately necessary treatment |
14. | Newly registered patients |
15. | Appointments system |
16. | Qualifications of performers |
17. | Independent nurse prescribers and supplementary prescribers |
18. | Repeatable prescribing services |
19. | Patient records |
20. | Rights of entry |
21. | Refusal of approval of premises under paragraphs 29 and 29A of Schedule 2 to the 1992 Regulations |
22. | Withdrawal of approval of premises under paragraph 29A of Schedule 2 to the 1992 Regulations |
23. | Investigation of outstanding complaints |
24. | Complaints relating to general medical services made after 31st March 2004 |
25. | Reports to a medical officer |
26. | Inquiries about prescriptions and referrals |
27. | Notification of deaths |
28. | Arrangements with organisations providing deputy doctors |
29. | Notification of sub-contracts under general medical services contracts |
30. | Practice leaflet |
31. | Medical examination of medical practitioners |
32. | Patients not seen within three years |
33. | Patients aged 75 years and over |
34. | Arrangements for GP Registrars |
35. | Refund of fees paid under paragraph 38(f) of Schedule 2 to the 1992 Regulations |
36. | Annual reports |
37. | Determination of question whether a substance is a drug |
38. | Entry on to medical performers list of persons approved under regulation 18A or 18B of the 1992 Regulations |
39. | Outstanding appeals against refusal of approval under regulation 18A or 18B of the 1992 Regulations |
40. | Permission for use of facilities in private practice under section 72 of the 1977 Act |
41. | Recovery of overpayments |
42. | Continuation of pre-contract disputes relating to general medical services contracts |
43. | Application and interpretation of this Part |
44. | Carry over of approvals, applications, notices etc. |
45. | Newly registered patients |
46. | Temporary residents |
47. | Provision of immediately necessary treatment |
48. | Removals from the list of patients |
49. | Requirement to provide dispensing services |
50. | Sub-contracting |
51. | Complaints |
52. | Refund of fees |
53. | Annual returns and reviews |
54. | Carry-over of disputes between default and general medical services contracts |
55. | Grounds for termination of the general medical services contract |
56. | Notifications to patients affected by differences between the terms of a default and a general medical services contract |
57. | Definitions |
58. | Existing pilot schemes |
59. | Variation of transitional agreements |
60. | Interpretation of transitional agreements |
61. | Modification of the Implementation Directions for the purposes of transitional agreements |
62. | Modification of the 1992 Regulations for the purposes of transitional agreements |
63. | Modification of the Choice Regulations for the purposes of transitional agreements |
64. | Assignment of patients: transitional agreements |
65. | Representations against a requirement to assign: transitional agreements |
66. | Variation and termination of transitional agreements |
67. | Termination of transitional agreements varied under article 59 |
68. | Health service body status |
69. | Dispute resolution |
70. | Assignment of patients |
71. | Representations against assignments |
72. | Interpretation of this Part |
73. | Terms of general medical services contracts, default contracts and personal medical services agreements |
74. | Applications for approval of out of hours arrangements under general medical services contracts and default contracts |
75. | Applications for approval of out of hours arrangements under personal medical services agreements |
76. | Approvals of out of hours arrangements under general medical services contracts and default contracts |
77. | Approvals of out of hours arrangements under personal medical services agreements |
78. | Suspension of approvals and of out of hours arrangements under general medical services contracts, default contracts and personal medical services agreements |
79. | Refusal of approval of out of hours arrangements under general medical services contracts and default contracts |
80. | Refusal of approval of out of hours arrangements under personal medical services agreements |
81. | Review of approval of out of hours arrangements under general medical services contracts and default contracts |
82. | Review of approval of out of hours arrangements under general medical services contracts which follow default contracts |
83. | Review of out of hours arrangements under personal medical services agreements |
84. | Withdrawal of approval of out of hours arrangements under general medical services contracts and default contracts |
85. | Withdrawal of approval of out of hours arrangements under personal medical services agreements |
86. | Appeal against immediate withdrawal of approval of out of hours arrangements under general medical services contracts and default contracts |
87. | References to the NHS dispute resolution procedure in general medical services contracts which follow default contracts |
88. | Carry over of disputes relating to out of hours arrangements between default contracts and general medical services contracts |
89. | Appeal against immediate withdrawal of approval of out of hours arrangements under personal medical services agreements |
90. | Saving and transitory provision in relation to regulations 1 to 11 of the Out of Hours Regulations |
91. | Sub-contracting of out of hours services under general medical services contracts |
92. | Out of hours services to patients not registered with general medical services contractors or default contractors |
93. | Application of regulation 30 of the 2004 Regulations to general medical services contracts entered into under Part 2 of the Transitional Order |
94. | Interpretation |
95. | Cases where no decision has been made before the relevant date as to whether disciplinary action should be taken (regulation 4 of the Service Committees Regulations) |
96. | Referrals to investigating discipline committees before the relevant date (regulation 5 of the Service Committees Regulations) |
97. | Determination of a Primary Care Trust or the Secretary of State made before the relevant date (regulations 8, 9, 10 and 11 of the Service Committees Regulations) |
98. | Determination of a Primary Care Trust made on or after the relevant date (regulation 8 of the Service Committees Regulations) |
99. | Appeals to the Secretary of State against determinations of Primary Care Trusts (regulations 9, 10 and 11 of the Service Committees Regulations) |
100. | Excessive prescribing (regulation 15 of the Service Committees Regulations) |
101. | Investigation of certification (regulation 16 of the Service Committees Regulations) |
102. | Investigation of record keeping (regulation 17 of the Service Committees Regulations) |
103. | Decision as to treatment for which fees may be charged by doctors (regulation 18 of the Service Committees Regulations) |
104. | Functions of Local Medical Committees |
105. | Details to be included on prescription forms etc. |
106. | Transitional provision in cases where preferential treatment on transferring to medical lists was given |
107. | Continuing validity of forms |
108. | Transitory interpretation of references in enactments to primary medical services |
109. | Transitory interpretation of references to general medical services contracts |
110. | Meaning of suitable experience |
111. | Savings of certain provisions of the Medical Act 1983 |
112. | Saving of section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992 |
113. | Saving of sections 2A and 6(5) of the Health Service Commissioners Act 1993 |
114. | Transitional provision in relation to the National Health Service (Injury Benefits) Regulations 1995 |
115. | Transitory modification of section 18 of the 1990 Act |
116. | Modification of section 115 of the Police Act 1997 |
117. | Transitory modification of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994 |
118. | Transitory modification of the National Health Service (Vocational Training for General Medical Practice) Regulations 1997 |
119. | Minor and consequential amendments |
120. | Revocations |
Schedule 1 | Minor and consequential amendments |
Schedule 2 | Revocations |
(b) articles 32 and 33 apply to the contracts specified in sub-paragraph (a) and to a general medical services contract which takes effect immediately after a default contract with the same parties ceases to have effect; and
(c) article 34 applies to all general medical services contracts and default contracts entered into before 1st April 2005.
(2) Unless it is entered into with a person to whom the particular article does not apply, a general medical services contract or a default contract which falls within paragraph (1) shall include, or be deemed to include, terms which have the effect specified in articles 3 to 34.
(3) In this Part -
Applications for inclusion in lists of patients
3.
Where, on or before 31st March 2004, a person had applied to a relevant medical practitioner for inclusion in his list of patients pursuant to regulation 2 or 3(1) of the Choice Regulations but on 31st March 2004 that application had not yet been determined, the application shall, on 1st April 2004, be regarded as if it had been made to the succeeding contractor under -
Acceptance of applications for inclusion in lists of patients
4.
- (1) Where, on or before 31st March 2004, a relevant medical practitioner had agreed to accept a person on his list of patients pursuant to paragraph 6 of Schedule 2 to the 1992 Regulations[21] but on 31st March 2004 he had not yet sent the signed medical card or the application to the Primary Care Trust in accordance with sub-paragraph (3) of that paragraph, that acceptance shall be regarded on 1st April 2004 as an acceptance by the succeeding contractor and notification of that acceptance shall be sent by the succeeding contractor to the Primary Care Trust in accordance with -
(2) In paragraph (1), "medical card" has the same meaning as in regulation 2(1) of the 2004 Regulations.
Removal from the list of patients at the request of the patient
5.
Where, on or before 31st March 2004, a Primary Care Trust had received notice from a patient under regulation 23(1)(a) of the 1992 Regulations[22] that he wished to be removed from a relevant medical practitioner's list of patients but on 31st March 2004 that removal had not yet taken effect in accordance with regulation 23(1)(b) of those Regulations, the removal shall take effect as a removal from the list of patients of the succeeding contractor as if it were a removal pursuant to a request received by the Primary Care Trust in accordance with -
Removal from the list of patients at the request of the relevant medical practitioner
6.
- (1) Where, on or before 31st March 2004, a relevant medical practitioner had notified the Primary Care Trust that he wished to have a patient removed from his list of patients in accordance with paragraph 9 of Schedule 2 to the 1992 Regulations[23] but that removal had, on 31st March 2004, not yet taken effect, paragraph (2) shall apply.
(2) Except where paragraph (3) applies, the removal shall take effect as a removal from the list of patients of the succeeding contractor under -
(3) Where, on or before 31st March 2004, the Primary Care Trust had been -
paragraph (4) shall apply.
(4) In a case which falls within paragraph (3), the removal shall take effect as a removal from the list of patients of the succeeding contractor on -
whichever is the sooner.
Removals from the list of patients who are violent
7.
- (1) This article applies where, on or before 31st March 2004, a person had been removed from a relevant medical practitioner's list of patients with immediate effect pursuant to paragraph 9A of Schedule 2 to the 1992 Regulations[24] but -
(2) In a case to which paragraph (1)(a) applies written confirmation of the request for removal shall be given to the Primary Care Trust by the succeeding contractor within 7 days from the date on which notification was given under paragraph 9A(1).
(3) In a case to which paragraph (1)(b) applies, reasonable steps shall be taken by the succeeding contractor to inform the patient of the request for removal.
(4) In a case to which paragraph (1)(c) applies, the Primary Care Trust shall send written notice of the removal to the patient.
Removals from the list of patients who have moved
8.
- (1) Where, on or before 31st March 2004, a Primary Care Trust had informed a patient and a relevant medical practitioner, in accordance with regulation 23(2) of the 1992 Regulations[26], that the medical practitioner was no longer obliged to visit and treat him but the 30 days referred to in that regulation had not yet expired, that information shall be regarded as if it had been given under -
(2) Where, on or before 31st March 2004, a Primary Care Trust had given a relevant medical practitioner notice in writing, in accordance with regulation 23(4) of the 1992 Regulations[27], that it intended to remove a person from the practitioner's list of patients but the six months referred to in that regulation had not yet expired, that notice shall be regarded as if it had been given to the succeeding contractor under -
Removals not reflected in the list of patients on 31st March 2004
9.
- (1) This article applies where -
(2) In a case to which this article applies, the Primary Care Trust shall -
Applications for acceptance as a temporary resident
10.
Where, on or before 31st March 2004, a person had applied to a relevant medical practitioner for acceptance as a temporary resident under regulation 7 of the Choice Regulations but on 31st March 2004 that application had not yet been determined, the application shall be regarded as if it had been made to the succeeding contractor and shall be dealt with in accordance with -
Acceptance of temporary residents
11.
- (1) This article applies where -
(2) In a case to which this article applies, the person shall, on 1st April 2004, be treated as if he had been accepted as a temporary resident by the succeeding contractor under -
Termination of responsibility for temporary residents
12.
Where, on or before 31st March 2004, a relevant medical practitioner had informed the Primary Care Trust in writing in accordance with paragraph 10 of Schedule 2 to the 1992 Regulations that he wished to terminate his responsibility for a temporary resident but, on 31st March 2004, that responsibility had not yet terminated under paragraph 9 of that Schedule, the responsibility of the succeeding contractor for that temporary resident shall terminate seven days after the date on which the information under paragraph 10 of Schedule 2 to the 1992 Regulations was given to the Primary Care Trust by the relevant medical practitioner.
Provision of immediately necessary treatment
13.
Where, on 31st March 2004, a relevant medical practitioner was responsible for providing immediately necessary treatment to any person under paragraph 4(4) of Schedule 2 to the 1992 Regulations[30], the succeeding contractor shall continue to be responsible for providing such treatment to that person for the period for which the relevant medical practitioner would have been responsible if that paragraph had not been revoked.
Newly registered patients
14.
- (1) This article applies where, on 31st March 2004, a patient specified in paragraph (2) -
(2) The patient referred to in paragraph (1) is a patient -
(b) in respect of whom a Primary Care Trust had not granted deferment of the obligation to invite him to participate in a consultation under paragraph 14 of Schedule 2 to the 1992 Regulations.
(3) A patient to whom this article applies shall, on 1st April 2004, be regarded as a patient who falls within -
Appointments system
15.
Where, on or before 31st March 2004, a relevant medical practitioner had notified a Primary Care Trust under paragraph 31 of Schedule 2 to the 1992 Regulations -
that notice shall be regarded as a notice given by the succeeding contractor to the Primary Care Trust for the purposes of the term of the general medical services contract which gives effect to paragraph 82(c) of Schedule 6 to the 2004 Regulations or the equivalent term of the default contract.
Qualifications of performers
16.
- (1) Where, on 1st April 2004, a succeeding contractor continues to employ or engage a person who on 31st March 2004 was employed or engaged in accordance with the requirements of Schedule 2 to the 1992 Regulations by the relevant medical practitioner in relation to whom it is a succeeding contractor, paragraphs (2) and (3) shall apply.
(2) The requirements to make checks contained in the terms of the general medical services contract which give effect to paragraphs 57(1)(b) and 58(1) of Schedule 6 to the 2004 Regulations, or in the equivalent terms of the default contract -
(3) The requirement to obtain references in the term of the general medical services contract which gives effect to paragraph 59 of Schedule 6 to the 2004 Regulations, or in the equivalent term of the default contract, shall not apply if such references have been obtained, checked and found to be satisfactory by the relevant medical practitioner by whom the health care professional was employed or engaged on 31st March 2004.
Independent nurse prescribers and supplementary prescribers
17.
- (1) Where, on or before 31st March 2004, a relevant medical practitioner had notified the Primary Care Trust of any matters relating to an independent nurse prescriber or a supplementary prescriber under paragraph 28A of Schedule 2 to the 1992 Regulations[33], the succeeding contractor shall not be required to notify the Primary Care Trust of those same matters under -
(2) In paragraph (1), "independent nurse prescriber" and "supplementary prescriber" have the same meaning as in paragraph 1 of Schedule 2 to the 1992 Regulations[34].
Repeatable prescribing services
18.
- (1) Where, on 31st March 2004, a relevant medical practitioner met the requirements for providing repeatable prescribing services in regulation 33A of the 1992 Regulations[35] and had, on or before that date, notified the Primary Care Trust of his intention to provide such services in accordance with that paragraph, that notification shall be regarded, on 1st April 2004, as a notification given by the succeeding contractor under -
(2) For the purposes of a notification regarded as given under sub-paragraph (1), the date on which the succeeding contractor intends to begin to provide repeatable prescribing services included in the notification shall be deemed to be 1st April 2004.
(3) In this paragraph, "repeatable prescribing services" in relation to a relevant medical practitioner has the same meaning as in regulation 2(1) of the 1992 Regulations[36] and in relation to a general medical services contractor or a default contractor has the same meaning as in regulation 2(1) of the 2004 Regulations.
Patient records
19.
- (1) Where, on 31st March 2004, a relevant medical practitioner had the written consent of the Primary Care Trust to the keeping of computerised records under paragraph 36 of Schedule 2 to the 1992 Regulations[37] and that consent had not been withdrawn, that consent shall be regarded as written consent to the succeeding contractor for the purposes of -
(2) Where -
the records requested shall be sent by the succeeding contractor to the Primary Care Trust as soon as possible.
(3) Where, on or before 31st March 2004, a relevant medical practitioner had been informed of the death of a patient on its list by the Primary Care Trust or had otherwise learned of the death of such a patient but on 31st March 2004 had not yet sent that patient's records to the Primary Care Trust in accordance with paragraph 36(6)(b) of Schedule 2 to the 1992 Regulations, those records shall be sent to the Primary Care Trust by the succeeding contractor -
Rights of entry
20.
- (1) Where, on or before 31st March 2004, a relevant medical practitioner had received a written request for inspection of his practice premises under paragraph 27(b) of Schedule 2 to the 1992 Regulations[38] but, on 31st March 2004, no inspection had yet taken place pursuant to that request, the request shall, on 1st April 2004, be regarded as notice of an intended entry to the succeeding contractor under -
(2) In determining whether reasonable notice was given of any entry to the practice premises following a notice referred to in paragraph (1), regard shall be had to the date on which the request under paragraph 27(b) of Schedule 2 to the 1992 Regulations was made.
Refusal of approval of premises under paragraphs 29 and 29A of Schedule 2 to the 1992 Regulations
21.
- (1) Where, on or before 31st March 2004, a Primary Care Trust had notified a relevant medical practitioner under paragraph 29(12) of Schedule 2 to the 1992 Regulations[39] of its refusal of an application made under -
paragraphs (2) and (3) shall apply.
(2) Where, on 31st March 2004, the time for appealing against the refusal specified in paragraph 29(13) of Schedule 2 to the 1992 Regulations had not expired and no appeal had yet been made, the time for appealing shall continue as if paragraph 29 and, if applicable, paragraph 29A of that Schedule had not been revoked.
(3) Where -
that appeal shall be dealt with, or continue to be dealt with, as if paragraph 29 and, if applicable, paragraph 29A of that Schedule had not been revoked.
(4) Where an appeal dealt with under paragraph (3) is successful, the Primary Care Trust shall agree to a variation of the contract which it holds with the succeeding contractor which has the effect of adding to the list of practice premises under that contract the premises approved as a result of the appeal.
(5) A variation agreed by the Primary Care Trust pursuant to paragraph (4) shall have effect -
Withdrawal of approval of premises under paragraph 29A of Schedule 2 to the 1992 Regulations
22.
- (1) Where -
the time for appealing shall continue as if paragraph 29A of Schedule 2 to the 1992 Regulations had not been revoked.
(2) Where -
that appeal shall be dealt with, or continue to be dealt with, as if paragraph 29 and, if applicable, paragraph 29A of Schedule 2 to the 1992 Regulations were still in force.
(3) Where an appeal dealt with under paragraph (2) is successful, the Primary Care Trust shall agree to a variation of the contract which it holds with the succeeding contractor which has the effect of adding to the list of practice premises under that contract the premises approved as a result of the appeal.
(4) A variation agreed by the Primary Care Trust pursuant to paragraph (3) shall have effect -
Investigation of outstanding complaints
23.
- (1) Where, on 31st March 2004 -
that complaint must, from 1st April 2004, be investigated, or in an appropriate case continue to be investigated, by the succeeding contractor as if paragraph 47A had not been revoked.
(2) Where, on 31st March 2004 -
that complaint must be investigated by one of the persons specified in paragraph (3) as if paragraph 47A had not been revoked.
(3) The persons referred to in paragraph (2) are -
(4) The requirements referred to in paragraph (3) are that the former partner or partners -
(5) Where, under paragraph (3), a complaint made by or on behalf of a patient or former patient would fall to be investigated, or continue to be investigated, by more than one general medical services contractor or default contractor, the contractors concerned shall -
(6) Where, under this article, a complaint falls to be investigated by a Primary Care Trust the investigation shall be carried out in accordance with the directions dated 29th June 1998 on dealing with complaints about family health services practitioners given by the Secretary of State under section 17 of the 1977 Act[42].
Complaints relating to general medical services made after 31st March 2004
24.
The complaints procedure established and operated by a succeeding contractor under -
shall apply to any complaint which a patient or former patient of the relevant medical practitioner to whom it is a succeeding contractor could have made (but did not make) on or before 31st March 2004 under paragraph 47A of Schedule 2 to the 1992 Regulations as it applies to complaints made by a patient or former patient of the succeeding contractor in relation to any matter reasonably connected with the provision of services under the contract.
Reports to a medical officer
25.
- (1) Where, on or before 31st March 2004, a relevant medical practitioner had received a request for information or an inquiry from a medical officer (or an officer of the Department for Work and Pensions on his behalf or at his direction) under paragraph 48 of Schedule 2 to the 1992 Regulations[43] but, on 31st March 2004, he had not yet responded to that request or inquiry, the succeeding contractor shall respond as if the request or inquiry had been made under -
(2) In this article, "medical officer" means a medical practitioner who is -
Inquiries about prescriptions and referrals
26.
Where, on or before 31st March 2004, a relevant medical practitioner had received an inquiry about prescriptions or referrals from a Primary Care Trust under paragraph 49 of Schedule 2 to the 1992 Regulations[44] but had not yet responded to that inquiry, the succeeding contractor shall respond as if the inquiry had been made under -
Notification of deaths
27.
Where, on 31st March 2004, there was an outstanding requirement to report the death of a person on the practice premises of a relevant medical practitioner to the Primary Care Trust in accordance with paragraph 36C of Schedule 2 to the 1992 Regulations[45], the death shall be reported on 1st April 2004 by the succeeding contractor in accordance with -
Arrangements with organisations providing deputy doctors
28.
- (1) Where -
(b) on 1st April 2004, the arrangements covered by the remedial notice are continuing in the form of a sub-contract with the succeeding contractor,
the remedial notice issued under paragraph 21A(7) of Schedule 2 to the 1992 Regulations shall be regarded as a remedial notice served in the same terms on the succeeding contractor on 1st April 2004 under the term of its general medical services contract which gives effect to paragraph 115(1) of Schedule 6 to the 2004 Regulations (or under the equivalent term of its default contract).
(2) A remedial notice deemed to have been served on the succeeding contractor pursuant to paragraph (1) shall not count as a remedial notice for the purposes of the term of the general medical services contract which gives effect to paragraph 115(6) of Schedule 6 to the 2004 Regulations (or for the purposes of the equivalent term of the default contract).
(3) In this article, "remedial notice" means, in relation to a notice issued before 1st April 2004, a notice issued under paragraph 21A(7) of Schedule 2 to the 1992 Regulations and, in relation to a notice issued after that date, a notice served under the term of the general medical services contract which gives effect to paragraph 115(1) of Schedule 6 to the 2004 Regulations (or under the equivalent term of the default contract).
Notification of sub-contracts under general medical services contracts
29.
- (1) Where -
(b) the succeeding general medical services contractor wishes to continue those arrangements after 31st March 2004 in the form of a sub-contract to which paragraph 69 of Schedule 6 to the 2004 Regulations applies,
any requirement for the succeeding contractor to notify the Primary Care Trust of its intention to enter into that sub-contract contained in the term of its general medical services contract which gives effect to paragraph 69(1)(b) of Schedule 6 to the 2004 Regulations shall not apply, unless the date of termination of the arrangements is extended beyond the date which applied to them on 31st March 2004 or there is a material variation in the nature of those arrangements.
(2) In this article -
Practice leaflet
30.
- (1) This article applies where a relevant medical practitioner had compiled a practice leaflet which met the requirements of paragraph 47 of Schedule 2 to the 1992 Regulations[48] and that leaflet was, on 31st March 2004, available to patients on his list.
(2) In the circumstances to which this article applies, the practice leaflet made available to patients by -
need not, until 1st August 2004, include all the information specified in the term of the general medical services contract which gives effect to Schedule 10 to the 2004 Regulations (or in the equivalent term of the default contract) provided that, from the date of commencement of the contract until the practice leaflet does so comply, the general medical services contractor or the default contractor makes available to patients in written form the information specified in paragraph (3).
(3) The information referred to in paragraph (2) is -
(4) In this article, "practice leaflet" -
Medical examination of medical practitioners
31.
Where, on or before 31st March 2004 -
the requirement shall, on 1st April 2004, unless the Primary Care Trust notifies him otherwise in writing, be regarded as a request made to that medical practitioner for him to be medically examined on the grounds that he is incapable of adequately providing services under the succeeding contract and arrangements for the medical examination shall, with the consent of the medical practitioner, continue to be made by the Local Medical Committee for the area of the Primary Care Trust which is a party to the succeeding contract, pursuant to the function conferred on that committee by regulation 27 of the 2004 Regulations.
Patients not seen within three years
32.
The term of a general medical services contract which gives effect to paragraph 5 of Schedule 6 to the 2004 Regulations (or the equivalent term of a default contract) shall be read as if the reference to a consultation or clinic provided by the general medical services contractor (or the default contractor) included a reference to a consultation or clinic provided by -
Patients aged 75 years and over
33.
The term of a general medical services contract which gives effect to paragraph 6 of Schedule 6 to the 2004 Regulations (or the equivalent term of a default contract) shall be read as if the reference to participating in a consultation under that term included a reference to participating in a consultation under -
Arrangements for GP Registrars
34.
- (1) Where, before 1st April 2005, a general medical services contractor or a default contractor employs a GP Registrar for the purpose of being trained by a GP Trainer, the requirement for the general medical services contractor or the default contractor to have the agreement of the Secretary of State to that employment in -
shall not apply.
(2) In this article, "GP Registrar" and "GP Trainer" have the same meaning as in regulation 2(1) of the 2004 Regulations.
Refund of fees paid under paragraph 38(f) of Schedule 2 to the 1992 Regulations
35.
Where, on 31st March 2004, a patient had paid a fee to a medical practitioner under paragraph 38(f) of Schedule 2 to the 1992 Regulations but -
the period for applying for a refund and the powers of the Primary Care Trust in dealing with any application for a refund shall continue as if paragraph 39(1) of that Schedule had not been revoked.
Annual reports
36.
Notwithstanding the revocation of the 1992 Regulations, any medical practitioner to whom paragraph 50 of Schedule 2 to those Regulations (annual reports)[50] applied shall, by 30th June 2004, provide, either individually or as a member of a partnership, to the Primary Care Trust on whose medical list he appeared on 31st March 2004, an annual report in respect of the period of 12 months ending on 31st March 2004 which includes -
Determination of question whether a substance is a drug
37.
- (1) Where, on 31st March 2004, a Primary Care Trust had, under regulation 36(7) of the 1992 Regulations[53], informed a medical practitioner of its decision that a substance ordered by him was not a drug but -
the time for appealing shall continue as if regulation 36 of the 1992 Regulations were still in force.
(2) Where -
that appeal shall continue to be dealt with as if regulation 36 of the 1992 Regulations were still in force.
Entry on to medical performers list of persons approved under regulation 18A or 18B of the 1992 Regulations
38.
Where a Primary Care Trust -
it shall add that person's name to its medical performers list unless he is already on the medical performers list of another Primary Care Trust and is not withdrawing from that list.
Outstanding appeals against refusal of approval under regulation 18A or 18B of the 1992 Regulations
39.
- (1) Where, on 31st March 2004 -
the time for appealing shall continue as if those regulations had not been revoked.
(2) Where a medical practitioner whose nomination a Primary Care Trust had refused to approve under regulation 18A or 18B of the 1992 Regulations -
that appeal shall continue to be dealt with as if regulation 18G or, as the case may be, 18GG of the 1992 Regulations had not been revoked.
(3) Where -
the Primary Care Trust shall add that person's name to its medical performers list unless he is already on the medical performers list of another Primary Care Trust and is not withdrawing from that list.
Permission for use of facilities in private practice under section 72 of the 1977 Act
40.
Where, on 31st March 2004, a relevant medical practitioner had the permission of the Secretary of State under section 72 of the 1977 Act (permission for use of facilities in private practice), that permission shall be regarded, from 1st April 2004, as permission granted under that section to the succeeding contractor.
Recovery of overpayments
41.
- (1) Where, on or before 31st March 2004, a medical practitioner had admitted an overpayment drawn to its attention by a Primary Care Trust under regulation 35(2) of the 1992 Regulations[57] (claims and overpayments) but the overpayment, or any part of it, had not been recovered, the amount overpaid, or any part of it not recovered before 31st March 2004, shall, notwithstanding the repeal of the 1992 Regulations, continue to be recoverable by that Primary Care Trust and shall be treated as a debt owed by that medical practitioner to that Primary Care Trust.
(2) Notwithstanding the repeal of the 1992 Regulations, where a Primary Care Trust considers that a payment has been made to a medical practitioner under the Statement of Fees and Allowances when it was not due and has not drawn that alleged overpayment to the attention of the medical practitioner on or before 31st March 2004, the Primary Care Trust may draw that overpayment to the attention of the medical practitioner and -
(3) In this article "Statement of Fees and Allowances" means the statement determined and published by the Secretary of State under regulation 34 of the 1992 Regulations[58], as that statement had effect on 31st March 2004.
Continuation of pre-contract disputes relating to general medical services contracts
42.
- (1) Where, on or before 31st March 2004 -
the dispute shall, notwithstanding that the parties to the dispute have entered into a general medical services contract, continue to be dealt with under the procedure specified in regulation 9(2) of the 2004 Regulations.
(2) In the case of a dispute dealt with pursuant to paragraph (1), the determination -
Carry over of approvals, applications, notices etc.
44.
- (1) Subject to paragraph (3), in a case to which this Part applies -
from a date which is after the date on which the default contract ceases to have effect, shall be deemed to be a notice served on the general medical services contractor under its general medical services contract which takes effect on the date on which it would have taken effect had the default contract continued in force and any time specified in the general medical services contract for referring the matter to the NHS dispute resolution procedure shall be deemed to run from the date on which the notice was given to or served on the default contractor;
(e) subject to paragraph (2), any notification or information given to the Primary Care Trust or a patient by the default contractor under its default contract shall be deemed to be a notification or information given by the general medical services contractor under the equivalent term of its general medical services contract on the date on which the general medical services contract takes effect and any reference in the relevant term of the general medical services contract to the date on which the event referred to in the notification shall take effect shall be read as a reference to the date on which that event would have taken effect had the default contract remained in force;
(f) any report, notification or information (other than a notification required to be given under the term of the default contract equivalent to paragraph 86 of Schedule 6 to the 2004 Regulations) which, on the date on which the default contract ceased to have effect, was required to be given to any person by the default contractor under its default contract but had not been so given, shall be given by the general medical services contractor as if it was required to be given under the general medical services contract, subject to the modification that the timescale for giving any such report, notification or information shall be that which would have applied to the default contractor had the default contract remained in force;
(g) any notifications or acknowledgements required to be given by the Primary Care Trust to to a default contractor under its default contract on the date on which it ceases to have effect but which had not been so given shall be given by the Primary Care Trust to the general medical services contractor as if it is was required under the terms of the general medical services contract;
(h) any notifications required to be given by the Primary Care Trust under a default contract to a patient on the default contractor's list of patients on the date on which the default contract ceases to have effect but which had not been so given, shall be given to that patient by the Primary Care Trust -
(i) any request or inquiry made to the default contractor under the default contract but which has not been complied with on or before the date on which the default contract ceases to have effect, shall be complied with by the general medical services contractor as if it was a request or inquiry made under the equivalent term of the general medical services contract and any time specified in the general medical services contract for responding to any such request shall be deemed to run from the date on which the request was made to the default contractor;
(j) any preference expressed by a patient under the default contract to receive services from a particular performer or class of performer under that default contract and which he has not withdrawn on or before the date on which the default contract ceases to have effect shall, with effect from the date on which the general medical services contract takes effect, be regarded, for the purposes of that general medical services contract, as a preference expressed under the term of that contract which gives effect to paragraph 18 of Schedule 6 to the 2004 Regulations;
(k) any checks which the default contractor has made under the terms of its default contract which are equivalent to paragraphs 57 to 59 of Schedule 6 to the 2004 Regulations or steps which it has taken to satisfy itself under the terms of that contract equivalent to paragraphs 58(1)(b), 60 or 69(1) of that Schedule shall be regarded as checks made or steps taken by the general medical services contractor under the terms of its general medical services contract which give effect to those paragraphs;
(l) any records relating to a patient which are required to be sent to the Primary Care Trust by the default contractor under the term of its default contract which is equivalent to paragraph 73(6) of Schedule 6 to the 2004 Regulations but which have not been sent on or before the date on which the default contract ceases to have effect, shall be sent to the Primary Care Trust by the general medical services contractor by the date on which the default contractor would have been required to send them had its default contract not ceased to have effect;
(m) the reference to a warning given by the general medical services contractor in the term of the general medical services contract which gives effect to paragraph 20(3) of Schedule 6 to the 2004 Regulations shall be deemed to include a reference to a warning given by the default contractor.
(2) Where -
the right of the Primary Care Trust under the term of the general medical services contract which gives effect to paragraph 69 of Schedule 6 to the 2004 Regulations to object to the sub-contract covered by that notification shall not apply.
(3) Paragraph (1) does not apply to any action taken or required to be taken by either party to a default contract under -
contained in the default contract.
Newly registered patients
45.
- (1) Where a patient of a default contractor -
that patient shall be regarded as a patient of the general medical services contractor who, on the date on which the general medical services contract takes effect, falls within the term of the general medical services contract which gives effect to paragraph 4 of Schedule 6 to the 2004 Regulations.
(2) In the case of a patient to whom paragraph (1) applies, the reference to a period of six months in the term of the general medical services contract which gives effect to paragraph 4(2) of Schedule 6 to the 2004 Regulations shall be read as if it was a reference to six months from the date of the patient's acceptance on or assignment to the default contractor's list.
Temporary residents
46.
Where, on the date on which the default contract ceases to have effect -
the person shall be treated as if he had been accepted as a temporary resident by the general medical services contractor under the term of its general medical services contract which gives effect to paragraph 16 of Schedule 6 to the 2004 Regulations, subject to the modification that the reference to a period of three months in that term shall be read as a reference to a period of three months starting with the date on which the person was accepted as a temporary resident by the default contractor.
Provision of immediately necessary treatment
47.
Where, on the date on which the default contract ceases to have effect, a default contractor is responsible for providing immediately necessary treatment to any person under the term of the default contract equivalent to regulation 15 of the 2004 Regulations, the general medical services contractor shall continue to be responsible for providing such treatment to that person for the period for which the default contractor would have been responsible if the default contract had remained in force.
Removals from the list of patients
48.
- (1) Where, on the date on which the default contract ceases to have effect, a Primary Care Trust has received a request from a patient to be removed from a default contractor's list of patients but that removal has not yet taken effect under the term of the default contract equivalent to paragraph 19(3) of Schedule 6 to the 2004 Regulations, that removal shall take effect as a removal from the list of patients of the general medical services contractor on the date on which it would have taken effect had the default contract remained in force.
(2) Where, on the date on which the default contract ceases to have effect, a Primary Care Trust has informed a default contractor and one of its registered patients of the matters required under the term of the default contract equivalent to paragraph 23 of Schedule 6 to the 2004 Regulations but the 30 days referred to in that term has not expired, the information shall be regarded as if it had been given under the term of the general medical services contract which gives effect to paragraph 23 of Schedule 6 to the 2004 Regulations subject to the modification that the reference in that term to 30 days shall be read as a reference to 30 days from the date of the advice given to the patient by the default contractor.
(3) Where, on the date on which the default contract ceases to have effect, a Primary Care Trust has given notice in writing to a default contractor in accordance with the term of its contract which is equivalent to paragraph 24 of Schedule 6 to the 2004 Regulations but the six months referred to in that term has not expired, the notice shall be regarded as if it had been given under the term of the general medical services contract which gives effect to paragraph 24 of Schedule 6 to the 2004 Regulations subject to the modification that the reference in that term to six months shall be read as a reference to six months commencing with the date of the notice to the default contractor.
Requirement to provide dispensing services
49.
- (1) Where, on the date on which the default contract ceases to have effect -
the Primary Care Trust may give notice to the general medical services contractor under the term of its general medical services contract which gives effect to paragraph 47(5) of Schedule 6 to the 2004 Regulations as if the request had been made by the patient to the general medical services contractor on the date on which it was made to the default contractor.
(2) Where the Primary Care Trust has given notice to the default contractor under its default contract that it requires it to provide dispensing services to a patient from a date before the date on which the default contract ceases to have effect, that notice shall be regarded as a notice served on the general medical services contractor under the term of its general medical services contract which gives effect to paragraph 47(5) of Schedule 6 to the 2004 Regulations requiring it to provide dispensing services to the patient from the date on which the general medical services contract takes effect.
(3) In this article "dispensing services" has the same meaning as in regulation 2(1) of the 2004 Regulations.
Sub-contracting
50.
- (1) Where -
the term of the general medical services contract which gives effect to paragraph 69(1)(b) of Schedule 6 to the 2004 Regulations shall not apply to that sub-contract unless it is extended beyond the date referred to in sub-paragraph (b) or there is a material variation in its terms.
(2) In this article, "health care professional" has the same meaning as in section 28M of the 1977 Act[59].
Complaints
51.
- (1) Where -
(b) on the date on which the default contract ceases to have effect the investigation of that complaint has not been concluded,
the complaint shall be investigated or, in an appropriate case, continue to be investigated, by the general medical services contractor under the complaints procedure established in accordance with the term of its general medical services contract which gives effect to paragraph 92 of Schedule 6 to the 2004 Regulations.
(2) In a case to which this Part applies, any references in the terms of the general medical services contract which give effect to paragraphs 92 to 96 and 98 of Schedule 6 to the 2004 Regulations to -
shall be read as if they included a reference to services provided by or received from the default contractor, to the patient or former patient of the default contractor or to complaints made to the default contractor.
Refund of fees
52.
- (1) Where, on the date on which a default contract ceases to have effect, a patient has paid a fee to the default contractor under the term of its default contract equivalent to regulation 24(3) of the 2004 Regulations but -
the fee shall be regarded as if it had been paid to the general medical services contractor under its general medical services contract and the term of the general medical services contract which gives effect to regulation 24(4) of the 2004 Regulations shall apply subject to the modifications specified in paragraph (2).
(2) The modifications referred to in paragraph (1) are that -
Annual returns and reviews
53.
- (1) Where, in a case to which this Part applies, the periods or part of the periods covered by the default contract and the general medical services contract fall in the same financial year -
(2) In this article, "financial year" means the twelve months ending with 31st March.
Carry-over of disputes between default and general medical services contracts
54.
- (1) Where -
the adjudicator shall, in determining the dispute, consider the relevance of his determination to the general medical services contract which took effect immediately after the default contract ceased to have effect and, if he considers that his determination is relevant to that general medical services contract, he shall determine the dispute as if it were a dispute referred to him by the general medical services contractor under the NHS dispute resolution procedure contained in the general medical services contract.
(2) In this article, "adjudicator" means the Secretary of State or a person or persons appointed by the Secretary of State under section 4(5) of the 1990 Act or paragraph 101(5) of Schedule 6 to the 2004 Regulations.
Grounds for termination of the general medical services contract
55.
Where, on or before the date on which the default contract ceases to have effect -
those circumstances shall, for the purposes of the term of the general medical services contract which gives effect to paragraph 113 of Schedule 6 to the 2004 Regulations, be regarded as if they had arisen during the existence of the general medical services contract.
Notifications to patients affected by differences between the terms of a default and a general medical services contract
56.
Where, in a case to which this Part applies -
the Primary Care Trust shall notify those patients in writing of the change and inform them of the steps they can take to obtain elsewhere the services in question or, as the case may be, register elsewhere for the provision of essential services (or their equivalent).
Existing pilot schemes
58.
Any pilot scheme under which personal medical services were being provided on 31st March 2004 shall, on the coming into force of section 178(1) of the 2003 Act (abolition of pilot schemes) in relation to personal medical services, be deemed to have been made under section 28C of the 1977 Act[63] and accordingly shall not cease to have effect merely because of the repeal of Part 1 of the 1997 Act in relation to personal medical services.
Variation of transitional agreements
59.
- (1) The parties to a transitional agreement shall as soon as is reasonably practicable after 1st April 2004 enter into discussions with each other with a view to agreeing variations to the transitional agreement that will ensure that the terms of the transitional agreement comply with the Personal Medical Services Agreements Regulations.
(2) Subject to paragraph (3), no variation shall have effect unless it is in writing and signed by or on behalf of the contractor and the relevant body.
(3) If the parties to the transitional agreement have not agreed variations to the transitional agreement by 30th September 2004, the relevant body shall vary the transitional agreement without the consent of the contractor so that the terms of the transitional agreement comply with the Personal Medical Services Agreements Regulations.
(4) Where paragraph (3) applies, the relevant body shall notify the contractor in writing of the wording of the proposed variations and the date upon which the variations are to take effect.
(5) The date that the proposed variation is to take effect shall not be less than 14 days after the date on which the notice under paragraph (4) is served on the contractor.
(6) The parties to a transitional agreement may not agree (whether under this article or otherwise) any variation to the transitional agreement that would be contrary to the Personal Medical Services Agreements Regulations.
Interpretation of transitional agreements
60.
- (1) Until
a transitional agreement shall be interpreted in accordance with this article.
(2) Any reference in a transitional agreement to -
(3) In relation to the assignment of a patient to a medical practitioner in accordance with regulation 5 of the Choice Regulations, any reference in a transitional agreement to regulation 4(2)(b) of those Regulations shall be deemed to be a reference to article 64(1).
(4) In the case of a transitional agreement falling within paragraph (5), the transitional agreement shall be interpreted as if it had been varied to include terms having the effect specified in Schedule 4 to the Personal Medical Services Agreements Regulations (opt outs of out of hours services).
(5) A transitional agreement falls within this paragraph where the contractor has contracted to provide out of hours services only to patients to which it is required to provide the equivalent of general medical services (within the meaning of section 29(1A) of the 1977 Act[65] prior to its repeal) under the agreement.
(6) The transitional agreement shall be interpreted as if it had been varied to include a term or terms having the effect specified in paragraph 105 of Schedule 5 to the Personal Medical Services Agreements Regulations (termination by the relevant body on fitness grounds), subject to the modification that the reference in that term to a person falling within the cases specified in paragraph 105(3) during the existence of the agreement shall be read as if it referred to a person so falling on or after 1st April 2004.
(7) Where a transitional agreement includes the provision of services in the out of hours period within the meaning of paragraph 1(1) of Schedule 6 to the Personal Medical Services Agreements Regulations, the transitional agreement shall be interpreted as if it had been varied to include terms having the effect specified in Schedule 6 to those Regulations (out of hours transitional provisions), subject to the modification that the references to the NHS dispute resolution procedure in paragraphs 2(5), 3(6) and (7) and 5(5) of that Schedule shall, in the case of transitional agreements to which the NHS dispute resolution procedure does not apply, be deemed to include a reference to the dispute resolution procedure under the transitional agreement.
(8) For the purposes of paragraph (7), it shall be assumed that the out of hours services provided by the contractor under the transitional agreement to patients to which it is required to provide the equivalent of general medical services (within the meaning of section 29(1A) of the 1977 Act prior to its repeal) are provided by the contractor pursuant to regulation 20 of the Personal Medical Services Agreements Regulations (out of hours services).
Modification of the Implementation Directions for the purposes of transitional agreements
61.
- (1) The modifications referred to in article 60(2)(a) are as follows.
(2) As if any reference to -
(3) As if for Schedule 5 to the Implementation Directions there were substituted Schedule 9 to the Personal Medical Services Agreements Regulations (PCTs specified for the purposes of repeatable prescribing), and accordingly as if any reference in those directions to Schedule 5 to those Directions were a reference to Schedule 9 to those Regulations.
(4) As if any reference to personal medical services were a reference to medical services of a kind that could have been provided by a general medical practitioner in accordance with arrangements made under Part 2 of the 1977 Act prior to 1st April 2004.
(5) As if any reference to pilot schemes or pilot scheme agreements were a reference to transitional agreements.
(6) As if any reference to a services list, medical list or supplementary list were to a medical performers list.
(7) As if any reference to regulation 6(3)(d) of the Services List Regulations or regulation 18E(1)(e) of, and Part 3 of Schedule 3 to, the 1992 Regulations were a reference to regulation 6(3)(d) of the Performers Lists Regulations.
(8) As if in direction 9, the words "under regulation 4(2)(b) of those Regulations" were omitted.
(9) As if any reference to out of hours arrangements were to out of hours arrangements within the meaning given to that expression by article 72.
Modification of the 1992 Regulations for the purposes of transitional agreements
62.
- (1) The modification referred to in article 60(2)(b) is as follows.
(2) Any reference to Schedule 10 or, as the case may be Schedule 11, to the 1992 Regulations shall be a reference to Schedule 1 (in the case of Schedule 10) or 2 (in the case of Schedule 11) to the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004[66].
Modification of the Choice Regulations for the purposes of transitional agreements
63.
- (1) The modifications referred to in article 60(2)(d) are as follows.
(2) As if in regulation 1 a new paragraph (4) were added at the end as follows -
(3) As if in regulation 2(1) there were substituted -
(4) As if in regulation 5 -
and the Primary Care Trust shall, on receipt of the notification under sub-paragraph (a) notify the patient of the doctor to whom he has been assigned.";
(c) paragraphs (3), (5) and (6) were omitted.
(5) As if in regulation 7, the reference to a pilot scheme were to a transitional agreement.
Assignment of patients: transitional agreements
64.
- (1) A Primary Care Trust may require a contractor to assign a patient to a medical practitioner who performs personal medical services in connection with a transitional agreement to which the contractor is a party.
(2) Where a Primary Care Trust is considering requiring a contractor to assign a patient to a medical practitioner under paragraph (1), it shall have regard to -
(3) Where a contractor is unable to comply, in accordance with this article or regulation 5 of the Choice Regulations (as modified by article 63) with a requirement to assign a patient to a medical practitioner, and the Primary Care Trust is satisfied, after due enquiry, that the person concerned still wishes to be assigned to a provider of essential services (or their equivalent), the Primary Care Trust shall as soon as practicable assign, or require the assignment of, that person to another provider of essential services (or their equivalent) or medical practitioner in accordance with any relevant agreement, contract or enactment.
(4) A medical practitioner to whom a patient is assigned under this article or regulation 5 of the Choice Regulations (as modified by article 63) shall not be required to provide child health surveillance services, contraceptive services, maternity medical services or minor surgery services for that patient unless he is obliged to provide those services to him in connection with a transitional agreement.
(5) Where a contractor has requested the Primary Care Trust to remove a patient from a medical practitioner's list or a pooled list under a provision equivalent to paragraph 20 of Schedule 5 to the Personal Medical Services Agreements Regulations, the Primary Care Trust shall take all reasonable steps to assign, or require the assignment of, the patient to another provider of essential services (or their equivalent) or medical practitioner before the end of the working day after the day on which the Primary Care Trust receives notification from the contractor.
(6) In paragraph (5) -
Representations against a requirement to assign: transitional agreements
65.
- (1) A contractor who has been required under article 64(1) to assign a person to a medical practitioner may, within the period of seven days beginning with the day on which that assignment is made, make representations in writing to the Primary Care Trust against the requirement to assign, but shall remain responsible for providing personal medical services for the person to whom the requirement relates, pending notification of the confirmation or revision of the assignment by the Primary Care Trust.
(2) Where representations are made to it against a requirement to assign, a Primary Care Trust shall, subject to paragraph (4), promptly review the decision to require assignment and shall either confirm or revise it, but no person who participated in making the decision to require assignment shall participate in a review of that decision.
(3) Where representations are made against a decision to require assignment, the Primary Care Trust shall, before confirming or revising that decision, give the contractor the opportunity of an oral hearing in support of those representations.
(4) The Primary Care Trust shall, within the period of seven days beginning with the day on which it confirms or revises a decision under paragraph (3), notify the contractor accordingly and the provisions of this article and article 64 shall apply to any requirement to assign under a revised decision.
Variation and termination of transitional agreements
66.
- (1) The Secretary of State may by directions require a transitional agreement to be varied by the relevant body in accordance with the directions.
(2) If the Secretary of State is satisfied that a transitional agreement is (for any reason) unsatisfactory, he may give directions to the relevant body requiring it to bring the transitional agreement to an end in accordance with the terms of the directions.
Termination of transitional agreements varied under article 59
67.
Where a transitional agreement has been varied under article 59 to include a term which gives effect to paragraph 105 of Schedule 5 to the Personal Medical Services Agreements Regulations (termination by the relevant body on fitness grounds), the reference in that term to a person falling within the cases specified in paragraph 105(3) during the existence of the agreement shall be read as if it referred to a person so falling on or after 1st April 2004.
Health service body status
68.
- (1) A contractor (other than one falling within paragraph (2)) which was, on 31st March 2004 a health service body pursuant to the National Health Service (Pilot Schemes - Health Service Bodies) Regulations 1997[67] ("the 1997 Regulations") shall be regarded as such a body after that date and regulation 9 of the Personal Medical Services Agreements Regulations shall apply as if health service body status had been conferred on that contractor under that regulation.
(2) A contractor falls within this paragraph if it was a health service body only for the purpose of regulation 3(4) of the 1997 Regulations (being a party to an existing NHS contract).
(3) A contractor falling within paragraph (2) shall continue to be a health service body for the purpose of being a party to an NHS contract entered into on a date before that on which it ceased to be a pilot scheme health service body until the termination of that NHS contract.
(4) Paragraph (3) shall also apply to a provider of personal medical services under a pilot scheme whose agreement terminated before 1st April 2004.
Dispute resolution
69.
- (1) Any dispute relating to a pilot scheme that has been referred to the Secretary of State under section 4 of the 1990 Act[68] (NHS contracts) and which has not been determined on or before 31st March 2004 shall continue to be dealt with in accordance with the National Health Service Contracts (Dispute Resolution) Regulations 1996[69].
(2) Where a direction as to payment is made (whether before or after 31st March 2004) under section 4(7) of the 1990 Act against, or in favour of, a provider of services under a transitional agreement or a pilot scheme, the direction is enforceable in a county court (if the court so orders) as if it were a judgement or order of that court.
(c) otherwise make arrangements for the applicant to be provided with essential services (or their equivalent) in the area of the Primary Care Trust.
Representations against assignments
71.
- (1) Where, on 31st March 2004, a Primary Care Trust had assigned a patient to a relevant medical practitioner under regulation 4 of the Choice Regulations but the seven days for him to make representations against that assignment in regulation 6(1) of those Regulations had not yet expired, the succeeding contractor shall be entitled to make representations to the Primary Care Trust in writing against that assignment within the period of seven days beginning on the day on which the relevant medical practitioner received notice of the assignment under regulation 4 of the Choice Regulations, as if regulation 6 of the Choice Regulations were still in force.
(2) Where, on 31st March 2004, a Primary Care Trust had required a pilot scheme provider to assign a patient under regulation 4(2)(b) of the Choice Regulations but the seven days for him to make representations against that requirement to assign in regulation 6(2) of those Regulations had not yet expired, the PMS contractor who is a party to the personal medical services agreement which has succeeded the pilot scheme shall be entitled to make representations to the Primary Care Trust in writing against that requirement to assign within the period of seven days beginning on the day on which the pilot scheme provider received notice of the requirement under regulation 4 of the Choice Regulations, as if regulation 6 of the Choice Regulations were still in force.
(3) Where representations are made to a Primary Care Trust under paragraph (1) or (2), the Primary Care Trust shall deal with those representations in accordance with regulation 6 of the Choice Regulations as if those Regulations were still in force and shall, on or before 30th April 2004, either confirm or revise its decision to assign the patient.
(4) In this article, "relevant medical practitioner" and "succeeding contractor" have the meaning given in article 2(3).
(b) in relation to the period from 1st April 2004, means an arrangement under -
Terms of general medical services contracts, default contracts and personal medical services agreements
73.
Unless the contract or agreement is of a type or nature to which a particular article does not apply -
Applications for approval of out of hours arrangements under general medical services contracts and default contracts
74.
- (1) Where, on or before 31st March 2004, a medical practitioner had applied to the Primary Care Trust for approval of an out of hours arrangement under paragraph 18A(7) of Schedule 2 to the 1992 Regulations[73] but that application had not yet been determined, it shall, if the medical practitioner meets the requirements in paragraph (2), be treated, on 1st April 2004, as if it were an application made by the general medical services contractor under the term of its contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or by the default contractor under the equivalent term of its default contract) subject to the modification that the period of 28 days referred to in the term giving effect to paragraph 2(2) of Schedule 7 (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Primary Care Trust received the application under paragraph 18A(7) of Schedule 2 to the 1992 Regulations.
(2) The requirements referred to in paragraph (1) are that the medical practitioner -
(3) In any application which falls within paragraph (1) -
(c) in any reference to part of the out of hours period -
(d) any references to a particular transferee doctor shall be deemed to be references to -
Applications for approval of out of hours arrangements under personal medical services agreements
75.
- (1) Where, on or before 31st March 2004, a pilot scheme provider had applied to a relevant body for approval of an out of hours arrangement under regulation 4 of the PMS Out of Hours Regulations but that application had not yet been determined, it shall, if the pilot scheme provider has become a PMS contractor, be treated, on 1st April 2004, as if it were an application made by the PMS contractor under -
subject to the modification that the period of 28 days referred to in the term (or deemed term) giving effect to paragraph 2(2) of Schedule 6 to the Personal Medical Services Agreements Regulations shall be treated as beginning with the day on which the relevant body received the application under regulation 4 of the PMS Out of Hours Regulations.
(2) In any application which falls within paragraph (1) any references to the patients of the pilot scheme provider shall be deemed to be references to the patients of the PMS contractor.
Approvals of out of hours arrangements under general medical services contracts and default contracts
76.
- (1) Where, on 31st March 2004 -
that approval shall, if the medical practitioner meets the requirements in article 74(2), be treated from 1st April 2004 as if it were an approval granted to the general medical services contractor by the Primary Care Trust pursuant to the term of its contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or to the default contractor under the equivalent term of its default contract), except in the circumstances specified in paragraph (2).
(2) The circumstances referred to in paragraph (1) are that the approval under paragraph 18A of Schedule 2 to the 1992 Regulations related to an arrangement with a transferee doctor as defined in paragraph 18A(1)(c) of Schedule 2 to the 1992 Regulations and that doctor -
(3) The terms of an approval granted pursuant to paragraph (1) shall be the same as those of the approval granted under paragraph 18A of Schedule 2 to the 1992 Regulations except that -
(c) in any reference to part of the out of hours period -
(d) any references to a particular transferee doctor shall be deemed to be references to -
Approvals of out of hours arrangements under personal medical services agreements
77.
- (1) Where, on 31st March 2004 -
that approval shall, if the pilot scheme provider has become a PMS contractor, be treated from 1st April 2004 as if it were an approval granted to the PMS contractor by the relevant body pursuant to the term of its agreement which gives effect to paragraph 2 of Schedule 6 to the Personal Medical Services Agreements Regulations or the equivalent term deemed to be included in its transitional agreement pursuant to article 60(7).
(2) The terms of an approval granted pursuant to paragraph (1) shall be the same as those of the approval granted under regulation 4 of the PMS Out of Hours Regulations except that any references to the patients of the pilot scheme provider shall be deemed to be references to the patients of the PMS contractor.
Suspension of approvals and of out of hours arrangements under general medical services contracts, default contracts and personal medical services agreements
78.
- (1) Where an approval which falls within article 76 or 77 relates to an accredited service provider whose approval has been suspended under regulation 9 of the Out of Hours Regulations, that approval, and any out of hours arrangement made pursuant to that approval, shall be treated, from 1st April 2004, as being suspended under -
(2) Where, on 31st March 2004, an arrangement made by a Primary Care Trust with an accredited service provider under regulation 3(1) of the PMS Out of Hours Regulations is suspended following suspension of the approval of the accredited service provider under regulation 9 of the Out of Hours Regulations, that arrangement shall be treated, from 1st April 2004, as being suspended under -
Refusal of approval of out of hours arrangements under general medical services contracts and default contracts
79.
- (1) Where -
paragraphs (2) and (3) shall apply.
(2) In a case where the time for appealing under paragraph 18A(11) of Schedule 2 to the 1992 Regulations had not expired on or before 31st March 2004, that refusal shall be treated as if it were a refusal under the term of the general medical services contract referred to in paragraph (1)(b) which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract), subject to the modification that the 30 days referred to in the term of the general medical services contract giving effect to paragraph 2(5) of that Schedule (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Primary Care Trust's notification under paragraph 18A(10) was sent.
(3) In a case where, on 31st March 2004, an appeal had been made under paragraph 18A(11) of Schedule 2 to the 1992 Regulations but not yet been determined or withdrawn, that appeal shall, except in the circumstances specified in paragraph (4), continue to be dealt with as if paragraph 18A had not been revoked and, if the appeal is successful, the approval of the arrangement shall be treated as an approval given under the term of the general medical services contract referred to in paragraph (1)(b) which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the relevant default contract).
(4) The circumstances referred to in paragraph (3) are that the appeal related to an arrangement with a transferee doctor as defined in paragraph 18A(1)(c) of Schedule 2 to the 1992 Regulations and that doctor -
(5) For the purposes of a dispute pursuant to paragraph (2) or an appeal dealt with pursuant to paragraph (3), the application which is the subject of the dispute or appeal shall be read as if -
(c) in any reference to part of the out of hours period -
(d) any references to a particular transferee doctor were references to -
Refusal of approval of out of hours arrangements under personal medical services agreements
80.
- (1) Where -
paragraphs (2) and (3) shall apply.
(2) In a case where the time for appealing under regulation 4(5) of the PMS Out of Hours Regulations had not expired on or before 31st March 2004, that refusal shall be treated as if it were a refusal under -
subject to the modification that the 30 days referred to in the term (or deemed term) of the agreement giving effect to paragraph 2(5) of that Schedule shall be treated as beginning with the day on which the relevant body's notification under regulation 4(4) was sent.
(3) In a case where, on 31st March 2004, an appeal had been made under regulation 4(5) of the PMS Out of Hours Regulations but not yet been determined or withdrawn, that appeal shall continue to be dealt with as if regulation 4 had not been revoked and, if the appeal is successful, the approval of the arrangement shall be treated as an approval given under the term of the agreement to which the pilot scheme provider is a party which gives effect to paragraph 2 of Schedule 6 to the Personal Medical Services Agreements Regulations.
(4) For the purposes of a dispute pursuant to paragraph (2) or an appeal dealt with pursuant to paragraph (3), the application which is the subject of the dispute or appeal shall be read as if any references to the patients of the pilot scheme provider were references to the patients of the PMS contractor.
Review of approval of out of hours arrangements under general medical services contracts and default contracts
81.
- (1) Where -
that review shall continue as if it were a review under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract), subject to the modification that the 30 days referred to in the term giving effect to paragraph 4(2) of that Schedule (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Primary Care Trust sent its notice under paragraph 18B(1) of Schedule 2 to the 1992 Regulations.
Review of approval of out of hours arrangements under general medical services contracts which follow default contracts
82.
- (1) Where -
that review shall continue as if it were a review under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations, subject to the modification that the 30 days referred to in the term giving effect to paragraph 4(2) of that Schedule shall be treated as beginning with the day on which the Primary Care Trust sent its notice under the equivalent term of the default contract.
Review of out of hours arrangements under personal medical services agreements
83.
- (1) Where -
that review shall continue as if it were a review under the term of the agreement which gives effect to paragraph 3 of Schedule 6 to the Personal Medical Services Agreements Regulations or the equivalent term deemed to be included in the transitional agreement pursuant to article 60(7), subject to the modification that the 30 days referred to in the term (or deemed term) giving effect to paragraph 3(2) of that Schedule shall be treated as beginning with the day on which the relevant body sent its notice under regulation 5 of the PMS Out of Hours Regulations.
Withdrawal of approval of out of hours arrangements under general medical services contracts and default contracts
84.
- (1) Where -
paragraphs (2) to (4) shall apply.
(2) In a case where, on 31st March 2004 -
the withdrawal shall take effect as a withdrawal of approval under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract) on the date on which it would have taken effect had paragraph 18B(7) of Schedule 2 to the 1992 Regulations not been revoked.
(3) In a case where the time for appealing under paragraph 18B(6) of Schedule 2 to the 1992 Regulations had not expired on or before 31st March 2004, the notice of determination of withdrawal shall be deemed to be a notice of determination of withdrawal of approval on notice under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract), subject to the modifications that -
(4) In a case where, on 31st March 2004, an appeal had already been made under paragraph 18B(6) of Schedule 2 to the 1992 Regulations but not yet been determined or withdrawn, the appeal shall continue to be dealt with as if paragraphs 18A and 18B of that Schedule had not been revoked and, if the appeal is dismissed, the withdrawal of approval shall take effect as a withdrawal of approval under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract) on the date on which the general medical services contractor or the default contractor received notice of the dismissal of the appeal.
Withdrawal of approval of out of hours arrangements under personal medical services agreements
85.
- (1) Where -
(b) on or before 31st March 2004, a relevant body had notified a pilot scheme provider of its withdrawal of approval of that arrangement under regulation 5 of the PMS Out of Hours Regulations but that withdrawal had not yet taken effect,
paragraphs (2) to (4) shall apply.
(2) In a case where, on 31st March 2004 -
the withdrawal shall take effect as a withdrawal of approval under the term of the agreement which gives effect to paragraph 3 of Schedule 6 to the Personal Medical Services Agreements Regulations, or under the equivalent term deemed to be included in the transitional agreement pursuant to article 60(7), on the date on which it would have taken effect had regulation 5(5) of the PMS Out of Hours Regulations not been revoked.
(3) In a case where the time for appealing under regulation 5(4) of the PMS Out of Hours Regulations had not expired on or before 31st March 2004, the notice of determination of withdrawal shall be deemed to be a notice of determination of withdrawal of approval on notice under the term of the agreement which gives effect to paragraph 3 of Schedule 6 to the Personal Medical Services Agreements Regulations, or under the equivalent term deemed to be included in the transitional agreement pursuant to article 60(7), subject to the modifications that -
(4) In a case where, on 31st March 2004, an appeal had already been made under regulation 5(4) of the PMS Out of Hours Regulations but not yet been determined or withdrawn, the appeal shall continue to be dealt with as if regulation 5 of those Regulations had not been revoked and, if the appeal is dismissed, the withdrawal of approval shall take effect as a withdrawal of approval under -
on the date on which the PMS contractor received notice of the dismissal of the appeal.
Appeal against immediate withdrawal of approval of out of hours arrangements under general medical services contracts and default contracts
86.
- (1) Where -
paragraphs (2) and (3) shall apply.
(2) In a case where the time for appealing under paragraph 18C(4) had not expired on or before 31st March 2004, that withdrawal shall be treated as if it were a withdrawal of approval under the term of the general medical services contract which gives effect to paragraph 6(1)(c) of Schedule 7 to the 2004 Regulations (or under the equivalent term of a default contract) subject to the modification that the 30 days referred to in the term giving effect to paragraph 6(5) of that Schedule (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Primary Care Trust's notification under paragraph 18C(2) of Schedule 2 to the 1992 Regulations was sent.
(3) In a case where, on 31st March 2004, an appeal had already been made under paragraph 18C(4) but not yet been determined or withdrawn, that appeal shall, except in the circumstances specified in paragraph (4), continue to be dealt with as if paragraphs 18A and 18C of Schedule 2 to the 1992 Regulations had not been revoked and, if the appeal is successful, the approval of the arrangement shall be treated as an approval given under the term of the general medical services contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract).
(4) The circumstances referred to in paragraph (3) are that the appeal related to an arrangement with a transferee doctor as defined in paragraph 18A(1)(c) of Schedule 2 to the 1992 Regulations and that doctor -
(5) The terms of an approval granted pursuant to paragraph (2) or (3) shall be the same as those of the approval previously granted under paragraph 18A of Schedule 2 to the 1992 Regulations except that -
(c) in any reference to part of the out of hours period -
(d) any references to a particular transferee doctor shall be amended to be references to -
References to the NHS dispute resolution procedure in general medical services contracts which follow default contracts
87.
Where -
(b) on the date on which the default contract ceases to have effect -
(c) the default contractor has entered into a general medical services contract which takes effect immediately after the default contract ceases to have effect,
the refusal or notice shall be treated, for the purposes of referring the matter in accordance with the NHS dispute resolution procedure contained in the general medical services contract, as if it were a refusal or notice of withdrawal given under the equivalent terms of the general medical services contract and the general medical services contractor may refer the matter in accordance with that dispute resolution procedure before the end of the period of 30 days beginning with the day on which the Primary Care Trust sent the notice of refusal, determination, or, as the case may be, withdrawal, to the default contractor.
Carry over of disputes relating to out of hours arrangements between default contracts and general medical services contracts
88.
- (1) Where -
paragraph (2) shall apply.
(2) The dispute shall continue to be dealt with as if it were a dispute referred under the NHS dispute resolution procedure contained in the general medical services contract relating to -
Appeal against immediate withdrawal of approval of out of hours arrangements under personal medical services agreements
89.
- (1) Where -
paragraphs (2) and (3) shall apply.
(2) In a case where the time for appealing under regulation 6(2) of the PMS Out of Hours Regulations had not expired on or before 31st March 2004, that withdrawal shall be treated as if it were a withdrawal of approval under -
subject to the modification that the 30 days referred to in the term (or deemed term) giving effect to paragraph 5(5) of that Schedule shall be treated as beginning with the day on which the relevant body's notification under regulation 6(1) was sent.
(3) In a case where, on 31st March 2004, an appeal had already been made under regulation 6(2) of the PMS Out of Hours Regulations but not yet been determined or withdrawn, that appeal shall continue to be dealt with as if that regulation had not been revoked and, if the appeal is successful, the approval of the arrangement shall be treated as an approval given under the term of the agreement which gives effect to paragraph 2 of Schedule 6 to the Personal Medical Services Agreements Regulations or under the equivalent term deemed to be included in the transitional agreement under article 60(7).
(4) The terms of an approval granted pursuant to paragraph (2) or (3) shall be the same as those of the approval previously granted under regulation 4 of the PMS Out of Hours Regulations except that any references to the patients of the pilot scheme provider shall be deemed to be references to the patients of the PMS contractor.
Saving and transitory provision in relation to regulations 1 to 11 of the Out of Hours Regulations
90.
- (1) In this article, expressions used both in this article and in the Out of Hours Regulations have the same meaning as in the Out of Hours Regulations as modified by paragraph (3).
(2) Notwithstanding the revocation of the Out of Hours Regulations, regulations 1 to 11 of those Regulations shall, until 31st December 2004, continue in force as they had effect on 31st March 2004, subject to the modifications specified in paragraph (3), for the purposes of -
(3) The modifications referred to in paragraph (2) are as if -
(d) in regulation 7 -
(e) in regulation 11(2) -
(f) in the Schedule, in paragraph (7), for "medical list" there were substituted "medical performers list" and the remainder of the paragraph were omitted.
(4) Any approval of a relevant service provider which has been granted by a Primary Care Trust -
and which has not come to an end before that date, shall cease to have effect on 1st January 2005.
Sub-contracting of out of hours services under general medical services contracts
91.
- (1) Where, prior to 1st January 2005, a general medical services contractor wishes to sub-contract all or part of its out of hours services in circumstances which would require the written approval of the Primary Care Trust in accordance with the term of the general medical services contract which gives effect to paragraph 70 of Schedule 6 to the 2004 Regulations, it shall be deemed to have such written approval if, at the date on which it enters into the sub-contract -
(2) The general medical services contractor shall notify the Primary Care Trust in writing as soon as reasonably practicable of any sub-contract which it proposes to enter into or has entered into pursuant to paragraph (1).
(3) An approval deemed to have been granted pursuant to paragraph (1) shall be regarded, for all purposes, as an approval granted under the term of the general medical services contract which gives effect to paragraph 70 of the 2004 Regulations.
Out of hours services to patients not registered with general medical services contractors or default contractors
92.
- (1) Where a general medical services contractor or a default contractor is required under article 24 or 25 of the Transitional Order to provide any of the additional services to patients who are not included on its list of patients, it shall, for so long as that requirement continues, and subject to paragraphs (2) and (4), also be required to provide that service to those patients throughout the out of hours period.
(2) In the case of a general medical services contract, the requirement referred to in paragraph (1) shall cease on the date on which any opt out of out of hours services commences pursuant to the terms of the general medical services contract which give effect to paragraph 4 or 5 of Schedule 3 to the 2004 Regulations.
(3) Where paragraph (2) applies, the requirement to inform patients of opt outs in the term of the general medical services contract which gives effect to paragraph 6 of Schedule 3 to the 2004 Regulations shall apply to the patients to whom services are provided pursuant to this article as it applies to the general medical services contractor's own registered patients.
(4) Nothing in this article shall require a general medical services contractor or a default contractor to provide services under this article if, in the reasonable opinion of the default contractor or the general medical services contractor in the light of the patient's medical condition it would be reasonable in all the circumstances for the patient to wait for the services required until the next time at which he could obtain such services during core hours.
(5) Services included in a general medical services contract or a default contract pursuant to this article shall be deemed to fall within the definition of out of hours services for the purposes of -
Application of regulation 30 of the 2004 Regulations to general medical services contracts entered into under Part 2 of the Transitional Order
93.
Where a person enters into a general medical services contract pursuant to an entitlement under Part 2 of the Transitional Order under which services are not to be provided until on or after 1st January 2005, regulation 30 of the 2004 Regulations (out of hours services) shall apply to that general medical services contract as it applies to general medical services contracts under which services are to be provided before that date.
(2) Unless the context otherwise requires, any reference in this Part to -
Cases where no decision has been made before the relevant date as to whether disciplinary action should be taken (regulation 4 of the Service Committees Regulations)
95.
- (1) Where, before the relevant date, or on or after the relevant date in respect of a matter that occurred before the relevant date, a Primary Care Trust receives, or has received, information that could amount to an allegation that a doctor had failed to comply with his terms of service and -
paragraph (2) shall apply.
(2) Where this paragraph applies, the Primary Care Trust shall -
(3) If the appropriate Primary Care Trust, or its reference committee, decides, pursuant to paragraph (2)(a) or (b), to refer the matter to the discipline committee of another Primary Care Trust (B) in accordance with regulation 4(2)(a) or (7) -
Referrals to investigating discipline committees before the relevant date (regulation 5 of the Service Committees Regulations)
96.
Where a Primary Care Trust (A) has, before the relevant date, referred a matter in respect of a doctor to another Primary Care Trust (B) in accordance with regulation 4(2)(a) or (7) and -
(b) that Primary Care Trust (A) has received the report of the discipline committee of the Primary Care Trust (B) but has not yet determined what (if any) action to take as a result of the report, the Primary Care Trust (A) shall be entitled to take any action it could have taken pursuant to the Service Committees Regulations as if the amendments to regulations 2 to 8 had not taken effect, subject to article 98.
Determination of a Primary Care Trust or the Secretary of State made before the relevant date (regulations 8, 9, 10 and 11 of the Service Committees Regulations)
97.
- (1) Where, before the relevant date, a Primary Care Trust (or where relevant, the Secretary of State) has determined pursuant to regulation 8(5)(a) and 9(3) or regulation 11 (as the case may be) that an amount should be recovered from the doctor, insofar as any of that amount has not been recovered before the relevant date, it shall continue to be recoverable by the Primary Care Trust that was the appropriate Primary Care Trust for the purposes of the Service Committees Regulations in respect of that matter, and it shall be treated as a debt owed by that doctor to that Trust.
(2) Where a contracting PCT has record of, or receives notification of, an adverse determination made before the relevant date pursuant to regulation 8, 9, 10 or 11 in respect of a doctor (where, in the case of a determination under regulation 8, such a determination was not overturned on appeal), paragraph (3) shall apply without prejudice to any other rights the contracting PCT may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.
(3) Where this paragraph applies, the contracting PCT -
(4) Where a Performers List PCT has record of, or receives notification of, an adverse determination pursuant to regulation 8, 9, 10 or 11 made before the relevant date in respect of a doctor (where, in the case of a determination under regulation 8, such a determination was not overturned on appeal) it may take that determination into account in determining what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.
Determination of a Primary Care Trust made on or after the relevant date (regulation 8 of the Service Committees Regulations)
98.
- (1) Where, on or after the relevant date, an appropriate Primary Care Trust is determining what (if any) action to take pursuant to regulation 8 in accordance with provision made in this Part, it shall make such a determination in accordance with such limitations and modifications to that regulation as are specified in this article.
(2) The appropriate Primary Care Trust may -
and if it makes any one or more of the decisions specified in sub-paragraphs (b) to (d), it shall, after the period specified in regulation 8(11)(a) or (b) (as applicable) has expired, notify in writing the contracting PCT and the Performers List PCT (if any) of its decision and the reasons for it, if either one is a different Primary Care Trust to the appropriate Primary Care Trust.
(3) Where, pursuant to paragraph (2)(b), the appropriate Primary Care Trust determines that an amount should be recovered from the doctor, regulation 8(8) shall not apply and that amount shall be recoverable by the appropriate Primary Care Trust and it shall be treated as a debt owed by that doctor to that appropriate Primary Care Trust.
(4) Where the appropriate Primary Care Trust has notified the contracting PCT that it has made any of the determinations specified in paragraph (2)(b) to (d), or where the appropriate Primary Care Trust is the contracting PCT, paragraph (5) shall apply without prejudice to any other rights the contracting PCT may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.
(5) Where this paragraph applies, the contracting PCT -
(6) Where -
it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.
Appeals to the Secretary of State against determinations of Primary Care Trusts (regulations 9, 10 and 11 of the Service Committees Regulations)
99.
- (1) Where -
that appeal shall be determined pursuant to regulations 9, 10 and 11, as if the amendments to those regulations and Schedule 5 had not taken effect.
(2) Where an appropriate Primary Care Trust has made a determination in respect of a doctor on or after the relevant date pursuant to this Part -
as if the amendments to those regulations and to Schedule 5 had not taken effect.
(3) Where, on or after the relevant date, the Secretary of State is determining pursuant to regulation 9, 10 or 11 (as the case may be) what (if any) action to take in respect of a doctor, he shall make a determination pursuant to those regulations as if the amendments to those regulations and to Schedule 5 had not taken effect and that determination shall have effect in accordance with this article.
(4) If, in accordance with paragraph (3), the Secretary of State determines pursuant to -
he shall, in addition to the persons specified in regulation 10(14), notify the Primary Care Trusts specified in paragraph (5).
(5) The Secretary of State shall, pursuant to paragraph (4)(a) to (d), notify the contracting PCT and the Performers List PCT (if any) of his determination if those Primary Care Trusts are different to the Primary Care Trust referred to in regulation 10(14).
(6) Where, pursuant to regulation 8(5)(a) and 9(3) or 11, the Secretary of State has determined that an amount shall be recovered from a doctor he shall direct the appropriate Primary Care Trust, to recover that amount from the doctor and that amount shall be a debt owed to that appropriate Primary Care Trust.
(7) Where, pursuant to paragraph (5), the Secretary of State has notified the contracting PCT that he has taken any of the decisions specified in paragraph (4)(a) to (d), whether or not the contracting PCT is also the appropriate Primary Care Trust, paragraph (8) shall apply without prejudice to any other right the contracting PCT may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.
(8) Where this paragraph applies, the contracting PCT may, in relation to a relevant contractor, take into account the determination of the Secretary of State if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 115(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.
(9) The contracting PCT shall not, pursuant to paragraph (8), take into account any notification received that relates to a determination that was made by the Secretary of State that occurred more than 6 years prior to the date upon which the contracting PCT is considering the matter pursuant to paragraph (8).
(10) Where a Performers List PCT has received notification from the Secretary of State pursuant to paragraph (4) or (5), whether or not the Performers List PCT is also the appropriate Primary Care Trust, it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.
Excessive prescribing (regulation 15 of the Service Committees Regulations)
100.
- (1) Where, on 31st March 2004, a Primary Care Trust had -
the investigation by the committee shall continue and its determination be made as if that regulation were still in force.
(2) Where, on 31st March 2004, a professional committee had given notice of its determination to a medical practitioner under paragraph (18) of regulation 15 but -
the time for appealing shall continue as if regulation 15 were still in force.
(3) Where -
that appeal shall continue to be dealt with as if regulation 15 were still in force.
(4) In this article "professional committee" has the same meaning as in regulation 15.
Investigation of certification (regulation 16 of the Service Committees Regulations)
101.
- (1) Where the Secretary of State has -
the Secretary of State may, in a case falling within sub-paragraph (a), refer the matter as if the amendments to regulation 16 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee or joint committee of Local Medical Committees shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 16, subject to the provisions in this article.
(2) Where, pursuant to paragraph (1), the Local Medical Committee makes a determination pursuant to regulation 16(6), it shall forward its report to the contracting PCT and the Performers List PCT (if any), in addition to the persons specified in regulation 16(6), unless the doctor exercises his right of appeal pursuant to regulation 16.
(3) Where -
(b) the Secretary of State -
that appeal or referral shall be determined in accordance with regulation 16 as if the amendments to that regulation had not taken effect, save that written notification of the determination made by the referee or referees shall be given to the contracting PCT and the Performers List PCT (if any).
(4) The Secretary of State may, on or after the relevant date, determine that, pursuant to regulation 16(12), an amount should be recovered from a doctor, and shall, in determining whether an amount should be recovered, act as if the amendments to regulations 11(3), (4) and (5) and 16 and Schedule 5 had not taken effect.
(5) Where pursuant to regulation 16(12), the Secretary of State has determined that an amount should be recovered from a doctor -
that amount shall be recoverable by the appropriate Primary Care Trust, insofar as it has not already been recovered before the relevant date in respect of an amount falling within sub-paragraph (a), and that amount shall be a debt owed to that Primary Care Trust.
(6) Where the contracting PCT has received notification pursuant to this article of an adverse determination in respect of the doctor pursuant to regulation 16, paragraph (7) shall apply without prejudice to any other right the contracting PCT may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.
(7) Where this paragraph applies, the contracting PCT may, in relation to a relevant contractor, take into account the adverse determination of the Secretary of State if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 115(7) of Schedule 6 to the Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.
(8) The contracting PCT shall not, pursuant to paragraph (7), take into account any notification that relates to a determination that was made more than 6 years prior to the date upon which the contracting PCT is considering the matter pursuant to paragraph (7).
(9) Where a Performers List PCT has received notification of an adverse determination pursuant to regulation 16, it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.
Investigation of record keeping (regulation 17 of the Service Committees Regulations)
102.
- (1) Where the Secretary of State has -
the Secretary of State may, in a case falling within sub-paragraph (a), refer the matter as if the amendments to regulation 17 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 17, subject to the provisions in this article.
(2) Where, pursuant to paragraph (1), the Local Medical Committee makes a determination pursuant to regulation 17(9), it shall forward its report to the contracting PCT and the Performers List PCT, in addition to the persons specified in regulation 17(8), unless the doctor exercises his right of appeal pursuant to regulation 17(10).
(3) Where -
(b) the Secretary of State -
that appeal or referral shall be determined in accordance with regulation 17 as if the amendments to that regulation (and regulation 16(8) and (9) where applicable) had not taken effect, save that written notification of the determination made by the referee or referees shall be given to the contracting PCT and the Performers List PCT (if any).
(4) The Secretary of State may, on or after the relevant date, determine that, pursuant to regulation 17(14), an amount should be recovered from a doctor and shall, in determining whether an amount should be recovered, act as if the amendments to regulations 11(3), (4) and (5) and 17 and Schedule 5 had not taken effect.
(5) Where pursuant to regulation 17(14), the Secretary of State has determined that an amount should be recovered from a doctor -
that amount shall be recoverable by the appropriate Primary Care Trust, insofar as it has not already been recovered before the relevant date in respect of an amount falling within sub-paragraph (a), and that amount shall be a debt owed to that Primary Care Trust.
(6) Where the contracting PCT has received notification pursuant to this article of an adverse determination in respect of the doctor pursuant to regulation 17, paragraph (7) shall apply without prejudice to any other right the contracting PCT may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.
(7) Where this paragraph applies, the contracting PCT may, in relation to a relevant contractor, take into account the adverse determination of the Secretary of State if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 115(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.
(8) The contracting PCT shall not, pursuant to paragraph (7), take into account any notification that relates to a determination that was made more than 6 years prior to the date upon which the contracting PCT is considering the matter pursuant to paragraph (7).
(9) Where a Performers List PCT has received notification of an adverse determination pursuant to regulation 17, it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.
Decision as to treatment for which fees may be charged by doctors (regulation 18 of the Service Committees Regulations)
103.
- (1) Where a question has arisen as to whether any treatment given by a doctor to a patient is treatment for which he may demand or accept a fee from a patient within the meaning of regulation 18(1), and that question has arisen before the relevant date, or on or after the relevant date in respect of any fee charged by a doctor before the relevant date, and that question -
the question may, in a case falling within sub-paragraph (a), be referred as if the amendments to that regulation and Schedule 7 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 18 and Schedule 7, subject to the provisions in this article.
(2) Where a Local Medical Committee makes a determination pursuant to paragraph (1), regulation 18(6) shall apply to the Primary Care Trust.
(3) Where a Primary Care Trust -
that referral shall be determined in accordance with regulation 18 and Schedule 7 as if the amendments to that regulation and Schedule had not taken effect.
(4) Where the Secretary of State -
that referral shall be determined in accordance with regulation 18 and Schedule 7 as if the amendments to that regulation and Schedule had not taken effect.
Functions of Local Medical Committees
104.
Where -
the Local Medical Committee that had had the matter referred to it shall be deemed to be a Local Medical Committee that is recognised by a Primary Care Trust pursuant to section 45A of the 1977 Act for the purpose of exercising the continuing functions conferred on it in relation to the matter by this Part.
prescription forms, repeatable prescriptions or batch issues issued for the purposes of a default contract, a general medical services contract or a personal medical services agreement before 31st March 2005 need not include the name of the contractor.
(2) In paragraph (1), "batch issue", "prescription form" and "repeatable prescription" have the same meaning as in regulation 2(1) of the 2004 Regulations.
Transitional provision in cases where preferential treatment on transferring to medical lists was given
106.
- (1) This article applies to any case to which, on or before 31st March 2004, paragraph 1 of Schedule 1 (cases where preferential treatment on transferring to medical lists is given) to the Primary Care Act 1997[84] ("the Schedule") applies.
(2) If -
paragraph 7 of Schedule 1 (transitional and consequential provisions) to the Performers Lists Regulations shall apply.
(3) In a case where -
that medical practitioner shall be treated as though his name had been included in the medical list of that Primary Care Trust on 31st March 2004.
(4) In any case where representations under paragraph 3 of the Schedule have been made and the FHSAA ("the Authority") has not determined that matter on or before 31st March 2004, the matter shall be treated by the Authority as though it were an appeal against the refusal of the Primary Care Trust to include that medical practitioner's name in its medical performers list.
(5) If the Authority decides that appeal in favour of that medical practitioner -
(6) In a case to which paragraph (4) applies ("paragraph 4 case"), if that medical practitioner had applied to be included in the medical performers list of any Primary Care Trust or, by virtue of paragraph 7 of Schedule 1 to the Performers Lists Regulations, is treated as so applying, any appeal to the Authority in respect of that application shall be heard with the paragraph 4 case.
Continuing validity of forms
107.
Notwithstanding the amendments made by paragraphs 1(3) and 5 of Schedule 1 to the form of certificates set out in Part 2 of Schedule 2 to the Social Security (Medical Evidence) Regulations 1976[85] and in Part 2 of the Schedule to the Statutory Maternity Pay (Medical Evidence) Regulations 1987[86], a form which complies with those Regulations as in force on 31st March 2004 shall continue to be valid.
Transitory interpretation of references in enactments to primary medical services
108.
For so long as default contracts entered into pursuant to section 176(3) of the 2003 Act (general medical services: transitional) exist, a reference in any enactment to primary medical services under the 1977 Act shall be deemed to include a reference to services provided under such contracts.
Transitory interpretation of references to general medical services contracts
109.
- (1) For as long as default contracts entered into pursuant to section 176(3) of the 2003 Act (general medical services: transitional) exist, any reference to a general medical services contract or to a contract under section 28Q of the 1977 Act in the enactments listed in paragraph (2) shall be deemed to include a reference to a default contract.
(2) The enactments referred to in paragraph (1) are -
(3) In this article, "certificate of prescribed experience" and "certificate of equivalent experience" have the meanings assigned to them in regulation 2(1) of the National Health Service (Vocational Training for General Medical Practice) Regulations 1997.
(4) Notwithstanding the repeal of section 31 and 32 of the 1977 Act, the National Health Service (Vocational Training for General Medical Practice) Regulations 1997 and the Vocational Training for General Medical Practice (European Requirements) Regulations 1994 shall remain in force (subject to the transitory modifications made in this Part) until their revocation by virtue of article 31(5) of, and Part 2 of Schedule 10 to, the 2003 Order.
Savings of certain provisions of the Medical Act 1983
111.
Notwithstanding the coming into force of the amendments to sections 11 and 12 of the Medical Act 1983[102] made by paragraphs 47 to 49 of Schedule 11 to the 2003 Act [103], in relation to any employment before 1st April 2004 in -
sections 11(4) and 12(2)(a) of the Medical Act 1983 shall have effect as if those amendments had not been brought into force.
Saving of section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992
112.
Notwithstanding the coming into force of the amendments to the definition of worker in section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992[104] (health service practitioners) made by paragraph 59 of Schedule 11 to the 2003 Act[105], in relation to any complaint arising in respect of a matter which occurred before 1st April 2004, section 279 shall have effect as if those amendments had not been brought into force.
Saving of sections 2A and 6(5) of the Health Service Commissioners Act 1993
113.
Notwithstanding the coming into force of the amendments to sections 2A and 6(5) of the Health Service Commissioners Act 1993[106] made by paragraphs 62 and 63 of Schedule 11 to the 2003 Act[107], in relation to any complaint arising in respect of a matter which occurred before 1st April 2004, sections 2A and 6(5) shall have effect as if those amendments had not been brought into force.
Transitional provision in relation to the National Health Service (Injury Benefits) Regulations 1995
114.
Notwithstanding the amendments made to the National Health Service (Injury Benefits) Regulations 1995 by paragraph 13 of Schedule 1, those regulations shall, in relation to any employment before 1st April 2004, continue to apply as if those amendments had not been made.
Transitory modification of section 18 of the 1990 Act
115.
For as long as default contracts entered into pursuant to section 176(3) of the 2003 Act (general medical services: transitional) exist, section 18 of the 1990 Act[108] (indicative amounts for doctors' practices) shall be read as if -
that practice will, for that financial year, count as a single practice for the purposes of this section.".
Modification of section 115 of the Police Act 1997
116.
- (1) Until the coming into force of paragraph 4(4) of Schedule 35 to the Criminal Justice Act 2003[109], section 115 of the Police Act 1997[110] shall be read as if -
(b) in subsection (6E) -
(2) The modifications made by this article do not extend to Scotland or Northern Ireland.
Transitory modification of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994
117.
- (1) Until their revocation by virtue of article 31(5) of, and Part 2 of Schedule 10 to the 2003 Order, the Vocational Training for General Medical Practice (European Requirements) Regulations 1994 are to have effect as if they were amended in accordance with this article.
(2) In regulation 5 (acquired rights)[111], for paragraph (4)(a), substitute -
(3) The modifications made by this article do not extend to Scotland or Northern Ireland.
Transitory modification of the National Health Service (Vocational Training for General Medical Practice) Regulations 1997
118.
- (1) Until their revocation by virtue of article 31(5) of, and Part 2 of Schedule 10 to the 2003 Order, the National Health Service (Vocational Training for General Medical Practice) Regulations 1997 are to have effect as if they were amended in accordance with this article.
(2) In regulation 2 (interpretation) -
(b) in the definition of "medical list", in both sub-paragraphs (a) and (b), insert after the word "list" the words "that was";
(c) in paragraph (2) -
(3) Regulation 4 (experience and certificates required) shall be omitted.
(4) In regulation 5 (exemptions), in paragraph (1) for sub-paragraph (d) substitute -
Minor and consequential amendments
119.
The enactments listed in Schedule 1 are amended as there specified.
Revocations
120.
The enactments listed in Schedule 2 are revoked to the extent there specified.
Signed by authority of the Secretary of State
John Hutton
Minister of State, Department of Health
22nd March 2004
the doctor's statement shall be on the form provided by the Secretary of State for the purpose and shall be signed by the attending doctor.".
(3) In Part 2 of Schedule 2, (form of certificate) for "Health Authority or Primary Care Trust in whose medical list you are included" substitute "Primary Care Trust or Local Health Board in whose medical performers list you are included (or, in Scotland, by the Health Board in whose primary medical services performers list you are included)".
(b) in paragraph (3), for sub-paragraph (b)(i) substitute -
3.
In the Statutory Sick Pay (Medical Evidence) Regulations 1985[117], in Part 1 of Schedule 1 (rules)[118], for paragraph 3 substitute -
the doctor's statement shall be on the form provided by the Secretary of State for the purpose and shall be signed by the attending doctor.".
(3) In Schedule 1, for paragraph 8C (complaints against ophthalmic medical practitioners) substitute -
(6) For as long as there are in existence contracts entered into under article 13 of the General Medical Services Transitional and Consequential Provisions Order 2004[122] ("default contracts") any reference in this paragraph to a GMS contract shall be read as including a reference to a contract entered into under that article and any reference to a term of a GMS contract shall be read as including a reference to the equivalent term of the default contract.
(7) For as long as there are in existence transitional agreements as defined in article 1(4) of the General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004, any reference in this paragraph to a personal medical services agreement shall be read as including a reference to a transitional agreement and any reference to a term of a personal medical services agreement shall be read as including a reference to any equivalent term in the transitional agreement.".
(4) In paragraph 10 of Schedule 1A (information and undertakings to be given), for "whose dental, medical, pharmaceutical, supplementary or services list", substitute "any of whose lists".
(b) in sub-paragraph (h), insert at the end "or a list prepared pursuant to section 28X[129] of that Act".
8.
- (1) The Children (Private Arrangements for Fostering) Regulations 1991[130] shall be amended as provided in this paragraph.
(2) In regulation 2 (general welfare of children), in paragraph (2)(f), for the words "general medical practitioner" to the end, substitute "person who provides primary medical services pursuant to Part I of the National Health Service Act 1977;".
(ii) in paragraph (4), omit sub-paragraph (b);
(b) in regulation 3 (establishment of committees)[136], omit paragraph (1)(a);
(c) in regulation 4 (provisions relating to the start of disciplinary proceedings)[137] -
(d) in regulation 5 (referral to investigating committee)[138], omit paragraph (3)(a);
(e) in regulation 6 (time limits)[139], in paragraph (3)(a), omit the word "doctor,";
(f) in regulation 8 (determination of appropriate Health Authority or Primary Care Trust)[140] -
(g) in regulation 9 (appeal to the Secretary of State)[141] -
(h) in regulation 10 (procedure on appeal)[142] -
(i) in regulation 11 (recovery of amounts from practitioners following appeal)[143] -
(j) omit regulations 15 (excessive prescribing by doctors), 16 (investigation of certification), 17 (investigation of record keeping) and 18 (decision as to treatment for which fees may be charged by doctors);
(k) in regulation 20 (power of Local Representative Committees to consider complaints)[144], omit paragraph (1);
(l) in regulation 32 (service of documents)[145], in paragraph (1)(a), omit the word "doctor," and "medical,";
(m) in regulation 37 (referral of matters to professional bodies)[146], in paragraph (4)(a), omit the words "a doctor or";
(n) in Schedule 2 (constitution of discipline committees)[147] -
(o) in Schedule 4 (procedure for investigation by discipline committees)[148] -
(p) in Schedule 5 (advisory committees)[149], omit paragraph 1 and Part 2; and
(q) omit Schedule 7 (rules of procedure under regulation 18).
11.
In the Dental Vocational Training Authority Regulations 1993[150], in regulation 5 (application of regulations relating to membership and procedure)[151], in paragraph (1)(b)(iii), in the sub-paragraph (d) added by that paragraph, for "general" substitute "or performing primary".
(b) for the definition of "medical list" substitute -
(v) at the end, add paragraph (f) -
(d) omit the definitions of "medical pilot scheme employee" and "personal medical services"; and
(e) insert, in the appropriate alphabetical position -
(3) In regulation 3 (persons to whom the regulations apply)[159], omit paragraph (1)(f).
(4) In regulation 4A (recovery of costs)[160], in paragraph (6)(c), for
(2) These Regulations do not apply in the case of a dispute concerning a proposed term of arrangement which is intended to be -
(3) In this regulation -
16.
- (1) The Health Authorities (Membership and Procedure) Regulations 1996[165] shall be amended as provided in this paragraph.
(2) In regulation 1 (citation, commencement and interpretation) -
(3) In regulation 10 (disqualification for appointment) -
(4) In regulation 14 (appointment of committees and sub-committees), in paragraph (3), at end add "or provide or perform primary medical services under Part 1 of the 1977 Act".
(5) In regulation 16 (disability of chairman and members in proceedings on account of pecuniary interest), for "or performing personal medical services in connection with a pilot scheme under the National Health Service (Primary Care) Act 1997" substitute "or providing or performing primary medical services under Part 1 of the 1977 Act".
18.
- (1) The Prescription Only Medicines (Human Use) Order 1997[167] shall be amended as provided in this paragraph.
(2) In article 12B (exemption for health professionals who supply or administer prescription only medicines under a Patient Group Direction in order to assist doctors or dentists in providing national health services)[168], for paragraph 3(b)(i) substitute -
19.
- (1) In the National Health Service (Proposals for Pilot Schemes) and (Miscellaneous Amendments) Regulations 1997[169] -
(2) The amendment made by sub-paragraph (1) does not extend to Scotland.
(b) in paragraph (2)(d), for "General Practice (GP) Registrar" substitute "GP Registrar".
(3) In regulation 3 (conditions as to residence), in paragraph (1) for the words "the National Health Service (General Medical Services) Regulations 1992" substitute "the National Health Service (General Medical Services Contracts) Regulations 2004".
(4) Omit regulation 4 (amendment of the National Health Service (General Medical Services) Regulations 1992).
(c) at the end, add -
(3) In regulation 2 (consultation requirements for PCT orders) -
(ii) in sub-paragraph (b) -
(4) In regulation 3 (consultation on amendment of a PCT order or dissolution) -
(ii) in sub-paragraph (b) -
23.
- (1) The Primary Care Trusts (Membership, Procedure and Administration Arrangements) Regulations 2000[175] shall be amended as provided in this paragraph.
(2) In regulation 1 (citation, commencement and interpretation), in paragraph (2) -
(c) in the definition of "Part II services", omit "general medical services,";
(d) after the definition of "pilot scheme health service body", insert -
(3) In regulation 5 (disqualification for appointment), in paragraph (1) -
24.
In the Health Service Medicines (Control of Prices of Branded Medicines) Regulations 2000[176], in regulation 5 (application of regulations), in paragraph (b), for "Schedule 10 to the National Health Service (General Medical Services) Regulations 1992" substitute "Schedule 1 to the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc) Regulations 2004[177]".
26.
- (1) The National Health Service (Charges for Drugs and Appliances) Regulations 2000[179] shall be amended as provided in this paragraph.
(2) In regulation 2 (interpretation), in paragraph (1) -
(b) in the definition of "dispensing services" for "under a pilot scheme" substitute "under the terms of a GMS contract which give effect to paragraphs 47 to 51 of Schedule 6 to the GMS Contract Regulations or under the terms of a PMS agreement which give effect to paragraphs 45 to 51 of Schedule 5 to the National Health Service (Personal Medical Services Agreements) Regulations 2004[180]";
(c) after the definition of "exemption certificate" insert -
(f) omit the definition of "pilot scheme";
(g) after the definition of "Patient Group Direction" insert -
(k) for the definition of "repeatable prescription" substitute -
(l) in the definition of "terms of service", omit "general medical services".
(3) After regulation 2(3) insert -
(4) In regulation 3 (supply of drugs and appliances by chemists), in paragraph (3)(c), omit from "doctor" to the end and insert "prescriber pursuant to the term of a general medical services contract which gives effect to paragraph 44(2) of Schedule 6 to the GMS Contract Regulations or the equivalent term of a PMS agreement or of other arrangements for the provision of primary medical services made under section 16CC(2) of the Act.".
(5) In regulation 4 (supply of drugs and appliances by doctors), in paragraph (7), for "doctor in respect of the provision by him of general medical services or personal medical services in connection with a pilot scheme" substitute "contractor under a GMS contract, a PMS agreement or arrangements made under section 16CC(2) of the Act".
(6) In regulation 6 (supply of drugs and appliances at walk-in centres), in paragraph (1), for "doctor, supplementary prescriber or independent nurse prescriber" substitute "prescriber".
(3) In rule 2(2)(a) -
(4) In rule 15(1) (applications in respect of contingent removal decisions), after "of the 1977 Act", insert "or under regulations making provision corresponding to section 49M, pursuant to section 28X(4) of that Act".
(5) At the end of rule 46(b) (publication of certain decisions by FHSAA), after "of the 1977 Act", add "or under regulations making provision corresponding to section 49M, pursuant to section 28X(4) of that Act".
29.
- (1) The Children's Homes Regulations 2001[189] shall be amended as provided in this paragraph.
(2) In regulation 2 (interpretation)[190], in paragraph (1), for the definition of "general practitioner", substitute -
(3) In regulation 21 (medicines), in paragraph (4)(a) -
30.
- (1) The Private and Voluntary Health Care (England) Regulations 2001[191] shall be amended as provided in this paragraph.
(2) In regulation 2 (interpretation), in paragraph (1), for sub-paragraphs (a), (b) and (c), substitute -
except in paragraph 1(c) of Part 2 of Schedule 3 where it means a person who provides the services specified in sub-paragraph (a) or (b);".
(3) In regulation 3 (prescribed techniques or technology and exceptions to the definition of independent hospital), in paragraph (3)(e) -
(4) In regulation 4 (meaning of independent clinic), in paragraph (1)(a), for the words "general medical services" to the end, substitute "primary medical services under Part I of that Act; and".
32.
- (1) The National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements) (England) Regulations 2002[194] shall be amended as provided in this paragraph.
(2) In regulation 2 (interpretation), in paragraph (1) -
other than an individual who is resident in Scotland;";
(c) for the definition of "the relevant Primary Care Trust" substitute -
(d) in the appropriate alphabetical position, insert -
(3) In regulation 3 (functions of the Secretary of State exercisable by Strategic Health Authorities and Primary Care Trusts), in paragraph (7), in sub-paragraph (a)(i), for "medical practitioners providing general medical services under the Act, or performing personal medical services in connection with a pilot scheme under the 1997 Act," substitute "persons providing primary medical services under Part 1 of the Act".
(4) In regulation 4 (functions relating to pilot schemes), omit paragraph (5)(b).
(5) In regulation 6 (limitations and restrictions on the exercise of functions relevant to both Strategic Health Authorities and Primary Care Trusts), omit paragraph (5).
(6) In regulation 9 (arrangements by Strategic Health Authorities for exercise of functions), after paragraph (6) insert -
may be exercised on behalf of the Authority by a committee, sub-committee or officer of the Authority.".
(7) In regulation 10 (arrangements by Primary Care Trusts for exercise of functions) -
(b) omit paragraphs (7) and (8).
(8) In regulation 11 (arrangements with health service bodies in Wales), in paragraph (3), after "the 2002 Act" insert "the Health and Social Care (Community Health and Standards) Act 2003".
(9) In Schedule 3 (functions of Strategic Health Authorities not to be exercisable by Primary Care Trusts) insert the following entries at the end of the table -
The National Health Service (General Medical Services) Contracts Regulations 2004, Schedule 3 | Opt outs of additional and out of hours services |
The National Health Service (Personal Medical Services Agreements) Regulations 2004, Schedule 4 | Opt outs of out of hours services |
The Directions as to the functions of Strategic Health Authorities (GMS Contract Disputes) dated 8th March 2004 | Dispute resolution relating to patient lists |
The Directions as to the functions of Strategic Health Authorities (PMS Agreement Disputes) dated 18th March 2004 | Dispute resolution relating to patient lists |
(3) In regulation 5(1)(e)(iii) (disqualification for appointment) omit ", as the case may be,".
(4) In Schedule 2 (access to meetings and documents), in paragraph (5)(a)(iii), for the paragraph 6B which is to be read as if inserted into Schedule 12A to the Local Government Act 1972, substitute -
34.
In the Counter Fraud and Security Management Service Regulations 2002[203] -
(b) in regulation 3(1)(e)(iii) (disqualification for appointment), omit ", as the case may be,".
35.
- (1) The Residential Family Centres Regulations 2002[204] shall be amended as provided in this paragraph.
(2) In regulation 2 (interpretation), in paragraph (1), for the definition of "general practitioner", substitute -
36.
In the Health Protection Agency (Yr Asiantaeth Diogelu Iechyd) Regulations 2003[205] -
(b) in regulation 3(1)(e)(iii) (disqualification for appointment), omit ", as the case may be,".
37.
- (1) The General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003[206] shall be amended as provided in this paragraph.
(2) In article 10 (the General Practitioner Register) -
(b) in paragraph (6), omit sub-paragraph (a); and
(c) in paragraph (7), after the word "practise" insert "in Scotland and Northern Ireland".
(3) In article 11 (general practitioners eligible for entry in the General Practitioner Register), in paragraph (2), for the words "the restriction on his right to practise as provided for in article 10(7)" substitute "that fact".
(4) In article 12 (acquired rights of general practitioners), in paragraph (2) for the words "the restriction on his right to practise as provided for in article 10 (6) or (7) (as appropriate)" substitute "that fact".
(5) In Schedule 1 (interpretation) -
or any combination of the above;
(b) in Scotland, the same as in the National Health Service (General Medical Services) (Scotland) Regulations 1995; or
(c) in Northern Ireland, the same as in the General Medical Services Regulations (Northern Ireland) 1997;".
(6) In Schedule 8 (transitional, transitory and saving provisions), in paragraph 22 (general practitioners permitted to work within the National Health Service during the transitional period) -
(b) in sub-paragraph (4), omit sub-paragraph (a); and
(c) in sub-paragraph (5), after the word "practise" insert "in Scotland or Northern Ireland".
(7) In Schedule 9 (consequential amendments to primary legislation) -
(8) In Schedule 10 (consequential amendments to, and revocations of, secondary legislation), omit paragraphs 1 (the National Health Service (General Medical Services) Regulations 1992), 5 (the National Health Service (Pilot Schemes: Miscellaneous Provisions and Consequential Amendments) Regulations 1998) and 7 (the National Health Service (General Medical Services Supplementary List) Regulations 2001).
(b) in regulation 4(1)(c)(iii) (disqualification for appointment) omit ", as the case may be,".
39.
In the Patients' Forums (Functions) Regulations 2003[211], in regulation 3 (entry and inspection of premises), in paragraph (3) -
(b) in sub-paragraph (e), for "arrangements under section 28C of that Act" substitute "a personal dental services pilot scheme established under Part 1 of the National Health Service (Primary Care) Act 1997".
40.
In regulation 3 of the National Health Service (Travel Expenses and Remission of Charges) Regulations 2003[212] (NHS travel expenses), in paragraph (1)(a) for "personal medical" substitute "primary medical services provided under Part 1 of the Act".
(b) in regulation 3(1)(e)(iii) (disqualification for appointment), omit ", as the case may be,".
42.
In regulation 1(3) of the NHS Professionals Special Health Authority Regulations 2003 (citation, commencement, application and interpretation)[214], for the definition of "primary care list", substitute -
43.
In the Commission for Social Care Inspection (Membership) Regulations 2003[215] -
(b) in regulation 4 (disqualification for appointment or from holding office), in paragraph (1)(k)(ii), for "such a list", substitute "a primary care list".
44.
In the Commission for Healthcare Audit and Inspection (Membership) Regulations 2003[216] -
(b) in regulation 4 (disqualification for appointment or from holding office), in paragraph (1)(j)(ii), for "such a list", substitute "a primary care list".
45.
- (1) The Crime and Disorder Strategies (Prescribed Descriptions) (England) Order 2004[217] shall be amended as provided in this paragraph.
(2) In article 3, in paragraph (2) -
46.
- (1) The General Medical Services Transitional and Consequential Provisions Order 2004[218] shall be amended as provided in this paragraph.
(2) In article 1 (citation, commencement, application and interpretation), in paragraph (3), in the definition of "FHSAA", after "section 49S of the", insert "1977".
(3) In article 3 (entitlement to a general medical services contract as an individual medical practitioner), in paragraph (8), for "is refusing", substitute "refuses".
(4) In article 4 (appeal against refusal of a contract under article 3), in paragraph (4), after "the matter" insert "under dispute".
(5) In article 12 (effect of events taking place after 31st March 2004 on entitlement to enter into a general medical services contract), in paragraph (b), for "Schedule", in both places where it occurs, substitute "paragraph".
(6) In article 13 (entitlement to a contract under section 176(3) of the Act), in paragraph (8), for "is refusing", substitute "refuses".
(7) In article 22 (modification of certain out of hours provisions in the 2004 Regulations during the existence of contractual arrangements made under article 15), in paragraph (b)(ii), for "article 20(b)(ii)" substitute "article 21(b)(ii)".
(1) | (2) | (3) |
Regulations revoked | References | Extent of revocation |
The National Health Service (General Medical Services) Regulations 1992 | S.I. 1992/635 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1992 | S.I. 1992/2412 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1993 | S.I. 1993/540 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 1993 | S.I. 1993/2421 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1994 | S.I. 1994/633 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 1994 | S.I. 1994/2620 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1995 | S.I. 1995/80 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 1995 | S.I. 1995/3093 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1996 | S.I. 1996/702 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1997 | S.I. 1997/730 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 1997 | S.I. 1997/981 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 3) Regulations 1997 | S.I. 1997/2468 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1998 | S.I. 1998/682 | The whole Regulations |
The National Health Service (Functions of Health Authorities) (Prescribing Incentive Schemes) Regulations 1998 | S.I. 1998/632 | The whole Regulations |
The National Health Service (Pilot Schemes: Miscellaneous Provisions and Consequential Amendments) Regulations 1998 | S.I. 1998/646 | Regulations 3, 4 and 5 |
The National Health Service (Pilot Schemes: Part II Practitioners) Regulations 1998 | S.I. 1998/665 | The whole Regulations |
The National Health Service (Choice of Medical Practitioner) Regulations 1998 | S.I. 1998/668 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1998 | S.I. 1998/682 | The whole Regulations |
The Medical Act 1983 (Approved Medical Practices and Conditions of Residence) and National Health Service (General Medical Services) (Amendment) Regulations 1998 | S.I. 1998/1664 | Regulation 4 |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 1998 | S.I. 1998/2838 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 1999 | S.I. 1999/326 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 1999 | S.I. 1999/1627 | The whole Regulations |
The National Health Service (Choice of Medical Practitioner) Amendment Regulations 1999 | S.I. 1999/3179 | The whole Regulations |
The National Health Service (General Medical Services) Amendment Regulations 2000 | S.I. 2000/220 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 2000 | S.I. 2000/601 | The whole Regulations |
The National Health Service (Functions of Health Authorities) (Prescribing Incentive Schemes) Amendment Regulations 2000 | S.I. 2000/661 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 3) Regulations 2000 | S.I. 2000/1645 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 4) Regulations 2000 | S.I. 2000/2383 | The whole Regulations |
The Medical Act 1983 (Approved Medical Practices and Conditions of Residence) and National Health Service (General Medical Services) (Amendment) Regulations 2000 | S.I. 2000/3040 | Regulation 3 |
The National Health Service (General Medical Services) Amendment Regulations 2001 | S.I. 2001/706 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 2) Regulations 2001 | S.I. 2001/1178 | The whole Regulations |
The National Health Service (General Medical Services) (Electronic Communications) Order 2001 | S.I. 2001/2890 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 3) Regulations 2001 | S.I. 2001/3386 | The whole Regulations |
The National Health Service (General Medical Services) Amendment (No. 4) Regulations 2001 | S.I. 2001/3742 | The whole Regulations |
The Family Health Services Appeal Authority (Primary Care Act) Regulations 2001 | S.I. 2001/3743 | The whole Regulations |
The National Health Service (England) (Pilot Schemes: Miscellaneous Provisions and Consequential Amendments) Amendment Regulations 2002 | S.I. 2002/543 | The whole Regulations |
The National Health Service (Functions of Health Authorities) (England) (Support of Provision of Services and Appraisal) Regulations 2002 | S.I. 2002/545 | The whole Regulations |
The National Health Service (Pharmaceutical Services) and (General Medical Services) (No. 2) Amendment Regulations 2002 | S.I. 2002/551 | Regulation 3 |
The National Health Service (General Medical Services) Amendment Regulations 2002 | S.I. 2002/554 | The whole Regulations |
The Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002 | S.I. 2002/881 | Paragraph 9 of the Schedule |
The National Health Service (General Medical Services) Amendment (No. 3) Regulations 2002 | S.I. 2002/1768 | The whole Regulations |
The Abolition of the NHS Tribunal (Consequential Provisions) Regulations 2002 | S.I. 2002/1920 | Regulation 8 |
The National Health Service Reform and Health Care Professions Act 2002 (Supplementary, Consequential etc. Provisions) Regulations 2002 | S.I. 2002/2469 | Schedule 1, paragraphs 54, 78 and 79; The reference in Schedule 2 to the National Health Service (Pilot Schemes: Miscellaneous Provisions and Consequential Amendments) Regulations 1998; The references in Schedule 5 to the National Health Service (General Medical Services) Regulations 1992, the National Health Service (Functions of Health Authorities) (Prescribing Incentive Schemes) Regulations 1998 and the National Health Service (Choice of Medical Practitioner) Regulations 1998; The references in Schedule 7 to the National Health Service (General Medical Services) Regulations 1992; the Family Health Services Appeal Authority (Primary Care Act) Regulations 2001 and the National Health Service (Functions of Health Authorities) (England) (Support of Provision of Services and Appraisal) Regulations 2002 |
The National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations 2002 | S.I. 2002/2548 | The whole Regulations |
The National Health Service (Local Pharmaceutical Services Etc) Regulations 2002 | S.I. 2002/2861 | Regulation 31 |
The Medical Act 1983 (Amendment) Order 2002 | S.I. 2002/3135 | Paragraph 30 of Schedule 1 |
The National Health Service (Out of Hours Provision of Personal Medical Services and Miscellaneous Amendments) (England) Regulations 2003 | S.I. 2003/26 | The whole Regulations |
The National Health Service (Amendments relating to prescribing by nurses and pharmacists etc) (England) Regulations 2003 | S.I. 2003/699 | Regulation 3 |
The National Health Service (Pharmaceutical Services) (General Medical Services) and (Charges for Drugs and Appliances) Amendment Regulations 2003 | S.I. 2003/1084 | Regulations 11 to 17 |
The National Health Service Reform and Health Care Professions Act 2002 (Supplementary, Consequential etc Provisions) Regulations 2003 | S.I. 2003/1937 | Paragraph 5 of the Schedule |
The National Health Service (General Medical Services etc) (Patients' Forums) Amendment Regulations 2003 | S.I. 2003/2863 | Regulation 2 |
The National Health Service (Improved Access, Quality Information Preparation and Violent Patients Schemes) (England) Regulations 2003 | S.I. 2003/2824 | The whole Regulations |
In the case of general medical services, this Order supplements the General Medical Services Transitional and Consequential Provisions Order 2004 (S.I. 2004/433) ("the first transitional order").
Part 2 of the Order is concerned with transitional provision in relation to general medical services. It deals with matters which are still outstanding on 31st March 2004 under the National Health Service (General Medical Services) Regulations 1992 (S.I. 1992/635) ("the 1992 Regulations") which are revoked. In most cases, it provides for those matters to be dealt with as part of the new contractual arrangements.
Part 3 of the Order deals with transitional provision between default contracts (which, under article 13 of the first transitional order, are short-term contracts which can be entered into on or before 31st March 2004 by those who had been providing general medical services under section 29 of the 1977 Act pending agreement on a permanent general medical services contract) and the succeeding general medical services contract. It provides for certain actions etc taken under the default contract to carry forward to the general medical services contract.
Part 4 of the Order deals with transitional provision for personal medical services. Article 58 provides for personal medical services pilot schemes to be regarded from 1st April 2004 as agreements made under section 28C of the 1977 Act to be known as transitional agreements. Article 59 provides for transitional agreements to be varied over time to meet the requirements for personal medical services agreements set out in the National Health Service (Personal Medical Services Agreements) Regulations 2004 (S.I. 2004/627). Articles 60 to 67 make provision for various aspects of transitional agreements pending their variation in accordance with article 59.
Part 5 of the Order deals with transitional arrangements for both general medical services and personal medical services pilot schemes in relation to the assignment of patients under regulations 4 to 6 of the National Health Service (Choice of Medical Practitioner) Regulations 1998 (S.I. 1998/668) which are revoked.
Part 6 of the Order deals with out of hours arrangements and services in relation to both general medical services and personal medical services. Articles 73 to 81, 83 to 86 and 89 make transitional provision in relation to matters outstanding on 31st March 2004 under paragraphs 18A to 18C of the 1992 Regulations or regulations 4 to 6 of the National Health Service (Out of Hours Provision of Personal Medical Services and Miscellaneous Amendments) (England) Regulations 2003 (S.I. 2003/26). Articles 82, 87 and 88 make transitional provision in relation to matters outstanding on the date on which a default contract is replaced by a general medical services contract. Article 90 provides for the National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations (S.I. 2002/2548) to remain in force for certain purposes until 31st December 2004 subject to certain modifications. Articles 91 to 93 deal with other miscellaneous transitional matters in relation to out of hours services.
Part 7 of the Order is concerned with transitional provision in relation to the National Health Service (Service Committees and Tribunals) Regulations 1992 which are amended so that they no longer apply to doctors. It makes provision for matters which are outstanding in relation to doctors under those Regulations on 31st March 2004 to be concluded.
Part 8 of the Order includes a number of miscellaneous transitional and transitory provisions.
Part 9 of the Order (and Schedules 1 and 2) set out savings, modifications, amendments and revocations.
[7] S.I. 1998/668 as amended by S.I. 1999/3179 and 2002/2469.back
[8] Section 49S was inserted into the 1977 Act by section 27(1) of the Health and Social Care Act 2001 (c. 15) ("the 2001 Act").back
[9] Section 28Q was inserted into the 1977 Act by section 175(1) of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43) ("the 2003 Act").back
[10] Section 29 was amended by the Health Services Act 1980 (c. 53), section 7, the Health and Social Services and Social Security Adjudications Act 1983 (c. 41), Schedule 6, paragraph 2, the Medical Act 1983 (c. 54), Schedule 5, paragraph 16(a), the Health Authorities Act 1995 (c. 17) ("the 1995 Act"), Schedule 1, paragraph 18, the Medical (Professional Performance) Act 1995 (c. 51), Schedule, paragraph 28(b), the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 8, the 2001 Act, sections 17 and 23, the National Health Service Reform and Health Care Professions Act 2002 (c. 17) ("the 2002 Act"), Schedule 2, paragraph 3 and Schedule 8, paragraph 2 and S.I. 1985/39 and 2002/3135. It is to be repealed from 1st April by section 175(2) of the 2003 Act.back
[11] Section 28C was inserted into the Act by the National Health Service (Primary Care) Act 1997 (c. 46), section 21(1) and amended by the Health Act 1999 (c. 8) ("the 1999 Act") , Schedule 4, paragraph 15, the 2001 Act, Schedule 5, paragraph 11(4), the 2002 Act, Schedule 3, paragraph 7(2) and the 2003 Act, Schedule 11, paragraph 14.back
[12] Section 17 was substituted by the the 1999 Act, section 12(1) and amended by the 2001 Act, Schedule 5, paragraph 5(3) and the 2002 Act, Schedule 1, paragraph 7.back
[13] Section 44 was amended by the Health and Social Security Act 1984 (c. 48), section 24 and Schedule 8, Part 1, the National Health Service and Community Care Act 1990 (c. 19), section 12(4), the 1995 Act, Schedule 1, paragraph 32(a), the 1999 Act, section 11, the 2001 Act, section 43(6) and Schedule 5, paragraph 5(7), the 2002 Act, section 5 and S.I. 2002/2861 and was repealed, in relation to Local Medical Committees, by the 2003 Act, Schedule 11, paragraph 21.back
[14] Section 45A was inserted into the 1977 Act by paragraph 23 of Schedule 11 to the 2003 Act.back
[15] Section 29(2)(a) was substituted by the 2002 Act, Schedule 2, paragraph 3(3)(a).back
[16] S.I. 2002/2548, as amended by S.I. 2003/26.back
[21] Paragraph 6 was amended by S.I. 1998/682 and 2002/2469.back
[22] Regulation 23(1) was amended by S.I. 2002/2469.back
[23] Paragraph 9 was amended by S.I. 1994/633, 1998/682 and 2002/2469.back
[24] Paragraph 9A was inserted by S.I. 1994/633 and amended by S.I. 2002/2469.back
[25] Paragraph (6B) was inserted into regulation 19 by S.I. 1994/633 and amended by S.I. 1998/682 and 2002/2469.back
[26] Regulation 23(2) was amended by S.I. 1997/730, 2001/3742 and 2002/2469.back
[27] Regulation 23(4) was amended by S.I. 2001/3742 and 2002/2469.back
[28] Paragraph 7 was amended by S.I. 1998/682.back
[29] Paragraph 9 was amended by S.I. 1994/633, 1998/682 and 2002/2469; paragraph 10 was amended by S.I. 2002/2469.back
[30] Paragraph 4(4) was substituted by S.I. 1994/633 and amended by S.I. 1998/682.back
[31] Paragraph 14 was amended by S.I. 1998/682 and 2002/2469.back
[32] Regulation 3 was amended by S.I. 2002/2469.back
[33] Paragraph 28A was inserted by S.I. 1999/326 and amended by S.I. 2002/2469 and 2003/699.back
[34] These definitions were inserted into paragraph 1 by S.I. 2003/699.back
[35] Regulation 33A was inserted by S.I. 2003/1084.back
[36] The definition of "repeatable prescribing services" was inserted into regulation 2(1) of the 1992 Regulations by S.I. 2003/1084.back
[37] Paragraph 36 was substituted by S.I. 2000/2383 and amended by S.I. 2002/2469.back
[38] Paragraph 27(b) was amended by S.I. 2002/2469.back
[39] Paragraph 29 was amended by S.I. 2001/3742 and 2002/554 and 2469.back
[40] Paragraph 29A was inserted by S.I. 1995/80 and amended by S.I. 2001/3742 and 2002/554 and 2469.back
[41] Paragraph 47A was inserted by S.I. 1996/702.back
[42] Directions to Health Authorities on dealing with complaints about family health service practitioners and providers of personal medical services, 28th June 1998. A copy of these directions can be obtained by writing to the Department of Health, P.O. Box 777, London SE1 6XH.back
[43] Paragraph 48 was substituted by S.I. 1998/682.back
[44] Paragraph 49 was amended by S.I. 2002/2469 and 2003/1084.back
[45] Paragraph 36C was inserted by S.I. 2003/2644.back
[46] Paragraph 21A was inserted by S.I. 2003/26.back
[47] Paragraph 21(1) was amended by S.I. 2001/3742 and 2002/2469.back
[48] Paragraph 47 was amended by S.I. 2001/3742 and 2002/2469.back
[49] Paragraph 39(1) was amended by S.I. 2001/3742 and 2002/2469.back
[50] Paragraph 50 was amended by S.I. 1993/540, 1997/730 and 2002/2469.back
[51] Paragraph 47A was inserted by S.I. 1996/702 and amended by S.I. 2002/2469.back
[52] Schedule 13 was substituted by S.I. 1993/540.back
[53] Regulation 36(7) was amended by S.I. 2001/3742 and 2002/2469 and 2861.back
[54] Regulations 18A and 18B were substituted by S.I. 1998/2838 and amended by S.I. 2002/554 and 2469.back
[55] Regulation 18F(1) was substituted by S.I. 1998/2838 and amended by S.I. 2001/3742 and 2002/554 and 2469.back
[56] Regulation 18G was substituted by S.I. 1998/2838 and amended by S.I. 2001/3742 and 2002/554 and 2469; regulation 18GG was inserted by S.I. 2001/3742 and amended by S.I. 2002/2469.back
[57] Regulation 35(2) was amended by S.I. 1996/702, 2002/2469 and 2003/2644.back
[58] Regulation 34 was amended by S.I. 1993/540, 1997/2468, 2000/601 and 2002/2469.back
[59] Section 28M was inserted into the 1977 Act by section 172(1) of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43).back
[61] These directions are available on the Department of Health's website at www.dh.gov.uk or a copy can be obtained by writing to the Department of Health, P.O. Box 777, London SE1 6XH.back
[63] Section 28C was inserted into the Act by the National Health Service (Primary Care) Act 1997 (c. 46), section 21(1) and amended by the Health Act 1999 (c. 8), Schedule 4, paragraph 15, the Health and Social Care Act 2001 (c. 15), Schedule 5, paragraph 11(4), the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 3, paragraph 7(2) and the Health and Social Care (Community Health and Standards) Act 2003 (c. 43), Schedule 11, paragraph 14.back
[64] S.I. 1998/646, as amended by S.I. 2002/543 and 2469.back
[65] Subsection (1A) was substituted by S.I. 1985/39.back
[68] Section 4 of the National Health Service and Community Care Act 1990 was amended by the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 68, the Health Act 1999 (c. 8), Schedule 4, paragraph 76 and Schedule 5, the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 1, paragraph 40 and Schedule 5, paragraph 31, the Health (Wales) Act 2003 (c. 4), Schedule 3, paragraph 6 and S.I. 1991/195.back
[70] Regulation 4 was amended by S.I. 1999/3179 and 2002/2469.back
[71] Paragraph 18A was inserted by S.I. 1996/702 and paragraph (2) was substituted, in relation to England, by S.I. 2002/2548 and amended by S.I. 2003/26.back
[73] Paragraph 18A(7) (as inserted by S.I. 1996/702) was amended by S.I. 2001/3742 and 2002/2469, 2548 and 3135.back
[77] Section 28Q was inserted into the 1977 Act by section 175(1) of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43).back
[78] The Default Contract 2004 is published by the Department of Health. It is available on their web site at www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/ModernisingPay/GPContracts or a copy can be obtained by writing to the Department of Health, Room 3E46, Quarry House, Quarry Hill, Leeds LS2 7UE.back
[80] S.I. 1992/664 as amended by S.I. 1996/703, 1998/674, 2002/2469 and 2003/1397.back
[81] Regulation 15 was amended by S.I. 2002/2469 and 2003/1937.back
[84] 1997 c. 46. Schedule 1 is repealed by the Health and Social Care (Community Health and Standards) Act 2003 (c. 43), Schedule 14, Part 4 and the repeal was commenced on 1st April 2004 by S.I. 2004/288.back
[85] S.I. 1976/615; Part 2 of Schedule 2 was amended by S.I. 1991/2284, 2001/2931 and 2002/2469.back
[86] S.I. 1987/235. Relevant amending instruments are S.I. 2001/2931 and 2002/2469.back
[87] Section 3(4) was inserted into the Act by paragraph 8 of Schedule 11 to the Health and Social Care (Community Health and Standards) Act 2003 (c. 43) ("the 2003 Act").back
[88] Section 26(2)(b) and (4)(aa) were substituted by the 2003 Act, Schedule 11, paragraph 13(2)(b) and (3)(b).back
[89] Section 28D(bc) was inserted by the 2003 Act, section 177(2).back
[90] Section 45A was inserted into the Act by paragraph 23 of Schedule 11 to the 2003 Act.back
[91] Paragraph (c) was inserted into section 54(1) of the Act by paragraph 26(2)(c) of Schedule 11 to the 2003 Act.back
[92] Paragraph (d) was inserted into section 72(5) of the Act by paragraph 27(2) of Schedule 11 to the 2003 Act.back
[93] 1988 c. 24. Section 1(6) was amended by the 2003 Act, Schedule 11, paragraph 51.back
[95] 1990 c. 23. Section 1(2)(a) was substituted by the 2003 Act, Schedule 11, paragraph 57(2).back
[96] 1992 c. 52. Section 279(2) was inserted by the 2003 Act, Schedule 11, paragraph 59(4).back
[97] 1993 c. 46. Section 2A was inserted by the Health Service Commissioners (Amendment) Act 1996 (c. 5), section 1 and subsections (1)(a) and (2)(a) were substituted by the 2003 Act, Schedule 11, paragraph 62.back
[98] 1996 c. 18. Section 43K was inserted by the Public Interest Disclosure Act 1998 (c. 23), section 1 and subsection (1)(ba) was inserted by the 2003 Act, Schedule 11, paragraph 65(2).back
[99] 2001 c. 15. Paragraph 11 of Schedule 1 was substituted by the 2003 Act, Schedule 11, paragraph 72(2).back
[100] S.I. 1997/2817 as amended by S.I. 1998/669 and 2003/3148. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back
[101] S.I. 1994/3130 as amended by S.I. 1997/2817 and 2003/3148. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back
[103] Paragraphs 47 to 49 of Schedule 11 were commenced on 1st April 2004 by article 5(2)(s) of the Health and Social Care (Community Health and Standards) Act 2003 Commencement (No. 2) Order 2004 (S.I. 2004/288) ("the 2003 Act commencement order").back
[104] 1992 c. 52. Section 279 was amended by the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 122, the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 67, the Health and Social Care Act 2001 (c. 15), Schedule 5, paragraph 9, the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 2, paragraph 60 and Schedule 3, paragraph 13 and the 2003 Act, Schedule 11, paragraph 59.back
[105] Paragraph 59 of Schedule 11 was commenced on 1st April 2004 by article 5(2)(v) of the 2003 Act commencement order, subject to the transitional provision in article 7(9) of that Order.back
[106] 1993 c. 46. Section 2A was inserted by the Health Service Commissioners (Amendment) Act 1996 (c. 5), section 1 and amended by the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 68, the Health Service Commissioners (Amendment) Act 2000 (c. 28), section 1, the Scottish Public Services Ombudsman Act 2002 (asp 11), Schedule 6, paragraph 14 and the 2003 Act, Schedule 11, paragraph 62; section 6(5) was inserted by the Health Service Commissioners (Amendment) Act 1996 (c. 5), section 7(3) and amended by the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 2, paragraph 61 and the 2003 Act, Schedule 11, paragraph 63.back
[107] Paragraphs 62 and 63 of Schedule 11 were commenced on 1st April 2004 by article 5(2)(w) of the 2003 Act commencement order, subject to the transitional provision in article 7(10) of that Order.back
[108] 1990 c. 19. Section 18(3) (a) and (b) were substituted by the 2003 Act, Schedule 11, paragraph 56(3).back
[110] 1997 c. 50. Subsections (6C) and (6E) were inserted into section 115 by the Health and Social Care Act 2001 (c. 15), section 19(3) and section (6E) was amended by the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 2, paragraph 64.back
[111] Regulation 5 was previously amended by S.I. 1997/2817: the whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back
[113] S.I. 2004/478 (W.48).back
[114] S.I. 1976/ 615; relevant amending instruments are S.I. 1991/2284, 2001/2931 and 2002/2469.back
[116] Article 4B was inserted by S.I. 2000/1919.back
[118] Schedule 1 was amended by S.I. 1992/247 and 1998/646.back
[119] S.I. 1986/975; relevant amending instruments are S.I. 2001/3739 and 2002/2469.back
[123] S.I. 1987/235. Relevant amending instruments are S.I. 2001/2931 and 2002/2469.back
[125] Article 5 was amended by S.I. 2002/881, 2469 and 2861.back
[127] Regulation 1 has been previously amended by S.I. 1996/1755, 1998/646, 2000/2434, 2001/3786, and 2002/2469 and 2861.back
[128] Regulation 11 has been previously amended by S.I. 1997/2990, 1998/646 and 1975, 1999/945, 2000/603 and 2434, and 2001/2629, 3786 and 4031.back
[129] Section 28X was inserted into the Act by the Health and Social Care Community Health and Standards Act 2003 (c. 43) ("the 2003 Act"), section 179.back
[130] S.I. 1991/2050. Regulation 2 was previously amended by S.I. 1998/646.back
[132] The definition of "Local Dental Committee" was amended by S.I. 2001/2421 and 2002/2469.back
[133] Section 45A was inserted into the Act by paragraph 23 of Schedule 11 to the 2003 Act.back
[135] Regulation 2 was previously amended by S.I. 1996/703, 1998/674 and 2002/2469.back
[136] Regulation 3 was previously amended by S.I. 1996/703 and 2002/2469.back
[137] Regulation 4 was previously amended by S.I. 1996/703, 1998/674 and 2002/2469.back
[138] Regulation 5 was previously amended by S.I. 1996/703 and 2002/2469.back
[139] Regulation 6 was previously amended by S.I. 1996/703 and 2002/2469.back
[140] Regulation 8 was previously amended by S.I. 1996/703 and 2002/2469.back
[141] Regulation 9 was previously amended by S.I. 1996/703 and 2002/2469.back
[142] Regulation 10 was previously amended by S.I. 1996/703 and 2002/2469.back
[143] Regulation 11 was previously amended by S.I. 1996/703 and 2002/2469.back
[144] Regulation 20 was previously amended by S.I. 1998/674.back
[145] Regulation 32 was previously amended by S.I. 1996/703 and 2003/1937.back
[146] Regulation 37 was previously amended by S.I. 1996/703 and 2002/2469.back
[147] Schedule 2 was previously amended by S.I. 1996/703 and 2002/2469.back
[148] Schedule 4 was previously amended by S.I. 1996/703 and 2002/2469.back
[149] Schedule 5 was previously amended by S.I. 1996/703.back
[151] Regulation 5 was amended by S.I. 1997/2991 and 2000/696.back
[153] S.I. 1995/866; relevant amendments are S.I. 1998/667, 2002/2469 and 2003/631.back
[154] Regulation 2 was amended by S.I. 1997/646, 1998/667 and 2217, 2000/606, 2002/2469 and 2003/631.back
[157] Section 28Q was inserted into the National Health Service Act 1977 by section 175(1) of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43) ("the 2003 Act").back
[158] Section 28C was inserted into the Act by the National Health Service (Primary Care) Act 1997 (c. 46), section 21(1) and amended by the Health Act 1999 (c. 8), Schedule 4, paragraph 15, the Health and Social Care Act 2001 (c. 15), Schedule 5, paragraph 11(4), the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 3, paragraph 7(2) and the 2003 Act, Schedule 11, paragraph 14.back
[159] Paragraph (1)(f) of regulation 3 was inserted by S.I. 1998/667 and amended by S.I. 1998/2217 and 2002/2469.back
[160] Regulation 4A was inserted by S.I. 1997/646; paragraph (6), as previously inserted by S.I. 1998/667, was substituted by S.I. 2000/606 and amended by S.I. 2002/2469.back
[164] S.I. 1996/669 as amended by S.I. 2002/2469.back
[165] S.I. 1996/707. These Regulations (but not the title) were amended, for England, to relate to Strategic Health Authorities by S.I. 2002/2469. Other relevant amending instruments are S.I. 1997/2991, 1998/646 and 2621, 1999/1901, 2000/696 and 2002/556.back
[166] S.I. 1997/980 as amended by S.I. 2002/2469.back
[168] Article 12B was inserted by S.I. 2000/1917 and amended by S.I. 2002/2469.back
[169] S.I. 1997/2289. The relevant amending instrument is S.I. 1998/3.back
[170] S.I. 1997/2929. The relevant amending instrument is S.I. 1998/1136.back
[172] Regulation 2 has been previously amended by S.I. 2000/3040 and is prospectively amended by S.I. 2003/1250.back
[174] S.I. 1999/2337. The relevant amending instrument is S.I. 2002/2469.back
[175] S.I. 2000/89. Relevant amending instruments are S.I. 2002/881 and 2003/1616.back
[179] S.I. 2000/620, as amended by S.I. 2000/2393 and 3189, 2001/746 and 2887, 2002/548, 1386, and 2352, 2003/585, 699 and 1084 and 2004/663.back
[182] Section 28Q was inserted into the Act by section 175(1) of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43) ("the 2003 Act").back
[183] Section 28C was inserted into the Act by the National Health Service (Primary Care) Act 1997 (c. 46), section 21(1) and amended by the Health Act 1999 (c. 8), Schedule 4, paragraph 15, the Health and Social Care Act 2001 (c. 15), Schedule 5, paragraph 11(4), the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 3, paragraph 7(2) and the 2003 Act, Schedule 11, paragraph 14.back
[185] S.I. 2001/3750; relevant amendments are S.I. 2002/1921 and 2469.back
[186] Section 28X was inserted by section 179(1) of the 2003 Act.back
[188] Regulation 2 was previously amended by S.I. 2003/1590.back
[190] Regulation 2 has been previously amended by S.I. 2002/2469.back
[193] Regulation 2 was previously amended by S.I. 2002/865 and 2002/2469.back
[194] S.I. 2002/2375 as amended by S.I. 2002/2548 and 2003/1497.back
[196] Section 28Q was inserted by section 175(1) of the 2003 Act.back
[197] Section 28C was inserted into the Act by the National Health Service (Primary Care) Act 1997 (c. 46), section 21(1) and amended by the Health Act 1999 (c. 8), Schedule 4, paragraph 15, the Health and Social Care Act 2001 (c. 15), Schedule 5, paragraph 11(4), the National Health Service Reform and Health Care Professions Act 2002 (c. 17), Schedule 3, paragraph 7(2) and the 2003 Act, Schedule 11, paragraph 14.back
[201] Section 28X was inserted by section 179 of the Health and Social Care (Community Health and Standards) Act 2003 (c. 43).back
[208] Section 49N(1) was inserted by the Health and Social Care Act 2001 (c. 15) ("the 2001 Act"), section 25 and amended by the National Health Service Reform and Health Care Professions Act 2002 (c. 17) ("the 2002 Act"), Schedule 2, paragraph 25 and the Health and Social Care (Community Health and Standards) Act 2003 (c. 43) ("the 2003 Act"), Schedule 11, paragraph 24.back
[209] Section 29 is repealed by sections 175(2) and 196 of, and Schedule 14 to, the 2003 Act.back
[210] 1997 c. 46; section 8ZA was inserted by section 26(2) of the 2001 Act and was amended by section 4(3) of, and paragraphs 1 and 3 of Schedule3 to the 2002 Act; and is repealed by section 196 of, and Schedule 14 to, the 2003 Act so far as it relates to personal medical services and otherwise on a date to be appointed.back
[211] S.I.2003/2124 as amended by S.I. 2004/540.back