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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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Reform history JSON API

Independent nurse prescribers and supplementary prescribers

60

(1) Where –

(a) a contractor employs or engages a person who is an independent prescriber or a supplementary prescriber whose functions will include prescribing;

(b) a party to the contract is an independent prescriber or a supplementary prescriber whose functions will include prescribing; or

(c) the functions of a person who is an independent nurse prescriber or a supplementary prescriber whom the contractor already employs or has already engaged are extended to include prescribing,

it shall notify the Board in writing within the period of 7 days beginning with and including the date on which the contractor employed or engaged the person, the party became a party to the contract (unless, immediately before becoming such a party, he fell under paragraph (1)(a)) or the person’s functions were extended, as the case may be.

(2) Where –

(a) the contractor ceases to employ or engage a person who is an independent nurse prescriber or a supplementary prescriber whose functions included prescribing in his practice;

(b) the party to the contract who is an independent nurse prescriber or a supplementary prescriber whose functions include prescribing, ceases to be a party to the contract;

(c) the functions of a person who is an independent nurse prescriber or a supplementary prescriber whom the contractor employs or engages in his practice are changed so that they no longer include prescribing in his practice; or

(d) the contractor becomes aware that a person who is an independent nurse prescriber or a supplementary prescriber whom the contactor employs or engages has been removed or suspended from the relevant register,

he shall notify the Board in writing by the end of the second working day after the day when the event occurred.

(3) The contractor shall provide the following information when he notifies the Board in accordance with sub-paragraph (1) –

(a) the person’s full name;

(b) his professional qualifications;

(d) the date on which his entry in the relevant register was annotated to the effect that he was qualified to order drugs, medicines and appliances for patients;

(e) the date on which –

(i) he was employed or engaged, if applicable,

(ii) he became a party to the agreement, if applicable, or

(iii) one of his functions became to prescribe in his practice.

(4) The contractor shall provide the following information when he notifies the Board in accordance with sub-paragraph (2) –

(a) the person’s full name;

(b) his professional qualifications;

(d) the date –

(i) he ceased to be employed or engaged in his practice,

(ii) he ceased to be a party to the agreement,

(iii) his functions changed so as no longer to include prescribing, or

(iv) on which he was removed or suspended from the relevant register.

Signing of documents

61

(1) In addition to any other requirements relating to such documents whether in these regulations or otherwise, the contractor shall ensure that the documents specified in paragraph (2) include –

(a) the clinical profession of the health care professional who signed the document; and

(b) the name of the contractor on whose behalf it is signed.

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

(a) certificates issued in accordance with regulation 21, unless regulations relating to particular certificates provide otherwise;

(b) prescription forms and repeatable prescriptions ;

Level of skill

62

The contractor shall carry out his obligations under the contract with reasonable care and skill.

Appraisal and assessment

63

(1) The contractor shall ensure that any medical practitioner performing services under the contract –

(a) participates in the appraisal system provided by the Board, unless he participates in an appropriate appraisal system provided by another heath services body or is an armed forces GP; and

(b) co-operates with any assessment by or on behalf of the Board of services performed by that practitioner under the contract.

(2) In sub-paragraph (1), “armed forces GP” means a medical practitioner who is employed on a contract of service by the Ministry of Defence, whether or not as a member of the United Kingdom Armed Forces of Her Majesty.

Sub-contracting of clinical matters

64

(1) Subject to sub-paragraph (2), the contractor shall not sub-contract any of his rights or duties under the contract in relation to clinical matters unless –

(a) in all cases, including those which fall within paragraph 65,he has taken reasonable steps to satisfy himself that –

(i) it is reasonable in all the circumstances; and

(ii) that person is qualified and competent to provide the service; and

(b) except in cases which fall within paragraph 65, he has notified the Board in writing of his intention to sub-contract as soon as reasonably practicable before the date on which the proposed sub-contract is intended to come into operation.

(2) Sub-paragraph (1)(b) shall not apply to a contract for services with a health care professional for the provision by that professional personally of clinical services.

(3) The notification referred to in sub-paragraph (1)(b) shall include –

(a) the name and address of the proposed sub-contractor;

(b) the duration of the proposed sub-contract;

(d) the address of any premises to be used for the provision of services.

(4) Following receipt of a notice in accordance with sub-paragraph (1)(b), the Board may request such further information relating to the proposed sub-contract as appears to it to be reasonable and the contractor shall supply such information promptly.

(5) The contractor shall not proceed with the sub-contract or, if it has already taken effect, shall take appropriate steps to terminate it, where, within 28 days of receipt of the notice referred to in sub-paragraph (1)(b), the Board has served notice of objection to the sub-contract on the grounds that –

(a) the sub-contract would –

(i) put at serious risk the safety of the contractor’s patients, or

(ii) put the Board at risk of material financial loss; or

(b) the sub-contractor would be unable to meet the contractor’s obligations under the contract.

(6) Where the Board objects to a proposed sub-contract in accordance with sub-paragraph (5), it shall include with the notice of objection a statement in writing of the reasons for its objection.

(7) Sub-paragraphs (1) and (3) to (6) shall also apply in relation to any renewal or material variation of a sub-contract in relation to clinical matters.

(8) Where a Board does not object to a proposed sub-contract under paragraph (5), the parties to the contract shall be deemed to have agreed a variation of the contract which has the effect of adding to the list of practice premises any premises whose address was notified to it under sub-paragraph (3)(d) and paragraph 96(1) shall not apply.

(9) A contract with a sub-contractor must prohibit the sub-contractor from sub-contracting the clinical services he has agreed with the contractor to provide.

(10) The contractor shall not sub-contract any of his rights or duties under the contract in relation to the provision of essential services to a company or firm –

(a) owned wholly or partly by the contractor, or by any former or current employee of, or partner or shareholder in, the contractor;

(b) formed by or on behalf of the contractor, or from which he derives or may derive a pecuniary benefit; or

(c) formed by or on behalf of a former or current employee of, or partner or shareholder in, the contractor, or from which such a person derives or may derive a pecuniary benefit,

where that company or firm is or was formed wholly or partly for the purpose of avoiding restrictions on the sale of goodwill of a medical practice in Article 60 of and Schedule 10 to the 1972 Order or any Regulations made wholly or partly under those provisions.

Sub-contracting of out of hours services

65

(1) A contractor shall not, otherwise than in accordance with the written approval of the Board, sub-contract all or part of his duty to provide out of hours services to any person other than those listed in sub-paragraph (2) other than on a short-term occasional basis.

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

(a) a person who holds a contract with a Board which includes out of hours services;

(b) an Article 15B provider who is required to provide the equivalent of essential services to his patients during all or part of the out of hours period;

(c) a health care professional, not falling within paragraph (a) or (b), who is to provide the out of hours services personally under a contract for services; or

(d) a group of medical practitioners, whether in partnership or not, who provide out of hours services for each other under informal rota arrangements.

(3) An application for approval under sub-paragraph (1) shall be made by the contractor in writing to the Board and shall state –

(a) the name and address of the proposed sub-contractor;

(b) the address of any premises to be used for the provision of services;

(d) the services to be covered by the arrangement; and

(e) how it is proposed that the sub-contractor will meet the contractor’s obligations under the contract in respect of the services covered by the arrangement.

(4) Within 7 days of receipt of an application under sub-paragraph (3), a Board may request such further information relating to the proposed arrangements as seem to it to be reasonable.

(5) Within 28 days of receipt of an application which meets the requirements specified in sub-paragraph (3) or the further information requested under sub-paragraph (4) (whichever is the later), the Board shall –

(a) approve the application;

(b) approve the application with conditions; or

(6) The Board shall not refuse the application if it is satisfied that the proposed arrangement will, in respect of the services to be covered, enable the contractor to meet satisfactorily his obligations under the contract and will not –

(a) put at serious risk the safety of the contractor’s patients; or

(b) put the Board at risk of material financial loss.

(7) The Board shall inform the contractor by notice in writing of its decision on the application and, where it refuses an application, it shall include in the notice a statement of the reasons for its refusal.

(8) Where a Board approves an application under this paragraph the parties to the contract shall be deemed to have agreed a variation of the contract which has the effect of adding to the list of practice premises, for the purposes of the provision of services in accordance with that application, any premises whose address was notified to it under sub-paragraph (3)(b) and paragraph 96(1) shall not apply.

(9) Sub-paragraphs (1) to (8) shall also apply in relation to any renewal or material variation of a sub-contract in relation to out of hours services.

(10) A contract with a sub-contractor must prohibit the sub-contractor from sub-contracting the out of hours services it has agreed with the contractor to provide.

Withdrawal and variation of approval under paragraph 65

66

(1) Without prejudice to any other remedies which it may have under the contract, where a Board has approved an application made under paragraph 65(3) it shall, subject to paragraph 67, be entitled to serve notice on the contractor withdrawing or varying that approval, from a date specified in the notice, if it is no longer satisfied that the proposed arrangement will enable the contractor to meet satisfactorily his obligations under the contract.

(2) A notice served under sub-paragraph (1) shall take effect on the date on which it is received by the contractor.

(3) The notice referred to in sub-paragraph (1) shall take effect on whichever is the later of –

(a) the date specified in the notice; or

(b) (if applicable) the date of the final determination of the dispute resolution procedure (or any court proceedings) relating to the notice in favour of the Board.

67

(1) Without prejudice to any other remedies which it may have under the contract, where a Board has approved an application made under paragraph 65(3) it shall be entitled to serve notice on the contractor withdrawing or varying that approval with immediate effect if –

(a) it is no longer satisfied that the proposed arrangement will enable the contractor to meet satisfactorily his obligations under the contract; and

(b) it is satisfied that immediate withdrawal or variation is necessary to protect the safety of the contractor’s patients.

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

PART 5 — records, information, notifications and rights of entry

Patient records

68

(1) In this paragraph, “computerised records” means records created by way of entries on a computer.

(2) The contractor shall keep adequate records of his attendance on and treatment of his patients and shall do so –

(a) on forms supplied to him for the purpose by the Board; or

(b) with the written consent of the Board, by way of computerised records,

or in a combination of those two ways.

(3) The contractor shall include in the records referred to in sub-paragraph (2) clinical reports sent in accordance with paragraph 7 or from any other health care professional who has provided clinical services to a person on his list of patients.

(4) The consent of the Board required by sub-paragraph (2)(b) shall not be withheld or withdrawn provided the Board is satisfied, and continues to be satisfied, that –

(a) the computer system upon which the contractor proposes to keep the records has been accredited by the Department or another person on its behalf in accordance with General Practice Systems of Choice Level 0 and the Northern Ireland Minimum Systems Specification Version 2.

(b) the security measures, audit and system management functions incorporated into the computer system as accredited in accordance with head (a) have been enabled; and

(i) any guidelines issued by the Department and notified in writing to the contractor by the Board; and

(ii) any document amending any guidelines referred to in (i), which has been notified to the contractor by the Board,

concerning good practice in the keeping of electronic patient records.

(5) Where a patient’s records are computerised records, the contractor shall, as soon as possible following a request from the Board, allow the Board to access the information recorded on the computer system on which those records are held by means of the audit function referred to in sub-paragraph (4)(b) to the extent necessary for the Board to confirm that the audit function is enabled and functioning correctly.

(6) The contractor shall send the complete records relating to a patient to the Board –

(a) where a person on his list dies, before the end of the period of 14 days beginning with and including the date on which he was informed by the Board of the death, or (in any other case) before the end of the period of one month beginning with and including the date on which it learned of the death; or

(b) in any other case where the person is no longer registered with the contractor, as soon as possible at the request of the Board.

(7) To the extent that a patient’s records are computerised records, the contractor complies with sub-paragraph (6) if he sends to the Board a copy of those records –

(a) in written form; or

(b) with the written consent of the Board in any other form.

(8) The consent of the Board to the transmission of information other than in written form for the purposes of sub-paragraph (7)(b) shall not be withheld or withdrawn provided it is satisfied, and continues to be satisfied, with the following matters –

(a) the contractor’s proposals as to how the record will be transmitted;

(b) the contractor’s proposals as to the format of the transmitted record;

(d) how a written copy of the record can be produced by the Board.

(9) A contractor whose patient records are computerised records shall not disable, or attempt to disable, either the security measures, or the audit and system management functions referred to in sub-paragraph (4)(b).

Access to records for the purpose of the Quality Information Preparation Scheme

69

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

Confidentiality of personal data

70

The contractor shall nominate a person with responsibility for practices and procedures relating to the confidentiality of personal data held by him.

Practice leaflet

71

The contractor shall –

(a) compile a document (in this paragraph called a practice leaflet) which shall include the information specified in Schedule 8 ;

(b) review his practice leaflet at least once in every period of 12 months and make any amendments necessary to maintain its accuracy; and

Provision of information

72

(1) Subject to sub-paragraph (2), the contractor shall, at the request of the Board produce to the Board or to a person authorised in writing by the Board or allow it, or a person authorised in writing by it, to access –

(a) any information which is reasonably required by the Board for the purposes of or in connection with the contract; and

(b) any other information which is reasonably required in connection with the Board’s functions.

(2) The contractor shall not be required to comply with any request made in accordance with sub-paragraph (1) unless it has been made by the Board in accordance with directions relating to the provision of information by contractors given to it by the Department under Article 17 of the Order.

(3) The contractor shall produce the information requested, or, as the case may be, allow access to it –

(a) by such date as has been agreed as reasonable between the contractor and the Board; or

(b) in the absence of such agreement, within 28 days of the request being made.

Inquiries about prescriptions and referrals

73

(1) The contractor shall, subject to sub-paragraphs (2) and (3), sufficiently answer any inquiries whether oral or in writing from the Board concerning –

(a) any prescription form or repeatable prescription issued by a prescriber;

(b) the considerations by reference to which prescribers issue such forms;

(d) the considerations by which the contractor makes such referrals or provides for them to be made on his behalf.

(2) An inquiry referred to in sub-paragraph (1) may only be made for the purpose either of obtaining information to assist the Board to discharge its functions or of assisting the contractor in the discharge of his obligations under the contract.

(3) The contractor shall not be obliged to answer any inquiry referred to in sub-paragraph (1) unless it is made –

(a) in the case of sub-paragraph (1)(a) or (b), by an appropriately qualified health care professional; or

(b) in the case of sub-paragraph (1)(c) or (d), by an appropriately qualified medical practitioner,

appointed in either case by the Board to assist it in the exercise of its functions under this paragraph and that person produces, on request, written evidence that he is authorised by the Board to make such an inquiry on its behalf.

Reports to a medical officer

74

(1) The contractor must, if satisfied that the patient consents—

(a) supply in writing to any person specified in sub-paragraph (3), within such reasonable period as that person may specify, such clinical information as any of the persons mentioned in sub-paragraph (3)(a) to (d) considers relevant about a patient to whom the contractor or a person acting on behalf of the contractor has issued or has refused to issue a medical certificate; and

(b) answer any inquiries by any person mentioned in sub-paragraph (3) about—

(i) a prescription form or medical certificate issued or created by, or on behalf of, the contractor, or

(ii) any statement which the contractor or a person acting on behalf of the contractor has made in a report.

(2) For the purposes of being satisfied that a patient consents, a contractor may rely on an assurance in writing from any person mentioned in sub-paragraph (3) that the consent of the patient has been obtained, unless the contractor has reason to believe that the patient does not consent.

(3) For the purposes of sub-paragraphs (1) and (2), the persons are—

(a) a medical officer;

(b) a nursing officer;

(d) a physiotherapist; or

(e) an officer of the Department for Social Development who is acting on behalf of, and at the direction of, any person specified in paragraphs (a) to (d).

(4) In this paragraph—

“medical officer” means a medical practitioner who is—employed or engaged by the Department for Social Development, orprovided by an organisation under a contract entered into with the Department for Social Development;

“nursing officer” means a health care professional who is registered on the Nursing and Midwifery Register and—employed or engaged by the Department for Social Development, orprovided by an organisation under a contract entered into with the Department for Social Development;

“occupational therapist” means a health care professional who is registered in the part of the register maintained by the Health Professions Council under article 5 of the Health Professions Order 2001 relating to occupational therapists and—employed or engaged by the Department for Social Development, orprovided by an organisation under a contract entered into with the Department of Social Development; and

“physiotherapist” means a health care professional who is registered in the part of the register maintained by the Health Professions Council under article 5 of the Health Professions Order 2001 relating to physiotherapists and—employed by the Department for Social Development, orprovided by an organisation under a contract entered into with the Department for Social Development”.

Annual return and review

75

(1) The contractor shall submit an annual return relating to the contract to the Board which shall require the same categories of information from all persons who hold contracts with that Board.

(1A) Subject to Article 50 (annual returns and reviews) of the General Medical Services Transitional and Consequential Provisions (No. 2) (Northern Ireland) Order 2004, one such return may be requested by the Board at any time during each financial year in relation to such period (not including any period covered by a previous annual return) as may be specified in the request.

(1B) The contractor shall submit the completed return to the Board –

(a) by such date as has been agreed as reasonable between the contractor and the Board; or

(b) in the absence of such agreement, within 28 days of the request being made;

(2) Following receipt of the return referred to in sub-paragraph (1), the Board shall arrange with the contractor an annual review of his performance in relation to the contract.

(3) Either the contractor or the Board may, if they wishe to do so invite the Local Medical Committee participate in the annual review.

(4) The Board shall prepare a draft record of the review referred to in sub-paragraph (2) for comment by the contractor and, having regard to such comments, shall produce a final written record of the review.

(5) A copy of the final record referred to in sub-paragraph (4) shall be sent to the contractor.

Notifications to the Board

76

In addition to any requirements of notification elsewhere in the regulations, the contractor shall notify the Board in writing, as soon as reasonably practicable, of –

(a) any serious incident that, in the reasonable opinion of the contractor, affects or is likely to affect the contractor’s performance of his obligations under the contract;

(b) any circumstances which give rise to the Board’s right to terminate the contract under paragraph 103, 104 or 105(1);

(d) any change of which he is aware in the address of a registered patient;

(e) the death of any patient of which he is aware.

77

The contractor shall, unless it is impracticable for him to do so, notify the Board in writing within 28 days of any occurrence requiring a change in the information about him published by the Board in accordance with regulations made under Article 56(3) of the Order[^f00085].

78

(1) The contractor shall notify the Board in writing of any person other than a registered patient or a person whom the contractor has accepted as a temporary resident to whom he has provided the essential services described in regulation 15(6) or 98) within the period of 28 days beginning on the day that services were provided.

(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Notice provisions specific to a contract with a company limited by shares

79

(1) A contractor which is a company limited by shares shall give notice in writing to the Board forthwith when –

(a) any share in the contractor is transmitted or transferred (whether legally or beneficially) to another person on a date after the contract has been entered into;

(aa) a new director or secretary is appointed;

(b) it passes a resolution or the High Court makes an order that the contractor be wound up;

(c) circumstances arise which might entitle a creditor or the High Court to appoint a receiver, administrator or administrative receiver for the contractor;

(d) circumstances arise which would enable the High Court to make a winding up order in respect of the contractor; or

(e) the contractor is unable to pay his debts within the meaning of Article 103 of the Insolvency (Northern Ireland) Order 1989[^f00086].

(2) A notice under sub-paragraph (1)(a) shall confirm that the new shareholder, or, as the case may be, the personal representative of a deceased shareholder –

(a) is a medical practitioner, or that he satisfies the conditions specified in Article 57B(2)(b)(i) to (iv) of the Order[^f00087]; and

(b) meets the further conditions imposed on shareholders by virtue of regulations 4 and 5.

(3) A notice under sub-paragraph (1)(aa) shall confirm that the new director or, as the case may be, secretary meets the conditions imposed on directors and secretaries by virtue of regulation 5.

Notice provisions specific to a contract with a company limited by shares

80

(1) A contractor which is a partnership shall give notice in writing to the Board forthwith when –

(a) a partner leaves or informs his partners that he intends to leave the partnership, and the date upon which he left or will leave the partnership;

(b) a new partner joins the partnership.

(2) A notice under sub-paragraph (1)(b) shall –

(a) state the date that the new partner joined the partnership;

(b) confirm that the new partner is a medical practitioner, or that he satisfies the conditions specified in Article 57B(2)(b)(i) to (iv) of the Order;

(d) state whether the new partner is a general or a limited partner.

Notification of deaths

81

(1) The contractor shall report in writing to the Board the death on his practice premises of any patient no later than the end of the first working day after the date on which the death occurred.

(2) The report shall include –

(a) the patient’s full name;

(b) the patient’s Central Health Index number or Health and Care number where known;

(d) a brief description of the circumstances, as known, surrounding the death;

(e) the name of any medical practitioner or other person treating the patient whilst on the practice premises; and

(f) the name, where known, of any other person who was present at the time of the death.

(3) The contractor shall send a copy of the report referred to in sub-paragraph (1) to any other Board in whose area the deceased was resident at the time of his death.

Notifications to patients following variation of the contract

82

Where the contract is varied in accordance with Part 8 and, as a result of that variation –

(a) there is to be a change in the range of services provided to the contractor’s registered patients; or

(b) patients who are on the contractor’s list of patients are to be removed from that list,

the Board shall notify those patients in writing of the variation and its effect 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).

Entry and inspection by the Board

83

(1) Subject to the conditions in sub-paragraph (2), the contractor shall allow persons authorised in writing by the Board to enter and inspect the practice premises at any reasonable time.

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

(a) reasonable notice of the intended entry has been given;

(b) written evidence of the authority of the person seeking entry is produced to the contractor on request; and

(c) entry is not made to any premises or part of the premises used as residential accommodation without the consent of the resident.

(3) Either the contractor or the Board may, if he or it wishes to do so, invite the Local Medical Committee for the area of the Board to be present at an inspection of the practice premises which takes place under this paragraph.

PART 6 — complaints

Complaints procedure

84

(1) The contractor shall establish and operate a complaints procedure to deal with any complaints in relation to any matter reasonably connected with the provision of services under the contract, which shall comply with the requirements of paragraphs 85 to 88 and 90.

(2) The contractor shall take reasonable steps to ensure that patients are aware of –

(a) the complaints procedure,

(b) the role of the Board and other bodies in relation to complaints about services under under the contract.

(3) The contractor shall take reasonable steps to ensure that the complaints procedure is accessible to all patients.

Making of complaints

85

A complaint may be made by or, with his consent, on behalf of a patient, or former patient, who is receiving or has received services under the contract, or –

(a) where the patient is a 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 the child under the provisions of the Children (Northern Ireland) Order 1995[^f00088]; or

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

(b) where the patient is incapable of making a complaint, by a relative or other adult who has an interest in his welfare.

86

Where a patient has died a complaint may be made by a relative or other adult who had an interest in his welfare or, where the patient falls within paragraph 85(a)(ii) or (iii), by the Trust or voluntary organisation.

Period for making complaints

87

(1) Subject to sub-paragraph (2), the period for making a complaint is –

(a) six months from the date on which the matter which is the subject of the complaint occurred; or

(b) six months from the date on which the matter which is the subject of the complaint comes to the complainant’s notice provided that the complaint is made no later than 12 months after the date on which the matter which is the subject of the complaint occurred.

(2) Where a complaint is not made during the period specified in sub-paragraph (1), it shall be referred to the person nominated under paragraph 88(2)(a) and if he is of the opinion that –

(a) having regard to all the circumstances of the case, it would have been unreasonable for the complainant to make the complaint within that period; and

(b) notwithstanding the time that has elapsed since the date on which the matter which is the subject matter of the complaint occurred, it is still possible to investigate the complaint properly,

the complaint shall be treated as if it had been received during the period specified in sub-paragraph (1).

Further requirements for complaints procedures

88

(1) A complaints procedure shall also comply with the requirements set out in sub-paragraphs (2) to (6).

(2) The contractor must nominate –

(a) a person (who need not be connected with the contractor and who, in the case of an individual, may be specified by his job title) to be responsible for the operation of the complaints procedure and the investigation of complaints; and

(b) a partner, or other senior person associated with the contractor, to be responsible for the effective management of the complaints procedure and for ensuring that action is taken in the light of the outcome of any investigation.

(3) All complaints must be –

(a) either made or recorded in writing;

(b) acknowledged in writing within the period of three working days beginning with and including the day on which the complaint was made or, where that is not possible, as soon as reasonably practicable; and

(4) Within the period of 10 working days beginning with and including the day on which the complaint was received by the person specified under sub-paragraph 2(a) or, where that is not possible, as soon as reasonably practicable, the complainant must be given a written summary of the investigation and its conclusions.

(5) Where the investigation of the complaint requires consideration of the patient’s medical records, the person specified under sub-paragraph 2(a) must inform the patient or person acting on his behalf if the investigation will involve disclosure of information contained in those records to a person other than the contractor or an employee of the contractor.

(6) The contractor must keep a record of all complaints and copies of all correspondence relating to complaints, but such records must be kept separate from patients' medical records.

Co-operation with investigations

89

(1) The contractor shall co-operate with –

(a) any investigation of a complaint in relation to any matter reasonably connected with the provision of services under the contract undertaken by –

(i) the Board, and

(ii) the Northern Ireland Commissioner for Complaints; and

(b) any investigation of a complaint by a health services body, an NHS body or local authority which relates to a patient or former patient of the contractor.

(2) In sub-paragraph (1) –

“NHS body” means a clinical commissioning group, (in England and Wales and Scotland) an NHS Trust, an NHS foundation trust, NHS England , a Local Health Board, and a Health Board;

“local authority” means –any of the bodies listed in section 1 of the Local Authority Social Services Act 1970[^f00089];the Council of the Isles of Scilly, ora council constituted under section 2 of the Local Government etc, (Scotland) Act 1994[^f00090].

(3) The co-operation required by sub-paragraph (1) includes –

(a) answering questions reasonably put to the contractor by the Board;

(b) providing any information relating to the complaint reasonably required by the Board ; and

(c) attending any meeting to consider the complaint (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given) if the contractor’s presence at the meeting is reasonably required by the Board.

Provision of information about complaints

90

(1) The contractor shall inform the Board, at such intervals as required, of the number of complaints it has received under the procedure established in accordance with this Part.

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

PART 7 — dispute resolution

Local resolution of contract disputes

91

(1) Subject to sub-paragraph (3), in the case of any dispute arising out of or in connection with the contract, the contractor and the Department must make every reasonable effort to communicate and co-operate with each other with a view to resolving the dispute, before referring the dispute for determination in accordance with the dispute resolution procedure (or, where applicable, before commencing court proceedings).

(2) Either the contractor or the Department may, if it wishes to do so, invite the relevant Local Medical Committee ... to participate in discussions which take place pursuant to sub-paragraph (1).

(3) In the case of a dispute which falls to be dealt with under the procedure specified in paragraph 36, sub-paragraph (1) does not apply where it is not practicable for the parties to attempt local resolution before the expiry of the period specified in paragraph 36(4).

Dispute resolution: non-HSS contracts

92

(1) In the case of a contract which is not an HSS contract, any dispute arising out of or in connection with the contract, except matters dealt with under the complaints procedure pursuant to Part 6, may be referred for consideration and determination to the Family Practitioner Services Independent Appeal Panel , if –

(a) the Department so wishes and the contractor has agreed in writing; or

(b) the contractor so wishes (even if the Department does not agree).

(2) In the case of a dispute referred to the Family Practitioner Services Independent Appeal Panel under sub-paragraph (1) –

(a) the procedure to be followed is the dispute resolution procedure; and

(b) the parties agree to be bound by any determination made by the adjudicator.

Dispute resolution procedure

93

(1) Subject to sub-paragraph (2), the procedure specified in the following sub-paragraphs and paragraph 94 applies in the case of any dispute arising out of or in connection with the contract which is referred to the Family Practitioner Services Independent Appeal Panel –

(a) in accordance with Article 8(4) of the 1991 Order (where the contract is a HSS contract); or

(b) in accordance with paragraph 92(1) (where the contract is not a HSS contract).

(2) The procedure specified in this paragraph and paragraph 94 does not apply where a contractor refers a matter for determination in accordance with paragraph 36(1), and in such a case the procedure specified in that paragraph shall apply instead.

(3) Any party wishing to refer a dispute as mentioned in sub-paragraph (1) 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; and

(4) Any party wishing to refer a dispute as mentioned in sub-paragraph (1) must send the request under sub-paragraph (3) within a period of three years beginning with and including the date on which the matter giving rise to the dispute happened or should reasonably have come to the attention of the party wishing to refer the dispute.

(5) Where the dispute relates to a contract which is not a HSS contract, the Family Practitioner Services Independent Appeal Panel may determine the matter itself or, if it considers it appropriate, appoint a person to consider and determine it[^f00091].

(6) Before reaching a decision as to who should determine the dispute, either under sub-paragraph (5) or under Article 8(5) of the 1991 Order, the Family Practitioner Services Independent Appeal Panel shall, within the period of 7 days beginning with and including the date on which a matter was referred to it, send a written request to the parties to make in writing, within a specified period, any representations which they may wish to make about the matter under dispute .

(7) The Family Practitioner Services Independent Appeal Panel shall give, with the notice given under sub-paragraph (6), to the party other than the one which referred the matter to dispute resolution a copy of any document by which the matter was referred to dispute resolution.

(8) The Family Practitioner Services Independent Appeal Panel shall give a copy of any representations received from a party to the other party and shall in each case request (in writing) a party to whom a copy of the representations is given to make within a specified period any written observations which it wishes to make on those representations.

(9) Following receipt of any representations from the parties or, if earlier, at the end of the period for making such representations specified in the request sent under sub-paragraph (6) or (8), the Family Practitioner Services Independent Appeal Panel shall, if it decides to appoint a person to hear the dispute –

(a) inform the parties in writing of the name of the person or persons whom it has appointed; and

(b) pass to the person or persons so appointed any documents received from the parties under or pursuant to paragraphs (3), (6) or (8).

(10) For the purpose of assisting him in his consideration of the matter, the adjudicator may –

(a) invite representatives of the parties to appear before him to make oral representations either together or, with the agreement of the parties, separately, and may in advance provide the parties with a list of matters or questions to which he wishes them to give special consideration; or

(b) consult other persons whose expertise he considers will assist him in his consideration of the matter.

(11) Where the adjudicator consults another person under sub-paragraph (10)(b), he shall notify the parties accordingly in writing and, where he considers that the interests of any party might be substantially affected by the result of the consultation, he shall give to the parties such opportunity as he considers reasonable in the circumstances to make observations on those results.

(12) In considering the matter, the adjudicator shall consider –

(a) any written representations made in response to a request under sub-paragraph (6), but only if they are made within the specified period;

(b) any written observations made in response to a request under sub-paragraph (8), but only if they are made within the specified period;

(d) the results of any consultation under sub-paragraph (10)(b); and

(e) any observations made in accordance with an opportunity given under sub-paragraph (11).

(13) In this paragraph, “specified period” means such period as the Family Practitioner Services Independent Appeal Panel shall specify in the request, being not less than 2, nor more than 4, weeks beginning with and including the date on which the notice referred to is given, but the Family Practitioner Services Independent Appeal Panel may, if it considers that there is good reason for doing so, extend any such period (even after it has expired) and, where it does so, a reference in this paragraph to the specified period is to the period as so extended.

(14) Subject to the other provisions of this paragraph and paragraph 94 and to any agreement by the parties, the adjudicator shall have wide discretion in determining the procedure of the dispute resolution to ensure the just, expeditious, economical and final determination of the dispute.

Determination of dispute

94

(1) The adjudicator shall record his determination and the reasons for it, in writing and shall give notice of the determination (including the record of the reasons) to the parties.

(2) In the case of a contract referred for determination in accordance with paragraph 92(1), sub-paragraph (9) of Article 8 of the 1991 Order shall apply as that sub-paragraph applies in the case of a contract referred for determination in accordance with sub-paragraph (4) of Article 8 of that Order.

(3) In the case of a contract referred for determination in accordance with paragraph 92(1), sub-paragraph (5) of Article 57F of the Order shall apply as that subparagraph applies in the case of a contract referred for determination in accordance with sub-paragraph (4) of Article 8 of the 1991 Order.

Interpretation of Part 7

95

(1) In this Part, “any dispute arising out of or in connection with the contract” includes any dispute arising out of or in connection with the termination of the contract.

(2) Any term of the contract that makes provision in respect of the requirements in this Part shall survive even where the contract has terminated.

PART 8 — variation and termination of contracts

Variation of a contract: general

96

(1) Subject to Schedule 2 and paragraphs 64(8), 65(8), 97, 98 and 109, no amendment or variation shall have effect unless it is in writing and signed by or on behalf of the Board and the contractor.

(2) In addition to the specific provision made in paragraphs 97(6), 98(6) and 109, the Board may vary the contract without the contractor’s consent where it –

(a) is reasonably satisfied that it is necessary to vary the contract so as to comply with the Order, any regulations made pursuant to that Order, or any direction given by the Department pursuant to that Order; and

(b) notifies the contractor in writing of the wording of the proposed variation and the date upon which that variation is to take effect,

and, where it is reasonably practicable to do so, the date that the proposed variation is to take effect shall be not less than 14 days after the date on which the notice under head (b) is served on the contractor.

Variation provisions specific to a contract with an individual medical practitioner

97

(1) If a contractor which is an individual medical practitioner proposes to practise in partnership with a person during the existence of the contract, the contractor shall notify the Board in writing of –

(a) the name of the person with whom he proposes to practise in partnership; and

(b) the date on which the contractor wishes to change his status as a contractor from that of an individual medical practitioner to that of a partnership, which shall be not less than 28 days after the date upon which he has served the notice on the Board pursuant to this sub-paragraph.

(2) A notice under sub-paragraph (1) shall in respect of the person with whom the contractor is proposing to practise in partnership, and also in respect of himself as regards the matters specified in head (c) –

(a) confirm that he is either –

(i) a medical practitioner, or

(ii) a person who satisfies the conditions specified in Article 57B(2)(b)(i) to (iv) of the Order[^f00092];

(b) confirm that he is a person who satisfies the conditions imposed by regulations 4 and 5; and

and the notice shall be signed by the individual medical practitioner and by the person with whom he is proposing to practise in partnership.

(3) The contractor shall ensure that any person who will practise in partnership with him is bound by the contract, whether by virtue of a partnership deed or otherwise.

(4) If the Board is satisfied as to the accuracy of the matters specified in sub-paragraph (2) that are included in the notice, the Board shall give notice in writing to the contractor confirming that the contract shall continue with the partnership entered into by the contractor and his partners, from a date that the Board specifies in that notice.

(5) Where it is reasonably practicable, the date specified by the Board pursuant to sub-paragraph (4) shall be the date requested in the notice served by the contractor pursuant to sub-paragraph (1), or, where that date is not reasonably practicable, the date specified shall be a date after the requested date that is as close to the requested date as is reasonably practicable.

(6) Where a contractor has given notice to the Board pursuant to sub-paragraph (1), the Board –

(a) may vary the contract but only to the extent that it is satisfied is necessary to reflect the change in status of the contractor from an individual medical practitioner to a partnership; and

(b) if it does propose to so vary the contract, it shall include in the notice served on the contractor pursuant to sub-paragraph (4) the wording of the proposed variation and the date upon which that variation is to take effect.

Variation provisions specific to a contract with two or more individuals practising in partnership

98

(1) Subject to sub-paragraph (4), where a contractor consists of two or more individuals practising in partnership in the event that the partnership is terminated or dissolved, the contract shall only continue with one of the former partners if that partner is –

(a) nominated in accordance with sub-paragraph (3); and

(b) a medical practitioner who meets the condition in regulation 4(2)(a),

and provided that the requirements in sub-paragraphs (2) and (3) are met.

(2) A contractor shall notify the Board in writing at least 28 days in advance of the date on which the contractor proposes to change his status from that of a partnership to that of an individual medical practitioner pursuant to sub-paragraph (1).

(3) A notice under sub-paragraph (2) shall –

(a) specify the date on which the contractor proposes to change his status from that of a partnership to that of an individual medical practitioner;

(b) specify the name of the medical practitioner with whom the contract will continue, which must be one of the partners; and

(4) If a partnership is terminated or dissolved because, in a partnership consisting of two individuals practising in partnership, one of the partners has died, ... the remaining individual shall notify the Board in writing as soon as it is reasonably practicable of the death of his partner and sub-paragraph (4A) or (4B) shall apply. –

(a) the contract shall continue with the individual who has not died only if that individual is a medical practitioner who meets the condition in regulation 4(2)(a); and

(b) that individual shall in any event notify the Board in writing as soon as is reasonably practicable of the death of his partner.

(4A) If the remaining individual is a general medical practitioner, the contract shall continue with that individual.

(4B) If sub-paragraph (4A) does not apply, the Board may, if it thinks fit, serve notice in writing on the remaining individual confirming that the Board will allow the contract to continue with that individual, for a period specified by the Board of up to six months (the “interim period”) provided that he consents to the Board employing or supplying a general medical practitioner to him for the interim period to assist in the provision of clinical services under the contract.

(4C) Before deciding whether to serve a notice pursuant to paragraph (4B), the Board shall, whenever it is reasonably practicable to do so, consult the Local Medical Committee (if any) for its area.

(4D) If, during the interim period, the contractor withdraws his consent to the Board employing or supplying a general medical practitioner, the Board shall serve notice in writing on the contractor terminating the contract forthwith.

(4E) If, at the end of the interim period, the contractor has not entered into partnership with a general medical practitioner who is not a limited partner, the Board shall serve notice on the contractor terminating the contract forthwith.

(5) When the Board receives a notice pursuant to sub-paragraph (2) or (4) , it shall acknowledge in writing receipt of the notice, and in relation to a notice served pursuant to sub-paragraph (2), the Board shall do so before the date specified pursuant to sub-paragraph (3)(a).

(6) Where a contractor gives notice to the Board pursuant to sub-paragraph (2) or (4), the Board may vary the contract but only to the extent that it is satisfied is necessary to reflect the change in status of the contractor from a partnership to an individual medical practitioner.

(7) If the Board varies the contract pursuant to sub-paragraph (6), it shall notify the contractor in writing of the wording of the proposed variation and the date upon which that variation is to take effect.

(8) In this paragraph, “general medical practitioner” has the same meaning as in regulation 4(1).

Termination by agreement

99

The Board and the contractor may agree in writing to terminate the contract, and if the parties so agree, they shall agree the date upon which that termination should take effect and any further terms upon which the contract should be terminated.

Termination by the contractor

100

(1) A contractor may terminate the contract by serving notice in writing on the Board at any time.

(2) Where a contractor serves notice pursuant to sub-paragraph (1), the contract shall, subject to sub-paragraph (3), terminate six months after the date on which the notice is served (“the termination date”), save that if the termination date is not the last calendar day of a month, the contract shall instead terminate on the last calendar day of the month in which the termination date falls.

(3) Where the contractor is an individual medical practitioner, sub-paragraph (2) shall apply to the contractor, save that the reference to “ six months” shall instead be to “three months”.

(4) This paragraph and paragraph 101 are without prejudice to any other rights to terminate the contract that the contractor may have.

Late payment notices

101

(1) The contractor may give notice in writing (a “late payment notice”) to the Board if the Board has failed to make any payments due to the contractor in accordance with a term of the contract that has the effect specified in regulation 22, and the contractor shall specify in the late payment notice the payments that the Board has failed to make in accordance with that regulation.

(2) Subject to sub-paragraph (3), the contractor may, at least 28 days after having served a late payment notice, terminate the contract by a further written notice if the Board has still failed to make the payments due to the contractor, and that were specified in the late payment notice served on the Board pursuant to sub-paragraph (1).

(3) If, following receipt of a late payment notice, the Board refers the matter to the dispute resolution procedure within 28 days of the date upon which it is served with the late payment notice, and it notifies the contractor in writing that it has done so within that period of time, the contractor may not terminate the contract pursuant to sub-paragraph (2) until –

(a) there has been a determination of the dispute pursuant to paragraph 94 and that determination permits the contractor to terminate the contract; or

(b) the Board ceases to pursue the dispute resolution procedure,

whichever is the sooner.

Termination by the Board: general

102

The Board may only terminate the contract in accordance with the provisions in this Part.

Termination by the Board for breach of conditions in regulation 4

103

(1) Subject to sub-paragraph (1A), the Board shall serve notice in writing on the contractor terminating the contract forthwith if the contractor is an individual medical practitioner and the medical practitioner no longer satisfies the condition specified in regulation 4(1).

(1A) Where the failure of an individual medical practitioner to continue to satisfy the condition specified in regulation 4(1) is the result of a suspension specified in sub-paragraph (3B), sub-paragraph (1) shall not apply unless—

(a) the contractor is unable to satisfy the Board that it has in place adequate arrangements for the provision of clinical services under the contract for as long as the suspension continues; or

(b) the Board is satisfied that the circumstances of the suspension are such that if the contract is not terminated forthwith—

(i) the safety of the contractor’s patients is at serious risk, or

(ii) the Board is at risk of material financial loss.

(2) Except in a case to which paragraph 98(4) where the contractor is –

(a) two or more persons practising in partnership, and the condition specified in regulation 4(2)(a) is no longer satisfied; or

(b) a company limited by shares, and the condition specified in regulation 4(3)(a) is no longer satisfied,

sub-paragraph (3) shall apply.

(3) Where sub-paragraph (2)(a) or (b) applies, the Board shall –

(a) serve notice in writing on the contractor terminating the contract forthwith; or

(b) serve notice in writing on the contractor confirming that the Board will allow the contract to continue, for a period specified by the Board of in accordance with paragraph (3A) (the “interim period”), during which time the Board shall, with the consent of the contractor, employ or supply a general medical practitioner to the contractor for the interim period to assist the contractor in the provision of clinical services under the contract.

(3A) The period specified by the Board under sub-paragraph (3)(b) shall not exceed—

(a) six months; or

(b) in a case where the failure of the contractor to continue to satisfy the condition in regulation 4(2)(a) or, as the case may be, 4(3)(a), is the result of a suspension referred to in sub-paragraph (3B), the period for which that suspension continues.

(3B) The suspensions referred to in sub-paragraphs (1A) and (3A)(b) are suspension—

(a) by a Fitness to Practise Panel under—

(i) section 35D (functions of a fitness to practice panel) of the Medical Act 1983 in a health case, other than an indefinite suspension under section 35D(6), or

(ii) section 38(1) (power to order immediate suspension etc after a finding of impairment of fitness to practise) of the Act; or

(b) by a Fitness to Practise Panel or an Interim Orders Panel under section 41A (interim orders) of that Act.

(3C) In paragraph (3B), “health case” has the meaning given in section 35E(4) of the Medical Act 1983.

(4) Before deciding which of the options in sub-paragraph (3) to pursue, the Board shall, whenever it is reasonably practicable to do so, consult the Local Medical Committee (if any) for its area.

(5) If the contractor does not, pursuant to sub-paragraph (3)(b), consent to the Board employing or supplying a general medical practitioner during the interim period, the Board shall serve notice in writing on the contractor terminating the contract forthwith.

(6) If, at the end of the interim period, the contractor still falls within sub-paragraph (2)(a) or (b), the Board shall serve notice in writing on the contractor terminating the contract forthwith.

(7) In sub-paragraphs (3) and (5), “general medical practitioner” has the same meaning as in regulation 4(1).

Termination by the Board for the provision of untrue etc. information

104

The Board may serve notice in writing on the contractor terminating the contract forthwith, or from such date as may be specified in the notice if, after the contract has been entered into, it comes to the attention of the Board that written information provided to the Board by the contractor—

by the contractor—before the contract was entered into; orpursuant to paragraph 79(2) or (3) or 80(2),in relation to the conditions set out in regulations 4 and 5 (and compliance with those conditions) was, when given, untrue or inaccurate in a material respect.

Other grounds for termination by the Board

105

(1) The Board may serve notice in writing on the contractor terminating the contract forthwith, or from such date as may be specified in the notice if –

(a) in the case of a contract with a medical practitioner, that medical practitioner;

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

(i) the company,

(ii) any person legally and beneficially owning a share in the company, or

(iii) any director or secretary of the company,

falls within sub-paragraph (2) during the existence of the contract or, if later, on or after the date on which a notice in respect of his compliance with the conditions in regulation 5 was given under paragraph 79(2) or (3) or 80(2).

(2) A person falls within this sub-paragraph if –

(a) it does not satisfy the conditions prescribed in Article 57B(2)(b) or (3)(b) of the Order;

(b) he is the subject of a general or national disqualification;

(c) subject to sub-paragraph (3), he is disqualified or suspended (other than by an interim suspension order or direction pending an investigation or a suspension on the grounds of ill-health) from practising by any licensing body anywhere in the world;

(d) subject to sub-paragraph (4), he has been dismissed (otherwise than by reason of redundancy) from any employment by a health services body unless before the Board has served a notice terminating the contract pursuant to this paragraph, he is employed by the health services body that dismissed him or by another health and social services body;

(e) he is disqualified from a primary medical services performers list unless his name has subsequently been included in such a list;

(f) he has been convicted in the United Kingdom of murder;

(g) he has been convicted in the United Kingdom of a criminal offence other than murder and has been sentenced to a term of imprisonment of over six months;

(h) subject to sub-paragraph (5), he has been convicted elsewhere of an offence which would if committed in Northern Ireland –

(i) constitute murder; or

(ii) constitute a criminal offence other than murder, and been sentenced to a term of imprisonment of over six months;

(i) he has been convicted of an offence referred to in Schedule 1 to the Children and Young Persons (Northern Ireland) Act 1968[^f00093], Schedule 1 to the Children and Young Persons Act 1933[^f00094] or Schedule 1 to the Criminal Procedure (Scotland) Act 1995[^f00095];

(j) he has –

(i) been adjudged bankrupt or had sequestration of his estate awarded unless (in either case) he has been discharged or the bankruptcy order has been annulled,

(ii) been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986[^f00096] or Schedule 2A to the Insolvency (Northern Ireland) Order 1989 or a debt relief restrictions order or an interim debt relief restrictions order under Schedule 4ZB to the Insolvency Act 1986 or Schedule 2ZB to the Insolvency (Northern Ireland) Order 1989 , unless that order has ceased to have effect or has been annulled,

(iii) made a composition or arrangement with, or granted a trust deed for, his creditors unless he has been discharged in respect of it,

(iv) been wound up under Part V of the Insolvency (Northern Ireland) Order 1989[^f00097];

(k) there is –

(i) an administrator, administrative receiver or receiver appointed in respect of him, or

(ii) an administration order made in respect of him under Part III of the Insolvency (Northern Ireland) Order 1989;

(l) that person is a partnership and –

(i) a dissolution of the partnership is ordered by any competent court, tribunal or arbitrator, or

(ii) an event happens that makes it unlawful for the business of the partnership to continue, or for members of the partnership to carry on in partnership;

(m) he has been –

(i) removed from the office of charity trustee or trustee for a charity by an order made by the Charity Commissioners or the High Court on the grounds of any misconduct or mismanagement in the administration of the charity for which he was responsible or to which he was privy, or which he by his conduct contributed to or facilitated, or

(ii) removed under section 7 of the Law Reform (Miscellaneous Provisions) (Scotland) Act 1990[^f00098] (powers of the Court of Session to deal with management of charities) or under section 34 of the Charities and Trustee Investment (Scotland) Act 2005 (powers of Court of Session) , from being concerned in the management or control of any body;

(n) he is subject to a disqualification order under the Company Directors Disqualification (Northern Ireland) Order 2002[^f00099], the Company Directors Disqualification Act 1986[^f00100] or to an order made under section 429(2)(b) of the Insolvency Act 1986[^f00101] (failure to pay under county court administration order);

(o) he has refused to comply with a request by the Board for him to be medically examined on the grounds that it is concerned that he is incapable of adequately providing services under the contract and, in a case where the contract is with two or more individuals practising in partnership or with a company, the Board is not satisfied that the contractor is taking adequate steps to deal with the matter.

(3) A Board shall not terminate the contract pursuant to sub-paragraph (2)(c) where the Board is satisfied that the disqualification or suspension imposed by a licensing body outside the United Kingdom does not make the person unsuitable to be –

(a) a contractor;

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

(i) a person legally and beneficially holding a share in the company, or

(ii) a director or secretary of the company,

as the case may be.

(4) A Board shall not terminate the contract pursuant to sub-paragraph (2)(d) –

(a) until a period of at least three months has elapsed since the date of the dismissal of the person concerned; or

(b) if, during the period of time specified in head (a), the person concerned brings proceedings in any competent tribunal or court in respect of his dismissal, until proceedings before that tribunal or court are concluded,

and the Board may only terminate the contract at the end of the period specified in head (b) if there is no finding of unfair dismissal at the end of those proceedings.

(5) A Board shall not terminate the contract pursuant to sub-paragraph (2)(h) where the Board is satisfied that the conviction does not make the person unsuitable to be –

(a) a contractor;

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

(i) a person legally and beneficially holding a share in the company, or

(ii) a director or secretary of the company,

as the case may be.

106

The Board may serve notice in writing on the contractor terminating the contract forthwith or with effect from such date as may be specified in the notice if –

(a) the contractor has breached the contract and as a result of that breach, the safety of the contractor’s patients is at serious risk if the contract is not terminated; or

(b) the contractor’s financial situation is such that the Board considers that the Board is at risk of material financial loss.

Termination by the Board: remedial notices and breach notices

107

(1) Where a contractor has breached the contract other than as specified in paragraphs 103 to 106A and the breach is capable of remedy, the Board shall, before taking any action it is otherwise entitled to take by virtue of the contract, serve a notice on the contractor requiring it to remedy the breach (“remedial notice”).

(2) A remedial notice shall specify –

(a) details of the breach;

(b) the steps the contractor must take to the satisfaction of the Board in order to remedy the breach; and

(3) The notice period shall, unless the Board is satisfied that a shorter period is necessary to –

(a) protect the safety of the contractor’s patients; or

(b) protect itself from material financial loss,

be no less than 28 days from the date that notice is given.

(4) Where a Board is satisfied that the contractor has not taken the required steps to remedy the breach by the end of the notice period, the Board may terminate the contract with effect from such date as the Board may specify in a further notice to the contractor.

(5) Where a contractor has breached the contract other than as specified in specified in paragraphs 103 to 106A and the breach is not capable of remedy, the Board may serve notice on the contractor requiring the contractor not to repeat the breach (“breach notice”).

(6) If, following a breach notice or a remedial notice, the contractor –

(a) repeats the breach that was the subject of the breach notice or the remedial notice; or

(b) otherwise breaches the contract resulting in either a remedial notice or a further breach notice,

the Board may serve notice on the contractor terminating the contract with effect from such date as may be specified in that notice.

(7) The Board shall not exercise its right to terminate the contract under sub-paragraph (6) unless it is satisfied that the cumulative effect of the breaches is such that the Board considers that to allow the contract to continue would be prejudicial to the efficiency of the services to be provided under the contract.

(8) If the contractor is in breach of any obligation and a breach notice or a remedial notice in respect of that default has been given to the contractor, the Board may withhold or deduct monies which would otherwise be payable under the contract in respect of that obligation which is the subject of the default.

Termination by the Board: additional provisions specific to contracts with two or more individuals practising in partnership and companies limited by shares

108

(1) Where the contractor is a company limited by shares, if the Board becomes aware that the contractor is carrying on any business which the Board considers to be detrimental to the contractor’s performance of his obligations under the contract –

(a) the Board shall be entitled to give notice to the contractor requiring that he ceases carrying on that business before the end of a period of not less than 28 days beginning on and including the day on which the notice is given (“the notice period”); and

(b) if the contractor has not satisfied the Board that he has ceased carrying on that business by the end of the notice period, the Board may, by a further written notice, terminate the contract forthwith or from such date as may be specified in the notice.

(2) Where the contractor is two or more persons practising in partnership, the Board shall be entitled to terminate the contract by notice in writing on such date as may be specified in that notice where one or more partners have left the practice during the existence of the contract if in its reasonable opinion, the Board considers that the change in membership of the partnership is likely to have a serious adverse impact on the ability of the contractor or the Board to perform its obligations under the contract.

(3) A notice given to the contractor pursuant to sub-paragraph (2) shall specify –

(a) the date upon which the contract is to be terminated; and

(b) the Board’s reasons for considering that the change in the membership of the partnership is likely to have a serious adverse impact on the ability of the contractor or the Board to perform his obligations under the contract.

Contract sanctions

109

(1) In this paragraph and paragraph 110, “contract sanction” means –

(a) termination of specified reciprocal obligations under the contract;

(b) suspension of specified reciprocal obligations under the contract for a period of up to six months; or

(2) Where the Board is entitled to terminate the contract pursuant to paragraph 104, 105, 106 or 107(4) or (6) or paragraph 108, it may instead impose any of the contract sanctions if the Board is reasonably satisfied that the contract sanction to be imposed is appropriate and proportionate to the circumstances giving rise to the Board’s entitlement to terminate the contract.

(3) The Board shall not, under sub-paragraph (2), be entitled to impose any contract sanction that has the effect of terminating or suspending any obligation to provide, or any obligation that relates to, essential services.

(4) If the Board decides to impose a contract sanction, it must notify the contractor of the contract sanction that it proposes to impose, the date upon which that sanction will be imposed and provide in that notice an explanation of the effect of the imposition of that sanction.

(5) Subject to paragraph 110, the Board shall not impose the contract sanction until at least 28 days after it has served notice on the contractor pursuant to sub-paragraph (4) unless the Board is satisfied that it is necessary to do so in order to –

(a) protect the safety of the contractor’s patients; or

(b) protect itself from material financial loss.

(6) Where the Board imposes a contract sanction, the Board shall be entitled to charge the contractor the reasonable costs of additional administration that the Board has incurred in order to impose, or as a result of imposing, the contract sanction.

Contract sanctions and the dispute resolution procedure

110

(1) If there is a dispute between the Board and the contractor in relation to a contract sanction that the Board is proposing to impose, the Board shall not, subject to sub-paragraph (4), impose the proposed contract sanction except in the circumstances specified in sub-paragraph (2)(a) or (b).

(2) If the contractor refers the dispute relating to the contract sanction to the dispute resolution procedure within 28 days beginning on and including the date on which the Board served notice on the contractor in accordance with paragraph 109(4) (or such longer period as may be agreed in writing with the Board), and notifies the Board in writing that he has done so, the Board shall not impose the contract sanction unless –

(a) there has been a determination of the dispute pursuant to paragraph 94 and that determination permits the Board to impose the contract sanction; or

(b) the contractor ceases to pursue the dispute resolution procedure,

whichever is the sooner.

(3) If the contractor does not invoke the dispute resolution procedure within the time specified in sub-paragraph (2), the Board shall be entitled to impose the contract sanction forthwith.

(4) If the Board is satisfied that it is necessary to impose the contract sanction before the dispute resolution procedure is concluded in order to –

(a) protect the safety of the contractor’s patients; or

(b) protect itself from material financial loss,

the Board shall be entitled to impose the contract sanction forthwith, pending the outcome of that procedure.

Termination and the dispute resolution procedure

111

(1) Where the Department is entitled to serve written notice on the contractor terminating the contract pursuant to paragraph 104, 105, 106, 107(4) or (6) or 108, the Department shall, in the notice served on the contractor pursuant to those provisions, specify a date on which the contract terminates that is not less than 28 days after the date on which the Department has served that notice on the contractor unless sub-paragraph (2) applies.

(2) This sub-paragraph applies if the Department is satisfied that a period less than 28 days is necessary in order to –

(a) protect the safety of the contractor’s patients; or

(b) protect itself from material financial loss.

(3) In a case falling with sub-paragraph (1), where the exceptions in sub-paragraph (2) do not apply, where the contractor invokes the dispute resolution procedure before the end of the period of notice referred to in sub-paragraph (1), and he notifies the Department in writing that he has done so, the contract shall not terminate at the end of the notice period but instead shall only terminate in the circumstances specified in sub-paragraph (4).

(4) The contract shall only terminate if and when –

(a) there has been a determination of the dispute pursuant to paragraph 94 and that determination permits the Department to terminate the contract; or

(b) the contractor ceases to pursue the dispute resolution procedure,

whichever is the sooner.

(5) If the Department is satisfied that it is necessary to terminate the contract before the dispute resolution procedure is concluded in order to –

(a) protect the safety of the contractor’s patients; or

(b) protect itself from material financial loss,

sub-paragraphs (3) and (4) shall not apply and the Department shall be entitled to confirm, by written notice to be served on the contractor, that the contract will nevertheless terminate at the end of the period of the notice it served pursuant to paragraph 104, 105(1), 106, 107(4) or (6) or 108.

Consultation with the Local Medical Committee

112

(1) Whenever the Board is considering –

(a) terminating the contract pursuant to paragraph 104, 105, 106, 107(4) or (6) or 108;

(b) which of the alternative sanctions in writing available under the provisions of paragraph 106A it will serve; or

it shall, whenever it is reasonably practicable to do so, consult the Local Medical Committee (if any) for its area before it terminates the contract or imposes a contract sanction.

(2) Whether or not the Local Medical Committee has been consulted pursuant to sub-paragraph (1), whenever the Board imposes a contract sanction on a contractor or terminates a contract pursuant to this Part, it shall, as soon as reasonably practicable, notify the Local Medical Committee in writing of the contract sanction imposed or of the termination of the contract (as the case may be).

PART 9 — miscellaneous

Clinical governance

113

(1) The contractor shall have an effective system of clinical governance which shall include appropriate standard operating procedures in relation to the management and use of controlled drugs .

(2) The contractor shall nominate a person who will have responsibility for ensuring the effective operation of the system of clinical governance.

(3) The person nominated under sub-paragraph (2) shall be a person who performs or manages services under the contract.

(4) In this paragraph “system of clinical governance” means a framework through which the contractor endeavours continuously to improve the quality of his services and safeguard high standards of care by creating an environment in which clinical excellence can flourish.

Insurance

114

(1) The contractor shall at all times have in force in relation to it an indemnity arrangement which provides appropriate cover .

(2) The contractor shall not sub-contract his obligations to provide clinical services under the contract unless he has satisfied himself that the sub-contractor has in force in relation to it an indemnity arrangement which provides appropriate cover.

(3) In this paragraph –

(a) “indemnity arrangement” means a contract of insurance or other arrangement made for the purpose of indemnifying the contractor;

(aa) “appropriate cover” means cover against liabilities that may be incurred by the contractor in the performance of clinical services under the contract, which is appropriate, having regard to the nature and extent of the risks in the performance of such services;and

(b) a contractor shall be regarded as “ having in force in relation to it an indemnity arrangement if there is an indemnity arrangement in force in relation to a person employed or engaged by him in connection with clinical services which that person provides under the contract or, as the case may be, sub-contract.

115

The contractor shall at all times hold adequate public liability insurance in relation to liabilities to third parties arising under or in connection with the contract which are not covered by an indemnity arrangement referred to in paragraph 114(1).

Gifts

116

(1) The contractor shall keep a register of gifts which –

(a) are given to any of the persons specified in sub-paragraph (2) by or on behalf of –

(i) a patient,

(ii) a relative of a patient, or

(iii) any person who provides or wishes to provide services to the contractor or his patients in connection with the contract; and

(b) have, in his reasonable opinion, an individual value of more than £100·00.

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

(a) the contractor;

(b) where the contract is with two or more individuals practising in partnership, any partner;

(i) any person legally and beneficially holding a share in the company, or

(ii) a director or secretary of the company;

(d) any person employed by the contractor for the purposes of the contract;

(e) any general medical practitioner engaged by the contractor for the purposes of the contract;

(f) any spouse or civil partner of a contractor (where the contractor is an individual medical practitioner) or of a person specified in paragraphs (b) to (e); or

(g) any person (whether or not of the opposite sex) whose relationship with a contractor (where the contractor is an individual medical practitioner) or with a person specified in paragraphs (b) to (e) has the characteristics of the relationship between husband and wife.

(3) Sub-paragraph (1) does not apply where –

(a) there are reasonable grounds for believing that the gift is unconnected with services provided or to be provided by the contractor;

(b) the contractor is not aware of the gift; or

(4) The contractor shall take reasonable steps to ensure that he is informed of gifts which fall within sub-paragraph (1) and which are given to the persons specified in sub-paragraph (2)(b) to (g).

(5) The register referred to in sub-paragraph (1) shall include the following information –

(a) the name of the donor;

(b) in a case where the donor is a patient, the patient’s Central Health Index number or Health and Care number or, if the number is not known, his address;

(d) the nature of the gift;

(e) the estimated value of the gift; and

(f) the name of the person or persons who received the gift.

(6) The contractor shall make the register available to the Board on request.

Compliance with legislation and guidance

117

The contractor shall –

(a) comply with all relevant legislation; and

(b) have regard to all relevant guidance issued by the Board or the Department.

Third party rights

118

The contract shall not create any right enforceable by any person not a party to it.

SCHEDULE 6 — OUT OF HOURS SERVICES

Temporary arrangements for transfer of obligations and liabilities in relation to certain out of hours services

1

(1) In this Schedule –

“out of hours arrangement” means an arrangement under sub-paragraph (2); and

“transferee out of hours services provider” means a person referred to in sub-paragraph (5) who has undertaken to carry out the obligations of a contractor during all or part of the out of hours period in accordance with an out of hours arrangement specified to in sub-paragraph (2).

(2) Subject to the provisions of this Schedule, where a contractor is required to provide out of hours services pursuant to regulation 30 or 31, the contractor may, with the approval of the Board, make an arrangement with a person referred to in sub-paragraph (5) to transfer the contractor’s obligations under these regulations.

(3) Any arrangement made pursuant to sub-paragraph (2) shall cease to have effect –

(a) on the day when the transferee out of hours services provider ceases to meet any of the conditions required to provide primary medical services under these regulations; or

(b) on 1st January 2005,

whichever is the earlier.

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

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

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

(5) The person referred to in sub-paragraph (1) is any person who holds a contract with the Board which includes the provision of out of hours services.

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

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