Legalize / United Kingdom / Northern Ireland / Ni-Statutory-Rule

The Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 2004

Type Ni-Statutory-Rule

Publication 2004-03-29

Last updated 2023-11-06

State In force

Jurisdiction Northern Ireland

Department Government Printer for Northern Ireland

Source legislation.gov.uk

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articles Not indexed

Reform history JSON API

“post-natal period” means the period starting from the conclusion of delivery of the baby or the patient’s discharge from secondary care services, whichever is the later, and ending on the fourteenth day after the birth.

Minor surgery

8

(1) A contractor whose contract includes the provision of minor surgery shall comply with the requirements in sub-paragraphs (2) and (3).

(2) The contractor shall make available to patients where appropriate –

(a) curettage;

(b) cautery; and

(3) The contractor shall ensure that his record of any treatment provided under this paragraph includes the consent of the patient to that treatment.

SCHEDULE 2 — OPT OUTS OF ADDITIONAL AND OUT OF HOURS SERVICES

Opt outs of additional services: general

1

(1) In this Schedule –

“opt out notice” means a notice given under sub-paragraph (5) to permanently opt out or temporarily opt out of the provision of the additional service;

“permanent opt out” in relation to the provision of an additional service that is funded through the global sum means the termination of the obligation under the contract for the contractor to provide that service;

“permanent opt out notice” means an opt out notice to permanently opt out;

“preliminary opt out notice” means a notice given under sub-paragraph (2) that a contractor wishes to temporarily opt out or permanently opt out of the provision of an additional service;

“temporary opt out” in relation to the provision of an additional service that is funded through the global sum means the suspension of the obligation under the contract for the contractor to provide that service for a period of more than six months and less than twelve months and includes an extension of a temporary opt out and shall be construed accordingly; and

“temporary opt out notice” means an opt out notice to temporarily opt out.

(2) A contractor who wishes to permanently or temporarily opt out shall give to the Board in writing a preliminary opt out notice which shall state the reasons for wishing to opt out.

(3) As soon as is reasonably practicable and in any event within the period of 7 days beginning with the receipt of the preliminary opt out notice by the Board, the Board shall enter into discussions with the contractor concerning the support which the Board may give the contractor, or concerning other changes which the Board or the contractor may make, which would enable the contractor to continue to provide the additional service and the Board and the contractor shall use reasonable endeavours to achieve this aim.

(4) The discussions mentioned in sub-paragraph (3) shall be completed within the period of 10 days beginning with the date of the receipt of the preliminary opt out notice by the Board or as soon as reasonably practicable thereafter.

(5) Subject to sub-paragraph (9), if following the discussions mentioned in sub-paragraph (3), the contractor still wishes to opt out of the provision of the additional service, he shall send an opt out notice to the relevant Board.

(6) An opt out notice shall specify –

(a) the additional service concerned;

(b) whether the contractor wishes to –

(i) permanently opt out; or

(ii) temporarily opt out;

(d) the date from which the contractor would like the opt out to commence, which must –

(i) in the case of a temporary opt out be at least 14 days after the date of service of the opt out notice, and

(ii) in the case of a permanent opt out must be the day either three or six months after the date of service of the opt out notice, and

(e) in the case of a temporary opt out, the desired duration of the opt out.

(7) Where a contractor has given two previous temporary opt out notices within the period of three years ending with the date of the service of the latest opt out notice (whether or not the same additional service is concerned), the latest opt out notice shall be treated as a permanent opt out notice (even if the opt out notice says that he wishes to temporarily opt out).

(8) Paragraph 2 applies following the giving of a temporary opt out notice and paragraph 3 applies following the giving of a permanent opt out notice or a temporary opt out notice which pursuant to sub-paragraph (7) is treated as a permanent opt out notice.

(9) No temporary opt out notice may be served by a contractor prior to 1st April 2004.

Temporary opt outs and permanent opt outs following temporary opt outs

2

(1) As soon as is reasonably practicable and in any event within the period of 7 days beginning with and including the date of receipt of a temporary opt out notice under paragraph 1(5), the Board shall –

(a) approve the opt out notice and specify in accordance with sub-paragraphs (3) and (4) the date on which the temporary opt out is to commence and the date that it is to come to an end (“the end date”); or

(b) reject the opt out notice in accordance with sub-paragraph (2),

and shall notify the contractor of its decision as soon as possible, including reasons for its decision.

(2) A Board may reject the opt out notice on the ground that the contractor –

(a) is providing additional services to patients registered with another contractor or enhanced services; or

(b) has no reasonable need temporarily to opt out having regard to his ability to deliver the additional service.

(3) The date specified by the Board for the commencement of the temporary opt out shall wherever reasonably practicable be the date requested by the contractor in his opt out notice.

(4) Before determining the end date, the Board shall make reasonable efforts to reach agreement with the contractor.

(5) Where the Board approves an opt out notice, the contractor’s obligation to provide the additional service specified in the notice shall be suspended from the date specified by the Board in its decision under sub-paragraph (1), and shall remain suspended until the end date unless–

(a) the contractor and the Board agree in writing an earlier date, in which case the suspension shall come to an end on the earlier date agreed;

(b) the Board specifies a later date under sub-paragraph (6), in which case the suspension shall end on the later date specified;

(c) sub-paragraph (7) applies and the contractor refers the matter to the dispute resolution procedure or the court, in which case the suspension shall end–

(i) where the outcome of the dispute is to uphold the decision of the Department , on the day after the date of the decision of the Family Practitioner Services Independent Appeal Panel or the court,

(ii) where the outcome of the dispute is to overturn the decision of the Department , 28 days after the decision of the Family Practitioner Services Independent Appeal Panel or the court, or

(iii) where the contractor ceases to pursue the dispute resolution procedure or court proceedings, on the day after the date that the contractor withdraws his claim or the procedure is or proceedings are otherwise terminated by the Family Practitioner Services Independent Appeal Panel or the court;

(d) sub-paragraph (9) applies and –

(i) the Board refuses the contractor’s request for a permanent opt out within the period of 28 days ending with the end date, in which case the suspension shall come to an end 28 days after the end date,

(ii) the Board refuses the contractor’s request for a permanent opt out after the end date, in which case the suspension shall come to an end 28 days after the date of service of the opt out notice, or

(iii) the Department notifies the contractor after the end date that the Family Practitioner Services Independent Appeal Panel has not approved its proposed decision to refuse the contractor’s request to permanently opt out under sub-paragraph (14), in which case the suspension shall come to an end 28 days after the date of service of that notice.

(6) Before the end date, a Board may, in exceptional circumstances and with the agreement of the contractor, notify the contractor in writing of a later date on which the temporary opt out is to come to an end, being a date no more than six months later than the end date.

(7) Where the Board considers that –

(a) the contractor will be unable to satisfactorily provide the additional service at the end of the temporary opt out; and

(b) it would not be appropriate to exercise its discretion under sub-paragraph (6) to specify a later date on which the temporary opt out is to come to an end or the contractor does not agree to a later date,

the Board may notify the contractor in writing at least 28 days before the end date that a permanent opt out shall follow a temporary opt out.

(8) Where a Board notifies the contractor under sub-paragraph (7) that a permanent opt out shall follow a temporary opt out, the permanent opt out shall take effect immediately after the end of the temporary opt out.

(9) A contractor who has temporarily opted out may, at least three months prior to the end date, notify the Board in writing that he wishes to permanently opt out of the additional service in question.

(10) Where the contractor has notified the Board under sub-paragraph (9) that it wishes to permanently opt out, the temporary opt out shall be followed by a permanent opt out beginning on the day after the end date unless the Board refuses the contractor’s request to permanently opt out by giving a notice in writing to the contractor to this effect.

(11) The Department may only give a notice under sub-paragraph (10) with the approval of the Family Practitioner Services Independent Appeal Panel .

(12) Where the Department seeks the approval of the Family Practitioner Services Independent Appeal Panel to a proposed decision to refuse a permanent opt out, it shall notify the contractor of having done so.

(13) If the Family Practitioner Services Independent Appeal Panel has not reached a decision as to whether or not to approve the Department’s proposed decision to refuse a permanent opt out before the end date, the contractor’s obligation to provide the additional service shall remain suspended until the date specified in sub-paragraph (5)(d)(ii) or (iii) (whichever is applicable).

(14) Where after the end date the Family Practitioner Services Independent Appeal Panel notifies the Department that it does not approve the Department’s proposed decision to refuse a permanent opt out, the Department shall notify the contractor in writing of this fact as soon as is reasonably practicable.

(15) A temporary opt out or permanent opt out commences, and a temporary opt out ends at 8am on the relevant day unless –

(a) the day is a Saturday, Sunday or a public or local holiday agreed with the Board,

in which case the opt out shall take effect on the next working day at 8am; or

(b) the Board and the contractor agree a different time.

Permanent opt outs

3

(1) In this paragraph –

“A day” is the day specified by the contactor in his permanent opt out notice to a Board for the commencement of the permanent opt out;

“B day” is the day six months after the date of service of the permanent opt out notice; and

“C day” is the day nine months after the date of service of the permanent opt out notice.

(2) As soon as is reasonably practicable and in any event within the period of 28 days beginning with and including the date of receipt of a permanent opt out notice under paragraph 1(5) (or temporary opt out notice which is treated as a permanent opt out notice under paragraph 1(7), the Board shall –

(a) approve the opt out notice; or

(b) reject the opt out notice in accordance with sub-paragraph (3),

and shall notify the contractor of its decision as soon as possible, including reasons for its decision where its decision is to reject the opt out notice.

(3) A Board may reject the opt out notice on the ground that the contractor is providing an additional service to patients other than his registered patients or enhanced services.

(4) A contractor may not withdraw an opt out notice once it has been approved by the Board in accordance with sub-paragraph (2)(a) without the Board’s agreement.

(5) If the Board approves the opt out notice under sub-paragraph (2)(a), it shall use its reasonable endeavours to make arrangements for the contractor’s registered patients to receive the additional service from an alternative provider from A day.

(6) The contractor’s duty to provide the additional service shall terminate on A day unless the Board serves a notice under sub-paragraph (7) (extending A day to B day or C day).

(7) If the Board is not successful in finding an alternative provider to take on the provision of the additional service from A day, then it shall notify the contractor in writing of this fact no later than one month before A day, and –

(a) in a case where A day is three months after service of the opt out notice, the contractor shall continue to provide the additional service until B day unless at least one month before B day he receives a notice in writing from the Board under sub-paragraph (8) that despite using its reasonable endeavours, it has failed to find an alternative provider to take on the provision of the additional service from B day;

(b) in a case where A day is six months after the service of the opt out notice, the contractor shall continue to provide the additional service until C day unless at least one month before C day he receives a notice from the Department under sub-paragraph (11) that it has made an application to the Family Practitioner Services Independent Appeal Panel under sub-paragraph (10) seeking its approval to a decision to refuse a permanent opt out or to delay the commencement of a permanent opt out until after C day.

(8) Where in accordance with sub-paragraph (7)(a) the permanent opt out is to commence on B day and the Department , despite using its reasonable endeavours has failed to find an alternative provider to take on the provision of the additional service from that day, it shall notify the contractor in writing of this fact at least one month before B day, in which case the contractor shall continue to provide the additional service until C Day unless at least one month before C day he receives a notice from the Department under sub-paragraph (11) that it has applied to the Family Practitioner Services Independent Appeal Panel under sub-paragraph (10) seeking its approval to a decision to refuse a permanent opt out or to postpone the commencement of a permanent opt out until after C day.

(9) As soon as is reasonably practicable and in any event within 7 days of the Board serving a notice under sub-paragraph (8), the Board shall enter into discussions with the contractor concerning the support that the Board may give to the contractor or other changes which the Board or the contractor may make in relation to the provision of the additional service until C day.

(10) The Department may, if it considers that there are exceptional circumstances, make an application to the Family Practitioner Services Independent Appeal Panel for approval of a decision to –

(a) refuse a permanent opt out; or

(b) postpone the commencement of a permanent opt out until after C day.

(11) As soon as practicable after making an application under sub-paragraph (10) to the Family Practitioner Services Independent Appeal Panel , the Department shall notify the contractor in writing that it has made such an application.

(12) On receiving an application under sub-paragraph (10) for approval of a decision to refuse a permanent opt out, the Family Practitioner Services Independent Appeal Panel shall –

(a) approve the Department ’s application;

(b) reject the Department ’s application, but nonetheless recommend a different date for the commencement of the permanent opt out which may be later than C day; or

(13) On receiving an application under sub-paragraph (10) for approval of a decision to postpone the commencement of a permanent opt out until after C day the Family Practitioner Services Independent Appeal Panel shall –

(a) approve the Department ’s application;

(b) reject the Department ’s application, but nonetheless recommend –

(i) that the permanent opt out commence on an earlier date to that proposed by the Department in its application, or

(ii) that the permanent opt out be refused; or

(14) The Family Practitioner Services Independent Appeal Panel shall notify the Department and the contractor in writing of its decision under sub-paragraph (12) or (13) as soon as is practicable, including reasons for its decision.

(15) Where the Family Practitioner Services Independent Appeal Panel –

(a) approves a decision to refuse an opt out under sub-paragraph (12)(a); or

(b) recommends that a permanent opt out be refused under sub-paragraph (13)(b)(ii),

the Department shall notify the contractor in writing that the contractor may not opt out of the additional service.

(16) Where a Board notifies a contractor under sub-paragraph (15), the contractor may not serve a preliminary opt out notice in respect of that additional service for a period of 12 months beginning with the date of service of the Board’s notice under sub-paragraph (15) unless there has been a change in the circumstances of the contractor in relation to his ability to deliver services under the contract.

(17) Where the Family Practitioner Services Independent Appeal Panel –

(a) recommends a different date for the commencement of the permanent opt out under sub-paragraph (12)(b);

(b) approves a Department ’s application to postpone a permanent opt out under sub-paragraph (13)(a); or

the Department shall in accordance with the decision of the Family Practitioner Services Independent Appeal Panel notify the contractor in writing of its decision and the notice shall specify the date from which permanent opt out shall commence.

(18) Where the Family Practitioner Services Independent Appeal Panel rejects the Department ’s application under sub-paragraph (12)(c) or (13)(c), the Department shall notify the contractor in writing that there shall be a permanent opt out, and the permanent opt out shall commence on C day or 28 days after the date of service of the Department ’s notice, whichever is the later.

(19) If the Family Practitioner Services Independent Appeal Panel has not reached a decision on the Department ’s application under sub-paragraph (10) before C day, the contractor’s obligation to provide the additional service shall continue until a notice is served on the contractor by the Department under sub-paragraph (17) or (18).

(20) Nothing in sub-paragraphs (1) to (19) shall prevent the contractor and the Board from agreeing a different date for the termination of the contractor’s duty under the contract to provide the additional service and accordingly, varying the contract in accordance with paragraph 96(1) of Schedule 5.

(21) The permanent opt out takes effect at 08.00 on the relevant day unless the Board and the contractor agree a different day or time.

Out of hours opt outs where the opt out notice is served after 30th September 2004

4

(1) This paragraph applies where a contractor wishes to serve or serves an out of hours opt out notice after 30th September 2004.

(2) A contractor which wishes to terminate his obligation to provide out of hours services which was included in the contract pursuant to regulation 30 shall notify the Board in writing to that effect (“an out of hours opt out notice”).

(3) An out of hours opt out notice shall specify the date from which the contractor would like the opt out to take effect, which must be either three or six months after the date of service of the out of hours opt out notice.

(4) As soon as is reasonably practicable and in any event within 28 days of receiving the out of hours opt out notice, the Board shall approve the notice and specify in accordance with sub-paragraph (6) the date on which the out of hours opt out is to commence (“OOH day”).

(5) The Board shall notify the contractor of its decision as soon as possible including the reason for its decision.

(6) The date specified in sub-paragraph (4) shall be the date specified in the out of hours opt out notice.

(7) A contractor may not withdraw an out of hours opt out notice once it has been approved by the Board under sub-paragraph (4) without the Board’s agreement.

(8) Following receipt of the out of hours opt out notice, the Board must use its reasonable endeavours to make arrangements for the contractor’s registered patients to receive the out of hours services from an alternative provider from OOH day.

(9) Sub-paragraphs (6) to (21) of paragraph 3 shall apply to an out of hours opt out as they apply to a permanent opt out and as if the reference to “A day” was a reference to “OOH day” and the reference in paragraph 3(16) to a “preliminary opt out notice” was a reference to an out of hours opt out notice.

Out of hours opt outs where the opt out notice is served before 1st October 2004

5

(1) This paragraph shall apply where a contractor wishes to serve or serves an out of hours opt out notice before 1st October 2004.

(2) In this paragraph –

“OOH day” is the day specified by the Board for the commencement of the out of hours opt out in its decision under sub-paragraph (5);

“OOHB day” is the day six months after the date of service of the out of hours opt out notice; and

“OOHC day” is the day specified by the Board in its decision under sub-paragraph (11) or (13) (which must be nine months after the date of service of the out of hours opt out notice or before 2nd January 2005).

(3) A contractor which wishes to terminate his obligation to provide out of hours services which was included in the contract pursuant to regulation 30 shall notify the relevant Board in writing to that effect (“an out of hours opt out notice”).

(4) An out of hours opt out notice shall state the date on which the contractor would like the opt out to take effect, which must be either three or six months after the date of service of the out of hours opt out notice.

(5) As soon as is reasonably practicable and in any event within 28 days of receiving the out of hours opt out notice, the Board shall approve the notice and specify in accordance with sub-paragraphs (6) and (7) the date on which the out of hours opt out is to commence (OOH day) and the Board shall notify the contractor in writing of its decision as soon as possible, including reasons for its decision.

(6) Subject to sub-paragraph (7), OOH day shall be –

(a) the date specified in the out of hours opt out notice; or

(b) any other date before 2nd January 2005.

(7) A Board may not specify under sub-paragraph (5) a date earlier than the date specified in the out of hours opt out notice.

(8) A contractor may not withdraw an out of hours opt out notice once it has been approved by a Board under sub-paragraph (5) without the Board’s agreement.

(9) Following receipt of the out of hours opt out notice, the Board must use its reasonable endeavours to make arrangements for the contractor’s registered patients to receive out of hours services from an alternative provider from OOH day.

(10) The contractor’s duty to provide the out of hours services shall terminate on OOH day unless the Department –

(a) serves a notice under sub-paragraph (11) (extending OOH day to OOHB day or OOHC day); or

(b) makes an application under sub-paragraph (14) (seeking the approval of the Family Practitioner Services Independent Appeal Panel to a decision to refuse an opt out or to delay the taking of effect of an opt out until after OOH day).

(11) If the Department is not successful in finding an alternative provider to take on the provision of the out hours services from OOH day, then it shall notify the contractor in writing of this fact no later than one month before OOH day, and –

(a) in a case where OOH day is three months after service of the out of hours opt out notice, the contractor shall continue to provide the out of hours services until OOHB day unless at least one month before OOHB day he receives a notice in writing from the Department under sub-paragraph (13) that despite using its reasonable endeavours, it has failed to find an alternative provider to take on the provision of the out of hours services from OOHB day;

(b) in a case where OOH day is after the day three months after the service of the out of hours opt out notice, the contractor shall continue to provide the out of hours services until OOHC day (which shall be specified by the Department in accordance with sub-paragraph (12) and included in its notice to the contractor under this sub-paragraph) unless at least one month before OOHC day he receives a notice from the Department under sub-paragraph (16) that it has made an application to the Family Practitioner Services Independent Appeal Panel under sub-paragraph (14) seeking the Family Practitioner Services Independent Appeal Panel ’s approval to a decision to refuse an opt out or to postpone the commencement of the opt out until after OOHC day.

(12) OOHC day shall be any day before 2nd January 2005 or the day nine months after the service of the out of hours opt out notice.

(13) Where in accordance with sub-paragraph (11)(a) the out of hours opt out is to commence on OOHB day and the Department , despite using its reasonable endeavours has failed to find an alternative provider to take on the provision of the out of hours services from that day, it shall notify the contractor in writing of this fact at least one month before OOHB day, in which case the contractor shall continue to provide the out of hours services until OOHC day (which shall be specified by the Department in accordance with sub-paragraph (12) and included in its notice to the contractor under this sub-paragraph) unless at least one month before OOHC day he receives a notice from the Department under sub-paragraph (16) that it has applied to the Family Practitioner Services Independent Appeal Panel under sub-paragraph (14) seeking the approval of the Family Practitioner Services Independent Appeal Panel to a decision to refuse an opt out or to postpone the commencement of an opt out until after OOHC day.

(14) The Department may, if it considers there are exceptional circumstances, make an application to the Family Practitioner Services Independent Appeal Panel for approval of a decision to –

(a) refuse an opt out; or

(b) postpone the commencement of an opt out until after –

(i) OOHC day, or

(ii) OOH day where OOH day is 1st January 2005 and 1st January 2005 is nine months or more after the date of the out of hours opt out notice.

(15) Where OOH day is1st January 2005, and 1st January 2005 is nine months or more after the date of the out of hours opt out notice, an application under sub-paragraph (14) shall be made at least one month before OOH day.

(16) As soon as practicable after making an application under sub-paragraph (14) to the Family Practitioner Services Independent Appeal Panel , the Department shall notify the contractor in writing that it has made such an application.

(17) Sub-paragraphs (12) to (21) of paragraph 3 shall apply to an out of hours opt out as they apply to a permanent opt out and as if the reference to “C day” was a reference to OOHC day or OOH day where OOH day is 1st January 2005 and 1st January 2005 is nine months or more after the date of the out of hours opt out notice.

Informing patients of opt outs

6

(1) Prior to any opt out taking effect, the Board and the contractor shall discuss how to inform the contractor’s patients of the proposed opt out.

(2) The contractor shall, if requested by the Board inform his registered patients of an opt out and the arrangements made for them to receive the additional service or out of hours services by –

(a) placing a notice in the practice’s waiting room; or

(b) including the information in the practice leaflet.

(3) In this paragraph “opt out” means an out of hours opt out, a permanent opt out or a temporary opt out.

SCHEDULE 3 — LIST OF PRESCRIBED MEDICAL CERTIFICATES

1

To support a claim or to obtain payment either personally or by proxy; to prove inability to work or incapacity for self-support for the purposes of an award by the Department; or to enable proxy to draw pensions etc.

2

To establish pregnancy for the purpose of obtaining welfare foods

3

To secure registration of still-births.

4

To enable payment to be made to an institution or other person in case of mental disorder of persons entitled to payment from public funds.

5

To establish unfitness for jury service

6

To support late application for reinstatement in civil employment or notification of non-availability to take up employment owing to sickness.

7

To enable a person to be registered as an absent voter on grounds of physical incapacity

8

To support applications for certificates conferring exemption from charges in respect of drugs, medicines and appliances.

SCHEDULE 4 — FEES AND CHARGES

1

The contractor may demand or accept a fee or other remuneration –

(a) from any public body for services rendered for the purposes of that body’s statutory functions;

(b) from any body, employer or school for a routine medical examination of persons for whose welfare the body, employer or school is responsible, or an examination of such persons for the purpose of advising the body, employer or school of any administrative action they might take;

(c) for treatment which is not primary medical services or otherwise required to be provided under the contract and which is given:

(i) pursuant to the provisions of Article 31 of the Order (Accommodation and services for private patients), or

(ii) in a registered nursing home which is not providing services under that Order,

if, in either case, the person administering the treatment is serving on the staff of a hospital providing services under the Order as a specialist providing treatment of the kind the patient requires and if, within 7 days of giving the treatment, the contractor or the person providing the treatment supplies the Board, on a form provided by it for the purpose, with such information about the treatment as it may require;

(d) when he treats a patient under regulation 24(3), in which case he shall be entitled to demand and accept a reasonable fee (recoverable in certain circumstances under regulation 24(4)) for any treatment given, if he gives the patient a receipt;

(e) for attending and examining (but not otherwise treating) a patient –

(i) at his request at a police station in connection with possible criminal proceedings against him,

(ii) at the request of a commercial, educational or not-for-profit organisation for the purpose of creating a medical report or certificate,

(iii) for the purpose of creating a medical report required in connection with an actual or potential claim for compensation by the patient;

(f) for treatment consisting of an immunisation for which no remuneration is payable by the Board and which is requested in connection with travel abroad;

(g) for prescribing or providing drugs, medicines or appliances (including a collection of such drugs, medicines or appliances in the form of a travel kit) which a patient requires to have in his possession solely in anticipation of the onset of an ailment or occurrence of an injury while he is outside the United Kingdom but for which he is not requiring treatment when the medicine is prescribed;

(h) for a medical examination –

(i) to enable a decision to be made whether or not it is inadvisable on medical grounds for a person to wear a seat belt, or

(ii) for the purpose of creating a report –

(aa) relating to a road traffic accident or criminal assault, or

(bb) that offers an opinion as to whether a patient is fit to travel;

(i) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(j) where he is a contractor which is required by a Board under regulation 12 of the Pharmaceutical Regulations to provide drugs, medicines or appliances to a patient and provides for that patient, otherwise than under pharmaceutical services, any Scheduled drug;

(k) for prescribing or providing drugs or medicines for malaria chemoprophylaxis;

(l) when he treats a visiting patient under regulation 15(3) or (5), the contractor shall be entitled to demand and accept a fee as determined by the Department, if a receipt is provided to that patient and the contractor notifies the Board of the treatment provided;

(m) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SCHEDULE 5 — OTHER CONTRACTUAL TERMS

PART 1 — provision of services

Premises

1

Subject to any plan which is included in the contract pursuant to regulation 18(3), the contractor shall ensure that the premises used for the provision of services under the contract are –

(a) suitable for the delivery of those services; and

(b) sufficient to meet the reasonable needs of the contractor’s patients.

Attendance at practice premises

2

(1) The contractor shall take steps to ensure that any patient who –

(a) has not previously made an appointment; and

(b) attends at the practice premises during the normal hours for essential services,

is provided with such services by an appropriate health care professional during that surgery period except in the circumstances specified in sub-paragraph (2).

(2) The circumstances referred to in sub-paragraph (1) are that –

(a) it is more appropriate for the patient to be referred elsewhere for services under the Order; or

(b) the patient is then offered an appointment to attend again within a time which is appropriate and reasonable having regard to all the circumstances and the patient’s health would not thereby be jeopardised.

Attendance outside practice premises

3

(1) In the case of a patient whose medical condition is such that in the reasonable opinion of the contractor –

(a) attendance on the patient is required; and

(b) it would be inappropriate for the patient to attend at the practice premises,

the contractor shall provide services to that patient at whichever in his judgement is the most appropriate of the places set out in sub-paragraph (2).

(2) The places referred to in sub-paragraph (1) are –

(a) the place recorded in the patient’s medical records as being his last home address;

(b) such other place as the contractor has informed the patient and the Board is the place where he has agreed to visit and treat the patient; or

(3) Nothing in this paragraph prevents the contractor from –

(a) arranging for the referral of a patient without first seeing the patient, in a case where the medical condition of that patient makes that course of action appropriate; or

(b) visiting the patient in circumstances where this paragraph does not place him under an obligation to do so.

(4) Notwithstanding anything in this paragraph, the contractor shall not be required to attend on a patient ...outside Northern Ireland.

Newly registered patients

4

(1) Where a patient has been –

(a) accepted on a contractor’s list of patients under paragraph 15; or

(b) assigned to that list by the Board,

the contractor shall, in addition and without prejudice to his other obligations in respect of that patient under the contract, invite the patient to participate in a consultation either at his practice premises or, if the medical condition of the patient so warrants, at one of the places referred to in paragraph 3(2).

(2) An invitation under sub-paragraph (1) shall be issued within six months of the date of the acceptance of the patient on, or their assignment to, the contractor’s list.

(3) Where a patient (or, where appropriate, in the case of a patient who is a child, his parent) agrees to participate in a consultation mentioned in sub-paragraph (1) the contractor shall, in the course of that consultation make such inquiries and undertake such examinations as appear to him to be appropriate in all the circumstances.

Patients not seen within three years

5

Where a registered patient who –

(a) has attained the age of 16 years but has not attained the age of 75 years; and

(b) has attended neither a consultation with, nor a clinic provided by, the contractor within the period of 3 years prior to the date of his request;

requests a consultation the contractor shall, in addition and without prejudice to his other obligations in respect of that patient under the contract, provide such a consultation in the course of which it shall make such inquiries and undertake such examinations as appear to him to be appropriate in all the circumstances.

Patients aged 75 years and over

6

(1) Where a registered patient who –

(a) has attained the age of 75 years; and

(b) has not participated in a consultation under this paragraph within the period of twelve months prior to the date of his request,

requests a consultation, the contractor shall, in addition and without prejudice to his other obligations in respect of that patient under the contract, provide such a consultation in the course of which he shall make such inquiries and undertake such examinations as appear to him to be appropriate in all the circumstances.

(2) A consultation under sub-paragraph (1) shall take place in the home of the patient where, in the reasonable opinion of the contractor, it would be inappropriate, as a result of the patient’s medical condition, for him to attend at the practice premises.

Clinical reports

7

(1) Where the contractor provides any clinical services, other than under a private arrangement, to a patient who is not on his list of patients, he shall, as soon as reasonably practicable, provide a clinical report relating to the consultation, and any treatment provided, to the Board.

(2) The Board shall send any report received under sub-paragraph (1) –

(a) to the person with whom the patient is registered for the provision of essential services or their equivalent; or

(b) if the person referred to in head (a) is not known to it, to the Board in whose area the patient is resident.

(3) This paragraph does not apply in relation to out of hours services provided by a contractor on or after 1st May 2005.

Storage of vaccines

8

The contractor shall ensure that –

(a) all vaccines are stored in accordance with the manufacturer’s instructions,

(b) all refrigerators in which vaccines are stored have a maximum/minimum thermometer and that readings are taken on all working days.

Infection control

9

The contractor shall ensure that he has appropriate arrangements for infection control and decontamination.

Criteria for out of hours services

10

A contractor whose contract includes the provision of out of hours services shall only be required to provide such services if, in the reasonable opinion of the contractor in the light of the patient’s medical condition, it would not 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.

Standards for out of hours services

11

...a contractor which provides out of hours services must in the provision of such services meet any quality standards which have been approved by the Department and specified in writing by the Board in relation to the provision of those services.

Duty of co-operation in relation to additional, enhanced and out of hours services

12

(1) A contractor which does not provide to his registered patients or to persons whom he has accepted as temporary residents –

(a) a particular additional service;

(b) a particular enhanced service; or

shall comply with the requirements specified in sub-paragraph (2).

(2) The requirements referred to in sub-paragraph (1) are that the contractor shall –

(a) co-operate with any person responsible for the provision of that service;

(b) comply in core hours with any reasonable request for information from such a person or from the Board relating to the provision of that service or those services; and

(c) in the case of out of hours services, take reasonable steps to ensure that any patient who contacts the practice premises during the out of hours period is provided with information about how to obtain services during that period.

(3) Nothing in this paragraph shall require a contractor whose contract does not include the provision of out of hours services to make himself available during the out of hours period.

13

Where a contractor is to cease to be required to provide to his patients –

(a) a particular additional service;

(b) a particular enhanced service; or

he shall comply with any reasonable request for information relating to the provision of that service made by the Board or by any person with whom the Board intends to enter into a contract for the provision of such services.

PART 2 — patients

List of patients

14

The Board shall prepare and keep up to date a list of the patients –

(a) who have been accepted by the contractor for inclusion in his list of patients under paragraph 15 and who have not subsequently been removed from that list under paragraphs 19 to 27; and

(b) who have been assigned to the contractor under paragraph 32 or 33 and whose assignment has not subsequently been rescinded.

Application for inclusion in a list of patients

15

(1) The contractor may, if his list of patients is open, accept an application for inclusion in his list of patients made by or on behalf of any person whether or not resident in his practice area or included, at the time of that application, in the list of patients of another contractor or provider of primary medical services.

(2) The contractor may, if his list of patients is closed, only accept an application for inclusion in his list of patients from a person who is an immediate family member of a registered patient whether or not resident in his practice area or included, at the time of that application, in the list of patients of another contractor or provider of primary medical services.

(3) Subject to sub-paragraph (4), an application for inclusion in a contractor’s list of patients shall be made by delivering to the practice premises a medical card or an application signed (in either case) by the applicant or a person authorised by the applicant to sign on his behalf.

(4) An application may be made –

(a) on behalf of any child –

(i) by either parent, or in the absence of both parents, the guardian or other adult who has care of the child,

(ii) by a person duly authorised by an authority looking after a child under the provisions of the Children (Northern Ireland) Order 1995, or

(iii) by a person duly authorised by a voluntary organisation by which the child is being accommodated under the provisions of that Order; or

(b) on behalf of any adult who is incapable of making such an application, or authorising such an application to be made on their behalf, by a relative or the primary carer of that person.

(5) A contractor which accepts an application for inclusion in his list of patients shall notify the Board in writing as soon as possible.

(6) On receipt of a notice under sub-paragraph (5), the Board shall –

(a) include that person in the contractor’s list of patients from the date on which the notice is received; and

(b) notify the applicant (or, in the case of a child or incapable adult, the person making the application on their behalf) of the acceptance.

Temporary residents

16

(1) The contractor may, if his list of patients is open, accept a person who is ordinarily resident in Northern Ireland as a temporary resident provided he is satisfied that the person is –

(a) temporarily resident away from his normal place of residence and is not being provided with essential services (or their equivalent) under any other arrangement in the place where he is temporarily residing; or

(b) moving from place to place and not for the time being resident in any place.

(2) For the purposes of sub-paragraph (1), a person shall be regarded as temporarily resident in a place if, when he arrives in that place, he intends to stay there for more than 24 hours but not more than three months.

(3) A contractor which wishes to terminate his responsibility for a person accepted as a temporary resident before the end of –

(a) three months; or

(b) such shorter period for which he agreed to accept him as a patient,

shall notify him either orally or in writing and his responsibility for that patient shall cease 7 days after the date on which the notification was given.

(4) At the end of three months, or on such earlier date as his responsibility for the temporary resident has come to an end, the contractor shall notify the Board in writing of any person whom he accepted as a temporary resident.

Refusal of applications for inclusion in the list of patients or for acceptance as a temporary resident

17

(1) The contractor shall only refuse an application made under paragraph 15 , 15A, 15B or 16 if he has reasonable grounds for doing so which do not relate to the applicant’s race, gender, social class, marital status, age, religion, political opinion, sexual orientation, appearance, disability, medical condition or whether or not the applicant has dependants.

(2) The reasonable grounds referred to in paragraph (1) may, in the case of an application made under paragraph 15 or 15B , include the grounds that the applicant—

(a) does not live in the contractor’s practice area; or

(b) lives in the outer boundary area (the area referred to in paragraph 18(1A)).

(3) A contractor which refuses an application made under paragraph 15 , 15A, 15B or 16 shall, within 14 days of his decision, notify the applicant (or, in the case of a child or incapable adult, the person making the application on their behalf) in writing of the refusal and the reason for it.

(4) The contractor shall keep a written record of refusals of applications made under paragraph 15 , 15A and 15B and of the reasons for them and shall make this record available to the Board on request.

Patient preference of practitioner

18

(1) Where the contractor has accepted an application for inclusion in his list of patients, he shall –

(a) notify the patient (or, in the case of a child or incapable adult, the person who made the application on their behalf) of the patient’s right to express a preference to receive services from a particular performer or class of performer either generally or in relation to any particular condition; and

(b) record in writing any such preference expressed by or on behalf of the patient.

(2) The contractor shall endeavour to comply with any reasonable preference expressed under sub-paragraph (1) but need not do so if the preferred performer –

(a) has reasonable grounds for refusing to provide services to the patient; or

(b) does not routinely perform the service in question within the practice.

Removal from the list at the request of the patient

19

(1) The contractor shall notify the Board in writing of any request for removal from his list of patients received from a registered patient.

(2) Where the Board –

(a) receives notification from the contractor under sub-paragraph (1); or

(b) receives a request from the patient to be removed from the contractor’s list of patients,

it shall remove that person from the contractor’s list of patients.

(3) A removal in accordance with sub-paragraph (2) shall take effect –

(a) on the date on which the Board receives notification of the registration of the person with another provider of essential services (or their equivalent); or

(b) 14 days after the date on which the notification or request made under sub-paragraph (1) or (2) respectively is received by the Board,

whichever is the sooner.

(4) The Board shall, as soon as practicable, notify in writing –

(a) the patient; and

(b) the contractor,

that the patient’s name will be or has been removed from the contractor’s list of patients on the date referred to in sub-paragraph (3).

(5) In this paragraph and in paragraphs 20(1)(b) and (10), 21(6) and (7), 23 and 26, a reference to a request received from or advice, information or notification required to be given to a patient shall include a request received from or advice, information or notification required to be given to –

(a) in the case of a patient who is a child, a parent or other person referred to in paragraph 15(4)(a); or

(b) in the case of an adult patient who is incapable of making the relevant request or receiving the relevant advice, information or notification, a relative or the primary carer of the patient.

Removal from the list at the request of the patient

20

(1) Subject to paragraph 21, a contractor which has reasonable grounds for wishing a patient to be removed from his list of patients which do not relate to the patient’s race, gender, social class, marital status, age, religion, political opinion, sexual orientation, appearance, disability, medical condition, or whether or not the patient has dependants shall –

(a) notify the Board in writing that he wishes to have the patient removed; and

(b) subject to sub-paragraph (2), notify the patient of his specific reasons for requesting removal.

(2) Where in the reasonable opinion of the contractor –

(a) the circumstances of the removal are such that it is not appropriate for a more specific reason to be given; and

(b) there has been an irrevocable breakdown in the relationship between the patient and the contractor,

the reason given under sub-paragraph (1) may consist of a statement that there has been such a breakdown.

(3) Except in the circumstances specified in sub-paragraph (4), a contractor may only request a removal under sub-paragraph (1), if, within the period of 12 months prior to the date of his request to the Board, he has warned the patient that he is at risk of removal and explained to him the reasons for this.

(4) The circumstances referred to in sub-paragraph (3) are that –

(a) the reason for removal relates to a change of address;

(b) the contractor has reasonable grounds for believing that the issue of such a warning would –

(i) be harmful to the physical or mental health of the patient, or

(ii) put at risk the safety of one or more of the persons specified in sub-paragraph (5); or

(5) The persons referred to in sub-paragraph (4) are –

(a) the contractor, where he is an individual medical practitioner;

(b) in the case of a contract with two or more individuals practising in partnership, a partner in that partnership;

(d) a member of the contractor’s staff;

(e) a person engaged by the contractor to perform or assist in the performance of services under the contract; or

(f) any other person present –

(i) on the practice premises, or

(ii) in the place where services are being provided to the patient under the contract.

(6) The contractor shall record in writing –

(a) the date of any warning given in accordance with sub-paragraph (3) and the reasons for giving such a warning as explained to the patient; or

(b) the reason why no such warning was given.

(7) The contractor shall keep a written record of removals under this paragraph which shall include –

(a) the reason for removal given to the patient;

(b) the circumstances of the removal; and

and shall make this record available to the Board on request.

(8) A removal requested in accordance with sub-paragraph (1) shall, subject to sub-paragraph (9), take effect from –

(a) the date on which the Board receives notification of the registration of the person with another provider of essential services (or their equivalent); or

(b) the eighth day after the Board receives the notice referred to in sub-paragraph (1)(a),

whichever is the sooner.

(9) Where, on the date on which the removal would take effect under sub-paragraph (8), the contractor is treating the patient at intervals of less than seven days, the contractor shall notify the Board in writing of the fact and the removal shall take effect –

(a) on the eighth day after the Board receives notification from the contractor that the person no longer needs such treatment; or

(b) on the date on which the Board receives notification of the registration of the person with another provider of essential services (or their equivalent),

whichever is the sooner.

(10) The Board shall notify in writing –

(a) the patient; and

(b) the contractor,

that the patient’s name has been or will be removed from the contractor’s list of patients on the date referred to in sub-paragraph (8) or (9).

Removals from the list of patients who are violent

21

(1) A contractor which wishes a patient to be removed from his list of patients with immediate effect on the grounds that –

(a) the patient has committed an act of violence against any of the persons specified in sub-paragraph (2) or behaved in such a way that any such person has feared for his safety; and

(b) he has reported the incident to the police,

shall notify the Board in accordance with sub-paragraph (3).

(2) The persons referred to in sub-paragraph (1) are –

(a) the contractor where he is a medical practitioner;

(b) in the case of a contract with two or more individuals practising in partnership, any partner in that partnership;

(d) a member of the contractor’s staff;

(e) a person engaged by the contractor to perform or assist in the performance of services under the contract; or

(f) any other person present –

(i) on the practice premises, or

(ii) in the place where services were provided to the patient under contract.

(3) Notification under sub-paragraph (1) may be given by any means including telephone or fax but if not given in writing shall subsequently be confirmed in writing within seven days (and for this purpose a faxed notification is not a written one).

(4) The Board shall acknowledge in writing receipt of a request from the contractor under sub-paragraph (1).

(5) A removal requested in accordance with sub-paragraph (1) shall take effect at the time that the contractor –

(a) makes the telephone call to the Board; or

(b) sends or delivers the notification to the Board.

(6) Where, pursuant to this paragraph, ... he has notified the Board that he wishes to have a patient removed from his list of patients, it shall inform the patient concerned unless –

(a) it is not reasonably practicable for ... him to do so; or

(b) ... he has reasonable grounds for believing that to do so would –

(i) be harmful to the physical or mental health of the patient; or

(ii) put at risk the safety of one or more of the persons specified in sub-paragraph (2).

(7) Where the Board has removed a patient from the contractor’s list of patients in accordance with sub-paragraph (5), it shall give written notice of the removal to that patient.

(8) Where a patient is removed from the contractor’s list of patients in accordance with this paragraph, the contractor shall record in the patient’s medical records that the patient has been removed under this paragraph and the circumstances leading to his removal.

Removals from the list of patients registered elsewhere

22

(1) The Board shall remove a patient from the contractor’s list of patients if –

(a) the patient has subsequently been registered with another provider of essential services (or their equivalent) in the area of the Board; or

(b) it has received notice from another Board, NHS England , a Local Health Board or a Health Board that the patient has subsequently been registered with a provider of essential services (or their equivalent) outside the area of the Board.

(2) A removal in accordance with sub-paragraph (1) shall take effect –

(a) on the date on which the Board receives notification of the registration of the person with the new provider; or

(b) with the consent of the Board, on such other date as has been agreed between the contractor and the new provider.

(3) The Board shall notify the contractor in writing of persons removed from his list of patients under sub-paragraph (1).

Removals from the list of patients who have moved

23

(1) Subject to sub-paragraph (2), where the Board is satisfied that a person on the contractor’s list of patients has moved and no longer resides in that contractor’s practice area, the Board shall –

(a) inform that patient and the contractor that the contractor is no longer obliged to visit and treat the person;

(b) advise the patient in writing either to obtain the contractor’s agreement to the continued inclusion of the person on his list of patients or to apply for registration with another provider of essential services (or their equivalent); and

(c) inform the patient that if, after the expiration of 30 days from and including the date of the advice mentioned in paragraph (b), he has not acted in accordance with the advice and informed it accordingly, the Board will remove him from the contractor’s list of patients.

(2) If, at the expiration of the period of 30 days referred to in sub-paragraph (1)(c), the Board has not been notified of the action taken, it shall remove the patient from the contractor’s list of patients and inform him and the contractor accordingly.

24

Where the address of a patient who is on the contractor’s list of patients is no longer known to the Board, the Board shall –

(a) give to the contractor notice in writing that it intends, at the end of the period of six months commencing with the date of the notice, to remove the patient from the contractor’s list of patients; and

(b) at the end of that period, remove the patient from the contractor’s list of patients unless, within that period, the contractor satisfies the Board that he is still responsible for providing essential services to that patient.

Removals from the list of patients absent from the United Kingdom etc.

25

(1) The Board shall remove a patient from the contractor’s list of patients where it receives notification that that patient –

(a) intends to be away from the United Kingdom for a period of at least three months;

(b) is in Her Majesty’s Forces;

(d) has been absent from the United Kingdom for a period of more than three months; or

(e) has died.

(2) A removal in accordance with sub-paragraph (1) shall take effect –

(a) in the cases referred to in sub-paragraph (1)(a) to (c) from the date of the departure, enlistment or imprisonment or the date on which the Board first receives notification of the departure, enlistment or imprisonment whichever is the later; or

(b) in the cases referred to in sub-paragraph (1)(d) and (e) from the date on which the Board first receives notification of the absence or death.

(3) The Board shall notify the contractor in writing of patients removed from his list of patients under sub-paragraph (1).

Removals from the list of patients accepted elsewhere as temporary residents

26

(1) The Board shall remove from the contractor’s list of patients a patient who has been accepted as a temporary resident by another contractor or other provider of essential services (or their equivalent) where it is satisfied, after due inquiry –

(a) that the patient’s stay in the place of temporary residence has exceeded three months; and

(b) that he has not returned to his normal place of residence or any other place within the contractor’s practice area.

(2) The Board shall notify in writing of a removal under sub-paragraph (1) –

(a) the contractor; and

(b) where practicable, the patient.

(3) A notification to the patient under sub-paragraph (2)(b) shall inform him of –

(a) his entitlement to make arrangements for the provision to him of essential services (or their equivalent), including by the contractor by which he has been treated as a temporary resident; and

(b) the name and address of the Board in whose area he is resident.

Removals from the list of pupils etc. of a school

27

(1) Where the contractor provides essential services under the contract to persons on the grounds that they are pupils at or staff or residents of a school, the Board shall remove from the contractor’s list of patients any such persons who do not appear on particulars of persons who are pupils at or staff or residents of that school provided by that school.

(2) Where the Board has made a request to a school to provide the particulars mentioned in sub-paragraph (1) and has not received them, it shall consult the contractor as to whether it should remove from his list of patients any persons appearing on that list as pupils at, or staff or residents of, that school.

(3) The Board shall notify the contractor in writing of patients removed from his list of patients under sub-paragraph (1).

Termination of responsibility for patients not registered with the contractor

28

(1) Where a contractor –

(a) has received an application for the provision of medical services other than essential services –

(i) from a person who is not included in his list of patients,

(ii) from a person whom he has not accepted as a temporary resident, or

(iii) on behalf of a person mentioned in head (a)(i) or (ii), from one of the persons specified in paragraph 15(4); and

(b) has accepted that person as a patient for the provision of the service in question,

his responsibility for that patient shall be terminated in the circumstances referred to in sub-paragraph (2).

(2) The circumstances referred to in sub-paragraph (1) are –

(a) the patient informs the contractor that he no longer wishes him to be responsible for provision of the service in question;

(b) in cases where the contractor has reasonable grounds for terminating his responsibility which do not relate to the person’s race, gender, social class, marital status, age, religion, political opinion, sexual orientation, appearance, disability, medical condition or whether or not the patient has dependants, the contractor informs the patient that he no longer wishes to be responsible for providing him with the service in question; or

(i) no longer resides in the area for which the contractor has agreed to provide the service in question; or

(ii) is no longer included in the list of patients of an other contractor to whose registered patients the contractor has agreed to provide that service.

(3) A contractor which wishes to terminate his responsibility for a patient under sub-paragraph (2)(b) shall notify the patient of the termination and the reason for it.

(4) The contractor shall keep a written record of terminations under this paragraph and of the reasons for them and shall make this record available to the Board on request.

(5) A termination under sub-paragraph (2)(b) shall take effect –

(a) from the date on which the notice is given where the grounds for termination are those specified in paragraph 21(1); or

(b) in all other cases, 14 days from the date on which the notice is given.

Closure of lists of patients

29

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Approval of closure notice by the Board

30

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rejection of closure notice by the Board

31

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Assignment of patients to lists: open lists

32

(1) A Board may, subject to paragraph 34, assign a new patient to a contractor whose list of patients is open.

(2) In this paragraph and in paragraphs 33 and 35 to 37, a “new” patient means a person who –

(a) is resident (whether or not temporarily) within the area of the Board;

(b) has been refused inclusion in a list of patients of, or has not been accepted as a temporary resident by, a contractor whose premises are within such an area; and

Assignment of patients to lists: closed lists

33

(1) A Board may not assign a new patient to a contractor which has closed his list of patients except in the circumstances specified in sub-paragraph (2).

(2) A Board may, subject to paragraph 34, assign a new patient to a contractor whose practice premises are within the Board’s area and which has closed his list of patients, if –

(a) most or all of the providers of essential services (or their equivalent) whose practice premises are within the Board’s area have closed their lists of patients;

(b) the assessment panel has determined under paragraph 35(7) that patients may be assigned to the contractor in question, and that determination has not been overturned either by a determination of the Department under paragraph 36(13) or (where applicable) by a court; and

(c) the Board has entered into discussions with the contractor in question regarding the assignment of a patient if such discussions are required under paragraph 37.

Factors relevant to assignments

34

In making an assignment to a contractor under paragraph 32 or 33, the Board shall have regard to –

(a) the wishes and circumstances of the patient to be assigned;

(b) the distance between the patient’s place of residence and the contractor’s practice premises;

(c) whether, during the six months ending on the date on which the application for assignment is received by the Board, the patient’s name has been removed from the list of patients of any contractor in the area of the Board under paragraph 20 or its equivalent provision in relation to an Article 15B provider in the area of the Board;

(d) whether the patient’s name has been removed from the list of patients of any contractor in the area of the Board under paragraph 21 or its equivalent provision in relation to an Article 15B provider in the area of the Board and, if so, whether the contractor has appropriate facilities to deal with such a patient;

(e) such other matters as the Board considers to be relevant.

Assignments to closed lists: determinations of the assessment panel

35

(1) This paragraph applies where most or all of the providers of essential services whose practice premises are within a Local Medical Committee area have closed their lists of patients.

(2) If the Board wishes to assign new patients to contractors which have closed their lists of patients, it must prepare a proposal to be considered by the assessment panel which must include details of those contractors to which the Board wishes to assign patients.

(3) The Board must ensure that the assessment panel is appointed to consider and determine its proposal made under sub-paragraph (2), and the composition of the assessment panel shall be as described in sub-paragraph (3A).

(3A) The members of the assessment panel must be—

(a) The Chief Executive of the Board;

(b) a person representative of patients in an area other than that of the contractor which is party to the contract;

(c) a person representative of a Local Medical Committee which does not represent practitioners in the Local Medical Committee area of the contractor which is a party to the contract”.

Assignments to closed lists: dispute resolution procedure relating to determinations of the assessment panel

36

(1) Where an assessment panel makes a determination under paragraph 35(7) that the Department may assign new patients to contractors which have closed their lists of patients, any contractor specified in that determination may refer the matter to the Family Practitioner Services Independent Appeal Panel to review the determination of the assessment panel.

(2) Where a matter is referred to the Family Practitioner Services Independent Appeal Panel in accordance with sub-paragraph (1), it shall be reviewed in accordance with the procedure specified in the following sub-paragraphs.

(3) Where more than one contractor specified in the determination in accordance with paragraph 35(7) wishes to refer the matter for dispute resolution, those contractors may, if they all agree, refer the matter jointly, and in that case the Family Practitioner Services Independent Appeal Panel shall review the matter in relation to those contractors together.

(4) Within the period of 7 days beginning with and including the date of the determination by the assessment panel in accordance with paragraph 35(7), the contractor shall send to the Family Practitioner Services Independent Appeal Panel a written request for dispute resolution which shall include or be accompanied by –

(a) the names and addresses of the parties to the dispute;

(b) a copy of the contract (or contracts); and

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