The National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) Amendment Regulations 2014
| Jurisdiction | UK Non-devolved |
2014No. 465
NATIONAL HEALTH SERVICE, ENGLAND
The National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) Amendment Regulations 2014
3rdMarch2014
6thMarch2014
1stApril2014
The Secretary of State for Health, in exercise of the powers conferred by sections 85, 89(1), (2)(a), (c), (d), (3)(a), (4)(b) and (6), 94(1), (3)(c) and (f), (8)(a) and (9) and 272(7) and (8) of the National Health Service Act 2006( 1), makes the following Regulations.
PART 1
General
Citation and commencement
1. (1) These Regulations may be cited as the National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) Amendment Regulations 2014.
(2) They come into force on 1st April 2014.
Interpretation
2. In these Regulations-
"the General Medical Services Contracts Regulations" means the National Health Service (General Medical Services Contracts) Regulations 2004( 2); and
"the Personal Medical Services Agreements Regulations" means the National Health Service (Personal Medical Services Agreements) Regulations 2004( 3).
PART 2
Amendments to the General Medical Services Contracts Regulations
Amendment of regulation 2 of the General Medical Services Contracts Regulations
3. In regulation 2(1) of the General Medical Services Contracts Regulations (interpretation), omit the definition of "Patient Choice Scheme".
Substitution of regulation 26B of the General Medical Services Contracts Regulations
4. For regulation 26B of the General Medical Services Contracts Regulations( 4) (variation of contractual terms in respect of entering into arrangements under the Patient Choice Extension Scheme)( 5), substitute-
"Registered patients from outside practice area: variation of contractual terms
26B.
(1) A contractor may, on or after 1st October 2014, accept onto its list of patients a person who resides outside of the area referred to in regulation 18(1)(d) (the contractor's "practice area").
(2) Subject to paragraphs (4) and (5), the terms of the contractor's contract specified in paragraph (3) must be varied so as to require the contractor to provide to the person any services which the contractor is required to provide to its registered patients under the contract as if the person resided within the contractor's practice area.
(3) The terms of the contract specified in this paragraph are-
(a) the terms under which the contractor is to provide essential services;
(b) the terms under which the contractor is to provide for arrangements to access services throughout core hours;
(c) the terms under which the contractor is to provide out of hours services; and
(d) the terms which give effect to the following provisions of Schedule 6 (other contractual terms)-
(i) paragraph 2(1) (attendance at practice premises),
(ii) paragraph 3(2)(a) (attendance outside practice premises), and
(iii) paragraph 17(2) (refusal of applications for inclusion in the list of patients).
(4) Where the contractor is required to provide services to a patient in accordance with arrangements made under paragraph (1), the contract must also be varied so as to include terms which have the effect of releasing the contractor and the Board from all obligations, rights and liabilities relating to the terms specified in paragraph (3) (including any right to enforce those terms) where, in the opinion of the contractor, it is not clinically appropriate or practical under those arrangements-
(a) to provide the services or access to services in accordance with those terms; or
(b) to comply with those terms.
(5) The contract must also include a term which has the effect of requiring the contractor to notify a person in writing, where the contractor is minded to accept that person on its list of patients in accordance with arrangements made under paragraph (1), that the contractor is under no obligation to provide-
(a) essential services if, at the time treatment is required, it is not clinically appropriate or practical to provide primary medical services given the particular circumstances of the patient;
(b) out of hours services if, at the time treatment is required, it is not clinically appropriate or practical to provide such services given the particular circumstances of the patient; or
(c) additional services to the patient if it is not clinically appropriate or practical to provide such services given the particular circumstances of the patient.
Saving in respect of the Patient Choice Extension Scheme
26C.
(1) Where, before 1st April 2014-
(a) a patient is included in a contractor's registered list of patients pursuant to arrangements entered into by the contractor and the Board under the Patient Choice Extension Scheme; and
(b) the terms of the contractor's contract were varied pursuant to the provisions of regulation 26B as it had effect immediately before that date,
the patient may remain registered with the contractor's practice and any variation to the contractor's contract which exempts the contractor's practice from any obligations or liabilities under those arrangements continues to operate for such period as the patient remains so registered.
(2) Paragraph (6) of regulation 26B, as it had effect immediately before 1st April 2014, continues to have effect in relation to a contract where, before that date, a contractor entered into arrangements with the Board under the Patient Choice Extension Scheme.".
Insertion of paragraph 6A into Schedule 6 to the General Medical Services Contracts Regulations
5. In Schedule 6 to the General Medical Services Contracts Regulations (other contractual terms), after paragraph 6 (patients aged 75 years and over) insert-
"Patients aged 75 and over: accountable GP
6A.
(1) A contractor must ensure that for each of its registered patients aged 75 and over there is assigned an accountable general medical practitioner ("accountable GP").
(2) The accountable GP must-
(a) take lead responsibility for ensuring that any services which the contractor is required to provide under the contract are, to the extent that their provision is considered necessary to meet the needs of the patient, delivered to the patient;
(b) take all reasonable steps to recognise and appropriately respond to the physical and psychological needs of the patient in a timely manner;
(c) ensure that the patient receives a health check if, and within a reasonable period after, one has been requested; and
(d) work co-operatively with other health and social care professionals who may become involved in the care and treatment of the patient to ensure the delivery of a multi-disciplinary care package designed to meet the needs of the patient.
(3) The contractor must-
(a) inform the patient, in such manner as is considered appropriate by the practice, of the assignment to them of an accountable GP which must state the name and contact details of the accountable GP and the role and responsibilities of the accountable GP in respect of the patient;
(b) inform the patient as soon as any circumstances arise in which the accountable GP is not able, for any significant period, to carry out their duties towards the patient; and
(c) where the practice considers it to be necessary, assign a replacement accountable GP to the patient and give notice to the patient accordingly.
(4) The contractor must comply with the requirement in sub-paragraph (3)(a)-
(a) in the case of any person who is included in the contractor's list of patients immediately before 1st April 2014 and-
(i) is aged 75 or over on or before that date, by 30th June 2014, or
(ii) who attains the age of 75 after that date, within 21 days from the date on which that person attained that age; or
(b) in the case of any person aged 75 or over who is accepted by the contractor as a registered patient on or after 1st April 2014, within 21 days from the date on which that person is so accepted.
(5) In this regulation, "health check" means a consultation undertaken by the contactor which is of the type which a contractor is required to undertake at a patient's request under paragraph 6(1). ".
Substitution of paragraph 11 of Schedule 6 to the General Medical Services Contracts Regulations
6. In Schedule 6 to the General Medical Services Contracts Regulations (other contractual terms), for paragraph 11 (standards for out of hours services) substitute-
"Out of hours services: quality standards and monitoring
11.
(1) A contractor which provides out of hours services must, in the provision of those services, meet the quality requirements set out in the document entitled "National Quality Standards in the Delivery of Out of Hours Services" published on 20th July 2006( 6).
(2) Where a contractor does not provide out of hours services, the contractor must-
(a) monitor the quality of the out of hours services which are offered or provided to its registered patients having regard to the National Quality Standards referred to in sub-paragraph (1) and record, and act appropriately in relation to, any concerns arising;
(b) record any patient feedback received, including any complaints;
(c) report to the Board, either at the request of the Board or otherwise, any concerns arising about the quality of the out of hours services which are offered or provided to its registered patients having regard to-
(i) any patient feedback received, including any complaints, and
(ii) the quality requirements set out in the National Quality Standards referred to in sub-paragraph (1).".
Amendment of paragraph 12 of Schedule 6 to the General Medical Services Contracts Regulations
7. In Schedule 6 to the General Medical Services Contracts Regulations (other contractual terms), for paragraph 12(2)(c) (duty of co-operation in relation to additional, enhanced and out of hours services) substitute-
"(c) in the case of out of hours services-
(i) take reasonable steps to ensure that any patient who contacts the practice premises during the out of hours period is...
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