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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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(5) Within the period of 7 days beginning with and including the date on which the matter was referred to it, the Family Practitioner Services Independent Appeal Panel shall –

(a) give to the parties notice in writing that it is dealing with the matter; and

(b) include with the notice a written request to the parties to make in writing within a specified period any representations which they may wish to make about the dispute.

(6) The Family Practitioner Services Independent Appeal Panel shall give, with the notice given under sub-paragraph (5), to the party, other than the one which referred the matter to dispute resolution, a copy of any document by which the dispute was referred to dispute resolution.

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

(8) For the purpose of assisting it in its consideration of the matter, the Family Practitioner Services Independent Appeal Panel may –

(a) invite representatives of the parties to appear before it 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 it wishes them to give special consideration; or

(b) consult other persons whose expertise it considers will assist it in its consideration of the dispute.

(9) Where the Family Practitioner Services Independent Appeal Panel consults another person under sub-paragraph (8)(b), it shall notify the parties accordingly in writing and, where it considers that the interests of any party might be substantially affected by the result of the consultation, it shall give to the parties such opportunity as it considers reasonable in the circumstances to make observations on those results.

(10) In considering the dispute, the Family Practitioner Services Independent Appeal Panel shall consider –

(a) any written representations made in response to a request under sub-paragraph (5)(b), but only if they are made within the specified period;

(b) any written observations made in response to a request under sub-paragraph (7), but only if they are made within the specified period;

(d) the results of any consultation under sub-paragraph (8)(b); and

(e) any observations made in accordance with an opportunity given under sub-paragraph (9).

(11) Subject to the other provisions of this paragraph and to any agreement by the parties, the Family Practitioner Services Independent Appeal Panel shall have wide discretion in determining the procedure of the dispute resolution to ensure the just, expeditious, economical and final determination of the dispute.

(12) 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 one, nor more than two, 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 the period for determination of the dispute has been extended in accordance with sub-paragraph (16), 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.

(13) Subject to sub-paragraph (16), within the period of 21 days beginning with and including the date on which the matter was referred to it, the Family Practitioner Services Independent Appeal Panel shall determine whether the Department may assign patients to contractors which have closed their lists of patients; and if it determines that the Department may make such assignments, it shall also determine those contractors to which patients may be assigned.

(14) The Family Practitioner Services Independent Appeal Panel may not determine that patients may be assigned to a contractor which was not specified in the determination of the assessment panel under paragraph 35(7).

(15) In the case of a matter referred jointly by contractors in accordance with sub-paragraph (3), the Family Practitioner Services Independent Appeal Panel may determine that patients may be assigned to one, some or all of the contractors which referred the matter.

(16) The period of 21 days referred to in sub-paragraph (13) may be extended (even after it has expired) by a further specified number of days if an agreement to that effect is reached by –

(a) the Family Practitioner Services Independent Appeal Panel ;

(b) the Department ; and

(17) The Family Practitioner Services Independent Appeal Panel shall record its determination, and the reasons for it, in writing and shall give notice of the determination (including the record of the reasons) to the parties.

Assignments to closed lists: assignments of patients by a Board

37

(1) Before the Board may assign a new patient to a contractor, it shall, subject to sub-paragraph (3), enter into discussions with that contractor regarding additional support that the Board can offer the contractor, and the Board shall use its best endeavours to provide appropriate support.

(2) In the discussions referred to in sub-paragraph (1), both parties shall use reasonable endeavours to reach agreement.

(3) The requirement in sub-paragraph (1) to enter into discussions applies –

(a) to the first assignment of a patient to a particular contractor; and

(b) to any subsequent assignment to that contractor to the extent that it is reasonable and appropriate having regard to the numbers of patients who have been or may be assigned to him and the period of time since the last discussions under sub-paragraph (1) took place.

PART 3 — prescribing and dispensing

Prescribing

38

The contractor shall ensure that any prescription form or repeatable prescription for drugs, medicines or appliances issued by a prescriber complies as appropriate with the requirements in paragraphs 39 to 44 .

39

(1) Subject to paragraphs 40 and 41, a prescriber shall order any drugs, medicines or appliances which are needed for the treatment of any patient who is receiving treatment under the contract by issuing to that patient a prescription form and such a prescription form shall not be used in any other circumstances.

(2) In issuing any such prescription form the prescriber shall himself sign the prescription form in ink with his initials, or forenames, and surname in his own handwriting and not by means of a stamp and shall so sign only after particulars of the order have been inserted in the prescription form, and –

(a) the prescription form shall not refer to any previous prescription form; and

(b) a separate prescription form shall be used for each patient.

(3) Where a prescriber orders the drug buprenorphine or diazepam or a drug specified in Schedule 2 to the Misuse of Drugs Regulations (Northern Ireland) 2002 (controlled drugs to which regulations 14, 15, 16, 18, 19, 20, 21, 23, 26 and 27 of those Regulations apply)⁶⁴ for supply by instalments for treating addiction to any drug specified in that Schedule, he shall –

(a) specify the number of instalments to be dispensed and the interval between each instalment; and

(b) order only such quantity of the drug as will provide treatment for a period not exceeding 14 days.

(4) In a case of urgency a prescriber may request a chemist to dispense a drug or medicine before a prescription form is issued, only if –

(a) that drug or medicine is not a Scheduled drug;

(b) that drug is not a controlled drug within the meaning of the Misuse of Drugs Act 1971⁶⁵, other than a drug which is for the time being specified in Schedules 4 or 5 to the Misuse of Drugs Regulations (Northern Ireland) 2002⁶⁶; and

(c) he undertakes to furnish the chemist, within 72 hours, with a prescription form completed in accordance with sub-paragraph (3).

(5) In a case of urgency a prescriber may request a chemist to dispense an appliance before a prescription form is issued only if –

(a) that appliance does not contain a Scheduled drug or a controlled drug within the meaning of the Misuse of Drugs Act 1971, other than a drug which is for the time being specified in Schedule 5 to the Misuse of Drugs Regulations (Northern Ireland) 2002;

(b) in the case of a restricted availability appliance, the patient is a person, or it is for a purpose, specified in the Drug Tariff; and

(c) he undertakes to furnish the chemist, within 72 hours, with a prescription form completed in accordance with sub-paragraph (3).

Restrictions on prescribing by medical practitioners

40

(1) In the course of treating a patient to whom he is providing treatment under the contract, a medical practitioner shall not order on a prescription form a drug, medicine or other substance specified in any directions given by the Department under Article 57D of the Order⁶⁷ as being drugs, medicines or other substances which may not be ordered for patients in the provision of medical services under the contract but may, subject to regulation 24(2)(b), prescribe such a drug, medicine or other substance for that patient in the course of that treatment under a private arrangement.

(2) In the course of treating a patient to whom he is providing treatment under the contract, a medical practitioner shall not order on a prescription form a drug, medicine or other substance specified in any directions given by the Department under Article 57D of the Order as being a drug, medicine or other substance which can only be ordered for specified patients and specified purposes unless –

(a) that patient is a person of the specified description;

(b) that drug, medicine or other substance is prescribed for that patient only for the specified purpose; and

but may, subject to regulation 24(2)(b), prescribe such a drug, medicine or other substance for that patient in the course of that treatment under a private arrangement.

(3) In the course of treating a patient to whom he is providing treatment under the contract, a medical practitioner shall not order on a prescription form a restricted availability appliance unless –

(a) the patient is a person, or it is for a purpose, specified in the Drug Tariff; and

(b) the practitioner endorses the face of the form with the reference “SL2”,

but may, subject to regulation 24(2)(b), prescribe such an appliance for that patient in the course of that treatment under a private arrangement.

(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Restrictions on prescribing by supplementary prescribers

41

(1) The contractor shall have arrangements in place to secure that a supplementary prescriber will –

(a) give a prescription for a prescription only medicine;

(b) administer a prescription only medicine for parenteral administration; or

as a supplementary prescriber only under the conditions set out in sub-paragraph (2).

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

(a) the person satisfies the applicable conditions set out in regulation 215 of the Human Medicines Regulations 2012 (prescribing and administration by supplementary prescribers), unless those conditions do not apply by virtue of any of the exemptions set out in the subsequent provisions of those Regulations ;

(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(c) the drug, medicine or other substance is not specified in any directions given by the Department under Article 57D of the Order⁶⁸ as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under the contract;

(d) the drug, medicine or other substance is not specified in any directions given by the Department under Article 57D of the Order as being a drug, medicine or other substance which can only be ordered for specified patients and specified purposes unless –

(i) the patient is a person of the specified description,

(ii) the medicine is prescribed for that patient only for the specified purposes, and

(iii) if a supplementary prescriber is giving a prescription, he endorses the face of the form with the reference “SL2”.

(e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3) Where the functions of a supplementary prescriber include prescribing, the contractor shall have arrangements in place to secure that that person will only give a prescription for –

(a) an appliance; or

(b) a medicine which is not a prescription only medicine,

as a supplementary prescriber under the conditions set out in sub-paragraph (4).

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

(a) the supplementary prescriber acts in accordance with a clinical management plan which is in effect at the time he acts and which contains the following particulars –

(i) the name of the patient to whom the plan relates,

(ii) the illness or conditions which may be treated by the supplementary prescriber,

(iii) the date on which the plan is to take effect, and when it is to be reviewed by the medical practitioner or dentist who is a party to the plan,

(iv) reference to the class or description of medicines or types of appliances which may be prescribed or administered under the plan,

(v) any restrictions or limitations as to the strength or dose of any medicine which may be prescribed or administered under the plan, and any period of administration or use of any medicine or appliance which may be prescribed or administered under the plan,

(vi) relevant warnings about known sensitivities of the patient to, or known difficulties of the patient with, particular medicines or appliances,

(vii) the arrangements for notification of –

(aa) suspected or known adverse reactions to any medicine which may be prescribed or administered under the plan, and suspected or known adverse reactions to any other medicine taken at the same time as any medicine prescribed or administered under the plan,

(bb) incidents occurring with the appliance which might lead, might have led or has led to the death or serious deterioration of state of health of the patient, and

(viii) the circumstances in which the supplementary prescriber should refer to, or seek the advice of, the medical practitioner or dentist who is a party to the plan;

(b) he has access to the health records of the patient to whom the plan relates which are used by any medical practitioner or dentist who is a party to the plan;

(d) if it is a prescription for a drug, medicine or other substance, that drug, medicine or other substance is not specified in any directions given by the Department under Article 57D of the Order as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under the contract;

(e) if it is a prescription for a drug, medicine or other substance, that drug, medicine or other substance is not specified in any directions given by the Department under Article 57D of the Order as being a drug, medicine or other substance which can only be ordered for specified patients and specified purposes unless –

(i) the patient is a person of the specified description,

(ii) the medicine is prescribed for that patient only for the specified purposes, and

(iii) when giving the prescription, he endorses the face of the form with the reference “SL2”;

(f) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(g) if it is a prescription for an appliance, the appliance is listed in Part IX of the Drug Tariff; and

(h) if it is a prescription for a restricted availability appliance –

(i) the patient is a person of a description mentioned in the entry in Part IX of the Drug Tariff in respect of that appliance,

(ii) the appliance is prescribed only for the purposes specified in respect of that person in that entry, and

(iii) when giving the prescription, he endorses the face of the form with the reference “SL2”.

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

(5) In sub-paragraph (4)(a), “clinical management plan” means a written plan (which may be amended from time to time) relating to the treatment of an individual patient agreed by –

(a) the patient to whom the plan relates;

(b) the medical practitioner or dentist who is a party to the plan; and

(6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interpretation of paragraphs 38, 39, 40 and 41

42

For the purposes of paragraphs 38, 39, 40 and 41 in their application to a contractor whose contract includes the provision of contraceptive services, drugs includes contraceptive substances and appliances includes contraceptive appliances.

Excessive prescribing

43

(1) The contractor shall not prescribe drugs, medicines or appliances whose cost or quantity, in relation to any patient, is, by reason of the character of the drug, medicine or appliance in question in excess of that which was reasonably necessary for the proper treatment of that patient.

(2) In considering whether a contractor has breached his obligations under sub-paragraph (1), the Board shall seek the views of the Local Medical Committee (if any) for its area.

Provision of dispensing services

44

(1) Without prejudice to any separate right a medical practitioner may have under regulation 12 of the Pharmaceutical Regulations (arrangements for provision of pharmaceutical services by doctors)⁶⁹, a contractor may provide dispensing services to his registered patients under the contract only if he is required to do so by the Board in accordance with the following provisions of this paragraph.

(2) A contractor may provide dispensing services to his registered patients only if he is required to do so by the Board in accordance with the following provisions of this paragraph.

(3) Where the Board, is satisfied that a person, by reason of –

(a) distance;

(b) inadequacy of means of communication; or

will have serious difficulty in obtaining from a chemist any drugs, medicines or appliances, other than scheduled drugs, required for that person’s treatment, the Board shall require the contractor with whom the person is a registered patient to supply such drugs, medicines and appliances to that person until further notice.

(4) Notwithstanding anything contained in sub-paragraph (3) –

(a) a contractor shall not be required to undertake the supply of drugs, medicines and appliances under sub-paragraph (3) if the contractor satisfies the Board that the contractor does not normally provide dispensing services under the contract;

(b) a contractor shall be entitled to receive reasonable notice from the Board that the contractor is required to undertake the supply of drugs, medicines and appliances under sub-paragraph (2) or that such supply is to be discontinued.

(5) A contractor which is required under this paragraph to provide dispensing services to some or all of his registered patients may provide any necessary dispensing services to a person whom that contractor has accepted as a temporary resident.

Terms relating to the provision of dispensing services

45

(1) A contractor which has been required to secure the provision of dispensing services under paragraph 44 shall ensure that dispensing services are provided in accordance with the following sub-paragraphs.

(2) Subject to sub-paragraphs (3) and (4), a contractor providing dispensing services shall –

(a) record an order for the provision of any drugs, medicines or appliances which are needed for the treatment of the patient on a prescription form completed in accordance with paragraph 39(3);

(b) provide those drugs, medicines or appliances in a suitable container;

(c) provide for the patient a drug or medicine specified in any directions given by the Department under Article 57D of the Order⁷⁰ as being a drug or medicine which can only be ordered for specified patients and specified purposes only if –

(i) that patient is a person of the specified description, and

(ii) the drug or medicine is supplied for that patient only for the specified purpose; and

(d) provide for the patient a restricted availability appliance only if the patient is a person, or it is for a purpose, specified in the Drug Tariff.

(3) Sub-paragraph (2) does not apply to drugs, medicines or appliances ordered on a prescription form by an independent prescriber or a supplementary prescriber .

(4) Where a patient presents an order on a prescription form for drugs, medicines or appliances signed by an independent prescriber or a supplementary prescriber , or an order for a restricted availability appliance signed by and endorsed on its face with the reference “SL2” by an independent prescriber or a supplementary prescriber , to a contractor who may provide dispensing services, the contractor may provide to the patient such of the drugs, medicines or appliances so ordered as he supplies in the normal course of his practice.

(5) Drugs, medicines or appliances provided under sub-paragraph (4) shall be provided in a suitable container.

(6) A contractor providing dispensing services shall not provide for a patient a drug or medicine specified in any directions given by the Department under Article 57D of the Order as being drugs or medicines which may not be ordered for patients in the provision of medical services under the contract, except that, where it has ordered a drug or medicine which has an appropriate non-proprietary name either by the name or by its formula, it may provide a drug or medicine which has the same specification notwithstanding that it is a drug or medicine specified in such directions (but, in the case of a drug or medicine which combines more than one drug, only if the combination has an appropriate non-proprietary name).

(7) Subject to sub-paragraph (9), nothing in this paragraph shall prevent a contractor providing a Scheduled drug or a restricted availability appliance in the course of treating a patient under a private arrangement.

(8) A contractor providing dispensing services shall comply with paragraph 14A of Schedule 2 to the Pharmaceutical Regulations, as if modified as follows –

(a) for “paragraph 13(a)”, substitute “sub-paragraph (2)(a) of paragraph 45 of Schedule 5 to the GMS Regulations ”;

(b) for “paragraph 11A(2)”, substitute “sub-paragraph (4) of that paragraph ”;

(c) for “a doctor who is required by the Board under regulation 12 to provide drugs and appliances to a patient”, substitute “a contractor providing dispensing services to a patient”; and

(d) for “doctor”, substitute “ contractor ”.

(9) The provisions of regulation 24 (fees and charges) apply in respect of the provision of any drugs, medicines or appliances by a contractor providing dispensing services as they apply in respect of prescriptions for drugs, medicines or appliances.

(10) A contractor who is entitled to provide dispensing services may, with the consent of the patient, order a drug, medicine or appliance for a patient on a prescription form, rather than providing it himself.

Dispensing contractor list

46

(1) Where the contractor is required by the Board under paragraph 44 to provide dispensing services to his patients and is actually doing so, the Board shall include –

(a) the contractor’s name; and

(b) the address of the practice premises from which he is required to dispense,

on a list of such contractors (to be called the dispensing contractors list) which it shall prepare, maintain and publish.

(2) The Board shall remove the name of the contractor from the list referred to in sub-paragraph (1) where the contractor ceases to provide dispensing services to his patients.

Provision of drugs, medicines and appliances for immediate treatment or personal administration

47

(1) Subject to sub-paragraph (2), a contractor –

(a) shall provide to a patient any drug, medicine or appliance, not being a Scheduled drug, where such provision is needed for the immediate treatment of that patient before a provision can otherwise be obtained; and

(b) may provide to a patient any drug, medicine or appliance, not being a Scheduled drug, which he personally administers or applies to that patient,

but shall, in either case, provide a restricted availability appliance only if it is for a person or a purpose specified in the Drug Tariff.

(2) Nothing in sub-paragraph (1) authorises a person to supply any drug or medicine to a patient otherwise than in accordance with Part 12 of the Human Medicines Regulations 2012 .

PART 4 — persons who perform services

Qualifications of performers

48

(1) Subject to sub-paragraph (2), no medical practitioner shall perform medical services under the contract unless he is –

(a) included in the primary medical services performers list maintained by that Board;

(b) not suspended from that list or from the Medical Register; and

(2) Sub-paragraph (1)(a) shall not apply in the case of –

(a) a medical practitioner employed by a Heath and Social Services Trust, (in Scotland) a Health Board, an NHS Trust or an NHS foundation trust who is providing services other than primary medical services at the practice premises;

(b) a person who is provisionally registered under section 15, 15A or 21 of the Medical Act 1983⁷² acting in the course of his employment in a resident medical capacity in an approved medical practice; or

(c) a GP Registrar who has applied to a Board to have his name included in its primary medical services performers list until the first of the following events arises –

(i) the Board notifies him of its decision on that application; or

(ii) the end of a period of two months, starting with and including the date on which his vocational training scheme began.

(d) a medical practitioner who is undergoing a programme of post-registration supervised clinical practice approved by the General Medical Council , but only in so far as any medical services such a medical practitioner performs constitute part of that programme.

(3) In this paragraph, “vocational training scheme” has the meaning given in regulation 2 of the Health and Personal Social Services (Primary Medical Services Performers Lists) Regulations (Northern Ireland ) 2004.

49

No health care professional other than one to whom paragraph 48 applies shall perform clinical services under the contract unless he is appropriately registered with his relevant professional body and his registration is not currently suspended.

50

Where the registration of a health care professional or, in the case of a medical practitioner, his inclusion in a primary medical services performers list is subject to conditions, the contractor shall ensure compliance with those conditions insofar as they are relevant to the contract.

51

No health care professional shall perform any clinical services unless he has such clinical experience and training as are necessary to enable him properly to perform such services.

Conditions for employment and engagement

52

(1) Subject to sub-paragraphs (2) and (3), a contractor shall not employ or engage a medical practitioner (other than one falling within paragraph 48(2)), unless –

(a) that practitioner has provided him with the name and address of the Board on whose primary medical services performers list he appears; and

(b) the contractor has checked that the practitioner meets the requirements in paragraph 48.

(2) Where the employment or engagement of a medical practitioner is urgently needed and is not possible for the contractor to check the matters referred to in paragraph 48 in accordance with sub-paragraph (1)(b) before employing or engaging him he may be employed or engaged on a temporary basis for a single period of up to 7 days whilst such checks are undertaken.

(3) Where the prospective employee is a GP Registrar, the requirements set out in sub-paragraph (1) shall apply with the modifications that –

(a) the name and address provided under sub-paragraph (1) may be the name and address of the Board on whose primary medical services performers list he has applied for inclusion; and

(b) confirmation that his name appears on those lists shall not be required until the end of the first two months of the Registrar’s training period.

53

(1) A contractor shall not employ or engage –

(a) a health care professional other than one to whom paragraph 48 applies unless the contractor has checked that he meets the requirements in paragraph 49; or

(b) a health care professional to perform clinical services unless he has taken reasonable steps to satisfy himself that he meets the requirements in paragraph 51.

(2) Where the employment or engagement of a health care professional is urgently needed and it is not possible to check the matters referred to in paragraph 49 in accordance with sub-paragraph (1)(b) before employing or engaging him, he may be employed or engaged on a temporary basis for a single period of up to 7 days whilst such checks are undertaken.

(3) When considering a health care professional’s experience and training for the purposes of sub-paragraph (1)(b), the contractor shall have regard in particular to –

(a) any post-graduate or post-registration qualification held by the health care professional; and

(b) any relevant training undertaken by him and any relevant clinical experience gained by him.

54

(1) The contractor shall not employ or engage a health care professional to perform medical services under the contract , other than a medical practitioner falling within paragraph 48(2)(d), unless –

(a) that person has provided two clinical references, relating to two recent posts (which may include any current post) as a health care professional which lasted for three months without a significant break, or where this is not possible, a full explanation and alternative referees; and

(b) the contractor has checked and is satisfied with the references.

(2) Where the employment or engagement of a health care professional is urgently needed and it is not possible to obtain and check the references in accordance with sub-paragraph (1)(b) before employing or engaging him, he may be employed or engaged on a temporary basis for a single period of up to 14 days whilst his references are checked and considered, and for an additional single period of a further 7 days if the contractor believes the person supplying those references is ill, on holiday or otherwise temporarily unavailable.

(3) Where the contractor employs or engages the same person on more than one occasion within a period of three months, he may rely on the references provided on the first occasion, provided that those references are not more than twelve months old.

55

(1) Before employing or engaging any person to assist him in the provision of services under the contract, the contractor shall take reasonable care to satisfy himself that the person in question is both suitably qualified and competent to discharge the duties for which he is to be employed or engaged.

(2) The duty imposed by sub-paragraph (1) is in addition to the duties imposed by paragraphs 52 to 54.

(3) When considering the competence and suitability of any person for the purpose of sub-paragraph (1), the contractor shall have regard, in particular, to –

(a) that person’s academic and vocational qualifications;

(b) his education and training; and

Training

56

The contractor shall ensure that for any health care professional who is –

(a) performing clinical services under the contract; or

(b) employed or engaged to assist in the performance of such services

there are in place arrangements for the purpose of maintaining and updating his skills and knowledge in relation to the services which he is performing or assisting in performing.

57

The contractor shall afford to each employee reasonable opportunities to undertake appropriate training with a view to maintaining that employee’s competence.

Terms and conditions

58

The contractor shall only offer employment to a general medical practitioner on terms and conditions which are no less favourable than those contained in the “Model terms and conditions of service for a salaried general practitioner employed by a GMS practice” published by the British Medical Association and the NHS Confederation as item 1.2 of the supplementary documents to the new GMS contract 2003⁷³.

Arrangements for GP Registrars

59

(1) The contractor shall only employ a GP Registrar... subject to the conditions in sub-paragraph (2).

(2) The conditions referred to in sub-paragraph (1) are that the contractor shall not, by reason only of having employed or engaged a GP Registrar, reduce the total number of hours for which other medical practitioners perform primary medical services under the contract or for which other staff assist them in the performance of those services.

(3) A contractor which employs a GP Registrar shall –

(a) offer him terms of employment in accordance with the rates and subject to the conditions contained in any guidance given by the Department concerning the grants, fees, travelling and other allowances payable to GP Registrars; and

(b) take into account any guidance issued by the Department in relation to the GP Registrar Scheme.

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 Order⁷⁴.

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 1989⁷⁵.

(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 Order⁷⁶; 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 1995⁷⁷; 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) –

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