Legalize / United Kingdom / Scotland / Scottish-Statutory-Instrument

The National Health Service (General Medical Services Contracts) (Scotland) Regulations 2018

Type Scottish-Statutory-Instrument

Publication 2018-02-15

Last updated 2026-03-14

State In force

Jurisdiction Scotland

Department King's Printer for Scotland

Source legislation.gov.uk

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(d) ensuring that test results are followed up appropriately.

(3) The records referred to in sub‑paragraph (1)(b) are an accurate record of the carrying out of a cervical screening test, the result of the test and any clinical follow up requirements.

Contraceptive services

3

(1) A contractor whose contract includes the provision of contraceptive services must make available to all its patients who request such services the services described in sub‑paragraph (2).

(2) The services referred to in sub‑paragraph (1) are—

(a) the giving of advice about the full range of contraceptive methods;

(b) where appropriate, the medical examination of patients seeking such advice;

(c) the treatment of such patients for contraceptive purposes and the prescription of contraceptive substances and appliances (excluding the fitting and implanting of intrauterine devices and implants);

(d) the giving of advice about emergency contraception and, where appropriate, the supplying or prescribing of emergency hormonal contraception or, where the contractor has a conscientious objection to emergency contraception, a prompt referral to another provider of primary medical services who does not have such conscientious objections;

(e) the provision of advice and referral in cases of unplanned or unwanted pregnancy, including advice about the availability of free pregnancy testing in the practice area and, where appropriate, where the contractor has a conscientious objection to the termination of pregnancy, a prompt referral to another provider of primary medical services who does not have such conscientious objections;

(f) the giving of initial advice about sexual health promotion and sexually transmitted infections; and

(g) the referral as necessary for specialist sexual health services, including tests for sexually transmitted infections.

Vaccinations and immunisations

4

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Childhood vaccinations and immunisations

5

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Child health surveillance

6

(1) A contractor whose contract includes the provision of child health surveillance services must, in respect of any child under the age of 5 for whom it has responsibility under the contract—

(a) provide all the services described in sub‑paragraph (2), other than any examination so described which the parent refuses to allow the child to undergo, until the date upon which the child attains the age of 5 years; and

(b) maintain such records as are specified in sub‑paragraph (3).

(2) The services referred to in sub‑paragraph (1)(a) are—

(a) the monitoring—

(i) by the consideration of any information concerning the child received by or on behalf of the contractor; and

(ii) on any occasion when the child is examined or observed by or on behalf of the contractor (whether pursuant to sub-paragraph 2(b), or otherwise),

of the health, well‑being and physical, mental and social development (all of which characteristics are referred to in this paragraph as “development”) of the child while under the age of 5 years with a view to detecting any deviations from normal development; and

(b) the examination of the child at a frequency that has been agreed with the Health Board in accordance with the nationally agreed evidence based programme set out in the fourth edition of “Health for all Children”⁷⁰.

(3) The records mentioned in sub‑paragraph (1)(b) are an accurate record of—

(a) the development of the child while under the age of 5 years, compiled as soon as is reasonably practicable following the first examination of that child and, where appropriate, amended following each subsequent examination mentioned in that sub‑paragraph; and

(b) the responses (if any) to offers made to the child’s parent for the child to undergo any examination referred to in sub‑paragraph (2)(b).

Maternity medical services

7

(1) A contractor whose contract includes the provision of maternity medical services must provide—

(a) to female patients who have been diagnosed as pregnant all necessary maternity medical services throughout the ante‑natal period;

(b) to female patients and their babies all necessary maternity medical services throughout the post-natal period other than neonatal checks;

(c) all necessary maternity medical services to female patients whose pregnancy has terminated as a result of miscarriage or abortion or, where the contractor has a conscientious objection to the termination of pregnancy, prompt referral to another provider of primary medical services who does not have such conscientious objections.

(2) In this paragraph—

“ante‑natal period” means the period from the start of the pregnancy to the onset of labour;

“maternity medical services” means—in relation to female patients (other than babies) all primary medical services relating to pregnancy, excluding intra partum care; andin relation to babies, any primary medical services necessary in their first 14 days of life; and

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

SCHEDULE 2 — OPT OUTS OF ADDITIONAL SERVICES

Opt outs of additional services: general

1

(1) In this schedule—

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

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

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

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

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

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

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

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

(4) The discussions mentioned in sub‑paragraph (3) must be completed within the period of 10 days beginning with the date on which the preliminary opt out notice was received by the Health Board or as soon as reasonably practicable thereafter.

(5) If following the discussions mentioned in sub‑paragraph (3), the contractor still wishes to opt out of the provision of the additional service, it must send an opt out notice to the Health Board.

(6) An opt out notice must specify—

(a) the additional service concerned;

(b) whether the contractor wishes to—

(i) opt out permanently; or

(ii) opt out temporarily;

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

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

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

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

(7) Where a contractor has given two previous temporary opt out notices within the period of 3 years ending with the date of the service of the latest opt out notice (whether or not the same additional service is concerned), the latest opt out notice will be treated as a permanent opt out notice (even if the opt out notice says that the contractor wishes to opt out temporarily).

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

Temporary opt outs and permanent opt outs following temporary opt outs

2

(1) As soon as is reasonably practicable and in any event within the period of 7 days beginning on the date on which a temporary opt out notice mentioned in paragraph 1(5) is received, the Health Board must—

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

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

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

(2) A Health Board may reject the temporary opt out notice on the ground that the contractor—

(a) is providing additional services to patients other than its own registered patients or enhanced services; or

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

(3) The date specified by the Health Board for the commencement of the temporary opt out is to be, wherever reasonably practicable, the date requested by the contractor in its opt out notice.

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

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

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

(b) the Health Board specifies a later date under sub‑paragraph (6), in which case the suspension is to end on that date;

(c) sub‑paragraph (7) applies and the contractor refers the matter to the NHS dispute resolution procedure (or, where applicable in the case of a non‑NHS contract, commences court proceedings), in which case the suspension will end—

(i) where the outcome of the dispute is to uphold the decision of the Health Board, on the day after the date of the decision of the adjudicator or, as the case may be, the court;

(ii) where the outcome of the dispute is to overturn the decision of the Health Board, 28 days after the decision of the adjudicator or, as the case may be, the court; or

(iii) where the contractor ceases to pursue the NHS dispute resolution procedure or, as the case may be, court proceedings, on the day after the date that the contractor withdraws its claim or the procedure is or proceedings are otherwise terminated by the adjudicator or the court;

(d) sub‑paragraph (9) applies and—

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

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

(iii) the Health Board notifies the contractor after the end date that the assessment panel has not approved its proposed decision to refuse the contractor’s request to opt out permanently under sub‑paragraph (16), in which case the suspension will come to an end 28 days after the date of service of the notice under that paragraph.

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

(7) Where the Health Board considers that—

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

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

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

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

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

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

(11) A Health Board may only give a notice under sub‑paragraph (10) with the approval of the assessment panel.

(12) The Health Board must ensure that an assessment panel is appointed by another Health Board as soon as is practicable to consider and determine whether or not to approve the Health Board’s proposed decision to refuse a permanent opt out.

(13) The Health Board must provide the assessment panel with such information as the assessment panel may reasonably require to enable it to reach a determination.

(14) Where a Health Board seeks the approval of the assessment panel to a proposed decision to refuse a permanent opt out, it must notify the contractor of having done so.

(15) If the assessment panel has not reached a decision as to whether or not to approve the Health Board’s proposed decision to refuse a permanent opt out before the end date, the contractor’s obligation to provide the additional service is to remain suspended until the date specified in sub‑paragraph (5)(d)(ii) or (iii) (whichever is applicable).

(16) Where after the end date the assessment panel notifies the Health Board that it does not approve the Health Board’s proposed decision to refuse a permanent opt out, the Health Board must notify the contractor in writing of this fact as soon as is reasonably practicable.

(17) A temporary opt out or a permanent opt out commences, and a temporary opt out ends, at 0800 hours on the relevant day unless—

(a) the day is not a working day, in which case the opt out will take effect on the next working day at 0800 hours; or

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

(18) Any decision or determination by the assessment panel for the purposes of this paragraph may be reached by a majority.

Permanent opt outs

3

(1) In this paragraph—

“Aday” is the day specified by the contractor in its permanent opt out notice to a Health Board for the commencement of the permanent opt out;

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

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

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

(a) approve the opt out notice; or

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

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

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

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

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

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

(7) If the Health Board is not successful in finding an alternative provider to take on the provision of the additional service from A day, then it must notify the contractor in writing of this fact not later than one month before A day, and—

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

(b) in a case where A day is six months after the service of the opt out notice, the contractor is to continue to provide the additional service until C day unless at least one month before C day it receives a notice from the Health Board under sub‑paragraph (11) that it has made an application to an assessment panel under sub‑paragraph (10) seeking approval of the assessment panel to a decision to refuse a permanent opt out or to delay the commencement of a permanent opt out until after C day.

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

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

(10) A Health Board may, if it considers that there are exceptional circumstances, make an application to the assessment panel for approval of a decision to—

(a) refuse a permanent opt out; or

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

(11) As soon as practicable after making an application under sub‑paragraph (10) to the assessment panel, the Health Board must notify the contractor in writing that it has made such an application.

(12) The Health Board must ensure that an assessment panel is appointed by another Health Board as soon as is practicable to consider and determine whether or not to approve the Health Board’s proposed decision to refuse a permanent opt out or to postpone the commencement of a permanent opt out until after C day.

(13) The Health Board must provide the assessment panel with such information as the assessment panel may reasonably require to enable it to reach a determination.

(14) On receiving an application under sub‑paragraph (10) for approval of a decision to refuse a permanent opt out, the assessment panel must—

(a) approve the Health Board’s application;

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

(15) On receiving an application under sub‑paragraph (10) for approval of a decision to postpone the commencement of a permanent opt out until after C day, the assessment panel must—

(a) approve the Health Board’s application;

(b) reject the Health Board’s application, but nonetheless recommend—

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

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

(16) The assessment panel must notify the Health Board and the contractor in writing of its decision under sub‑paragraph (14) or (15) as soon as is practicable, including reasons for its decision.

(17) Where the assessment panel—

(a) approves a decision to refuse an opt out under sub‑paragraph (14)(a); or

(b) recommends that a permanent opt out be refused under sub‑paragraph (15)(b)(ii),

the Health Board must notify the contractor in writing that the contractor may not opt out of the additional service.

(18) Where a Health Board notifies a contractor under sub‑paragraph (17), the contractor may not serve a preliminary opt out notice in respect of that additional service for a period of twelve months beginning with the date of service of the Health Board’s notice under sub‑paragraph (17) unless there has been a change in the circumstances of the contractor in relation to its ability to deliver services under the contract.

(19) Where the assessment panel—

(a) recommends a different date for the commencement of the permanent opt out under sub‑paragraph (14)(b);

(b) approves a Health Board’s application to postpone a permanent opt out under sub‑paragraph (15)(a); or

the Health Board must in accordance with the decision of the assessment panel notify the contractor in writing of its decision and the notice must specify the date of the commencement of the permanent opt out.

(20) Where the assessment panel rejects the Health Board’s application under sub‑paragraph (14)(c) or (15)(c), the Health Board must notify the contractor in writing that there will be a permanent opt out, and the permanent opt out must commence on C day or 28 days after the date of service of the Health Board’s notice, whichever is the later.

(21) If the assessment panel has not reached a decision on the Health Board’s application under sub‑paragraph (10) before C day, the contractor’s obligation to provide the additional service will continue until a notice is served on the contractor by the Health Board under sub‑paragraph (19) or (20).

(22) Nothing in sub‑paragraphs (1) to (21) above prevents the contractor and the Health Board from agreeing a different date for the termination of the contractor’s duty under the contract to provide the additional service and, accordingly, varying the contract in accordance with paragraph 94(1) of schedule 6.

(23) The permanent opt out takes effect at 0800 hours on the relevant day unless—

(a) the day is not a working day, in which case the opt out will take effect on the next working day at 0800 hours; or

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

(24) Any decision or determination by the assessment panel for the purposes of this paragraph may be reached by a majority.

Informing patients of opt-outs

4

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

(2) The contractor must, if requested by the Health Board inform the contractor’s registered patients of an opt out and the arrangements made for them to receive the additional service by—

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

(b) including the information in the practice leaflet.

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

SCHEDULE 3 — MINIMUM STANDARDS FOR PRACTICE PREMISES

1

The contractor must ensure that it meets minimum standards for its practice premises which are that—

(a) the contractor complies with any obligations under the Health and Safety at Work etc. Act 1974⁷¹ (and provision made under that Act) and the Equality Act 2010⁷² in relation to—

(i) the design or construction of the practice premises; and

(ii) the approach or access to the practice premises,

which the contractor has to its own members (where applicable), staff, contractors and to persons to whom it provides primary medical services, including taking such steps as are reasonable to—

(aa) provide for ease of access to the practice premises and ease of movement within the practice premises for all users of the practice premises (including wheelchair users);

(bb) provide adequate sound and visual systems for the hearing and visually impaired; and

(cc) remove barriers to the employment of disabled people;

(b) there are adequate facilities for the elderly and young children, including nappy-changing and feeding facilities;

(c) there are adequate lavatory and hand hygiene facilities for all persons on the practice premises which meet current infection control standards;

(d) there is such equipment as is necessary to enable the contractor to properly perform appropriate clinical services in the consultation rooms and treatment areas;

(e) the practice have arrangements for instrument decontamination that comply with any national guidelines for instrument decontamination published by the Scottish Ministers from time to time which apply to primary care in accordance with paragraph 119 of schedule 6;

(f) subject to sub-paragraph (g), consulting rooms and treatment areas are properly equipped for use by practitioners working in the practice, including—

(i) adequate arrangements to ensure the privacy of consultations; and

(ii) patients have personal privacy when dressing or undressing, either in a separate examination room or in a screened-off area around an examination couch within the relevant consulting rooms and treatment areas;

(g) in the case of branch surgeries where the contractor provides outlying consultation facilities in premises usually used for other purposes, and these outlying consultation facilities meet with the approval of the Health Board, the standards set out in sub-paragraph (f) do not apply in relation to the outlying consultation facilities;

(h) the access arrangements for the practice premises are convenient for all users;

(i) there are washbasins connected to running hot and cold water (ideally distributed through elbow, knee or sensor operated taps) in all consulting rooms and treatment areas, or, if this is not possible, then in immediately adjacent rooms;

(j) there are adequate internal waiting areas with—

(i) enough seating to meet all normal requirements, either in the reception area or elsewhere; and

(ii) a facility for patients to communicate confidentially with reception staff, including by telephone;

(k) there are adequate standards of lighting, heating and ventilation;

(l) the premises fittings and furniture of the practice premises are in good repair and (when being used for the provision of primary medical services) clean and hygienic;

(m) there are arrangements for the storage and disposal of clinical waste and that these arrangements comply with the legislative requirements and national guidance in place from time to time in accordance with paragraph 119 of schedule 6;

(n) there are, in the practice premises, arrangements for adequate fire precautions designed in accordance with the Building (Scotland) Regulations 2004⁷³ and agreed with the local fire authority, including provision for safe exit from the practice premises;

(o) there is adequate security for drugs, records, prescription pads and pads of doctors’ statements; and

(p) if the premises are to be used for minor surgery or the treatment of minor injuries, there are necessary facilities and equipment to enable the proper performance of these procedures in the practice premises.

SCHEDULE 4 — LIST OF PRESCRIBED MEDICAL CERTIFICATES

Description of medical certificate	Enactment under or for the purpose of which certificate required	Alternative provider	Alternative provider
1. To support a claim or to obtain payment either personally or by proxy; to prove incapacity to work or for self‑support for the purposes of an award by the Secretary of State; or to enable proxy to draw pensions etc.	Naval and Marine Pay and Pensions Act 1865⁷⁴Air Force (Constitution) Act 1917⁷⁵Pensions (Navy, Army, Air Force and Mercantile Marine) Act 1939⁷⁶Personal Injuries (Emergency Provisions) Act 1939⁷⁷Pensions (Mercantile Marine) Act 1942⁷⁸Polish Resettlement Act 1947⁷⁹Social Security Administration Act 1992⁸⁰Social Security Contributions and Benefits Act 1992⁸¹
1. To support a claim or to obtain payment either personally or by proxy; to prove incapacity to work or for self‑support for the purposes of an award by the Secretary of State; or to enable proxy to draw pensions etc.	Social Security Act 1998⁸²	Health care professional⁸³	Health care professional⁸³
2. To establish pregnancy for the purpose of obtaining welfare foods.	Section 13 of the Social Security Act 1988 (schemes for distribution etc. of welfare foods)⁸⁴	Registered midwife or registered nurse⁸⁵	Registered midwife or registered nurse⁸⁵
3. To secure registration of still‑birth.	Section 21 of the Registration of Births, Deaths and Marriages (Scotland) Act 1965 (special provision as to registration of still‑birth)⁸⁶	Registered midwife	Registered midwife
4. To establish unfitness for jury service.	Criminal Procedure (Scotland) Act 1995⁸⁷Court Of Session Act 1988⁸⁸
5. To support late application for reinstatement in civil employment or notification of non-availability to take up employment owing to sickness.	Reserve Forces (Safeguard of Employment) Act 1985⁸⁹
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(a)	a registered nurse;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(b)	a registered dentist;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(c)	a registered dispensing optician or a registered optometrist;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(d)	a registered pharmacist;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(e)	a registered osteopath;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(f)	a registered chiropractor
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(g)	a Christian Science practitioner;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(h)	a person registered as a member of a profession to which the Health Professions Order 2001 for the time being extends;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(i)	The manager of a care home service registered under a registered care home under Part 5of the Public Services Reform (Scotland) Act 2010⁹¹;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(j)	the warden of premises forming one of a group of premises provided for persons of pensionable age or disabled persons for which there is a resident warden, where the applicant states that he resides in such premises;
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(k)	a hospital manager (or a person on behalf of a manager) within the meaning of section 329 of the Mental Health (Care and Treatment) (Scotland) Act 2003⁹²; or
6. To enable a person to be registered as an absent voter on grounds of physical incapacity.	Paragraph 3(3) (b) of schedule 4 of Representation of the People Act 2000⁹⁰	(l)	a person registered as a social worker
7. To support applications for certificates conferring exemption from charges in respect of drugs, medicines and appliances.	National Health Service (Scotland) Act 1978⁹³National Health Service (Free Prescriptions and Charges for Drugs and Appliances) (Scotland) Regulations 2011⁹⁴	Registered midwife or health care professional	Registered midwife or health care professional
8. To support a claim by or on behalf of a severely mentally impaired person for exemption from liability to pay council tax or eligibility for a discount in respect of the amount of council tax payable.	Paragraph 2(1) (b) of schedule 1 of the Local Government Finance Act 1992⁹⁵
10. To secure certification of cause of death.	Section 24 of the Registration of Births, Deaths and Marriages (Scotland) Act 1965 (certificate of cause of death)⁹⁶

SCHEDULE 5 — FEES AND CHARGES

1

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

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

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

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

(i) pursuant to the provisions of section 57 of the Act⁹⁷ (accommodation and services for private patients); or

(ii) in accommodation provided by a care home service which is not providing services under the Act,

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

(d) under section 158 of the Road Traffic Act 1988 (payment for emergency treatment of traffic casualties)⁹⁸;

(e) when the contractor treats a patient under regulation 28(3), in which case the contractor is entitled to demand and accept a reasonable fee (recoverable in certain circumstances under regulation 28(4)) for any treatment given, if the contractor gives the patient a receipt;

(f) for attending and examining (but not otherwise treating) a patient—

(i) at the patient’s request at a police station in connection with possible criminal proceedings against the patient;

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

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

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

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

(i) for a medical examination—

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

(ii) for the purpose of creating a report—

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

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

(j) for prescribing or providing drugs or medicines for malaria chemoprophylaxis.

SCHEDULE 6 — OTHER CONTRACTUAL TERMS

PART 1 — PROVISION OF SERVICES

Premises

1

Subject to any plan which is included in the contract pursuant to regulation 21(3), the contractor must ensure that the premises used for the provision of services under the contract are—

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

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

Telephone services

2

(1) The contractor must not be a party to any contract or other arrangement under which the number for telephone services to be used—

(a) by patients to contact the practice for any purpose related to the contract; or

(b) by any other person to contact the practice in relation to services provided as part of the health service,

starts with the digits 087, or 09 or consists of a personal number, unless the service is provided free to the caller.

(2) In this paragraph, “personal number” means a telephone number which starts with the number 070 followed by a further 8 digits.

Attendance at practice premises

3

(1) The contractor must take steps to ensure that any patient who—

(a) has not previously made an appointment; and

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

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

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

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

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

Attendance outside practice premises

4

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

(a) attendance on the patient is required; and

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

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

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

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

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

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

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

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

Newly registered patients

5

(1) Where a patient has been—

(a) accepted on a contractor’s list of patients under paragraph 12; or

(b) assigned to that list by the Health Board,

the contractor must, in addition to and without prejudice to its other obligations in respect of that patient under the contract, invite the patient to participate in a consultation either at the contractor’s practice premises or, if the medical condition of the patient so warrants, at one of the places referred to in paragraph 4(2).

(2) An invitation under sub-paragraph (1) must be issued within six months of the date of the acceptance of the patient on, or their assignment to, the contractor’s list and may offer the patient a consultation with—

(a) the contractor;

(b) a medical practitioner employed or engaged by the contractor; or

(3) Where a patient (or, where appropriate, in the case of a patient who is a child, the child’s parent) agrees to participate in a consultation mentioned in sub-paragraph (1), with a person mentioned in sub-paragraph (2), that person must, in the course of that consultation make such inquiries and undertake such examinations as appear to him or her to be appropriate in all the circumstances.

Clinical reports

6

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

(2) The Health Board must send any report received under sub-paragraph (1)—

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

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

Storage of vaccines

7

The contractor must ensure that—

(a) all vaccines are stored in a pharmaceutical refrigerator, designed for the purpose of storing vaccines or medicines, in accordance with the manufacturer’s instructions;

(b) all refrigerators in which vaccines are stored have a calibrated maximum/minimum digital thermometer on which readings are taken on all working days to ensure the temperature remains within the specified range of +2°C to +8°C; and

Infection control

8

The contractor must ensure that it has appropriate arrangements for infection control and decontamination.

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

9

(1) A contractor which does not provide to its registered patients or to persons whom it has accepted as temporary residents—

(a) a particular additional service; ...

(b) a particular enhanced service; or

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

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

(a) co-operate, insofar as it is reasonable, with any person responsible for the provision of that service or those services; and

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

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

10

Where a contractor is to cease to be required to provide to its patients—

(a) a particular additional service; ...

(b) a particular enhanced service, or

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

PART 2 — PATIENTS

List of patients

11

The Health Board must prepare and keep up to date a list of the patients—

(a) who have been accepted by the contractor for inclusion in its list of patients under paragraph 12 and who have not subsequently been removed from that list under paragraphs 16 to 24; and

(b) who have been assigned to the contractor under paragraph 29 or 30 and whose assignment has not subsequently been rescinded.

Application for inclusion in a list of patients

12

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

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

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

(4) An application may be made—

(a) on behalf of any child—

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

(ii) by a person duly authorised by a local authority, where the child is in the care of a local authority under the Children (Scotland) Act 1995¹⁰⁰; or

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

(b) on behalf of any adult who is incapable of making such an application, or authorising such an application to be made on their behalf, by the primary carer of that person or by a person authorised under the Adults with Incapacity (Scotland) Act 2000¹⁰¹ to act on the patient’s behalf.

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

(6) On receipt of a notice under sub-paragraph (5), the Health Board must—

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

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

Temporary residents

13

(1) The contractor may, if its list of patients is open, accept a person as a temporary resident provided it is satisfied that the person is—

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

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

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

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

(a) three months; or

(b) such shorter period for which it agreed to accept the person as a patient,

must notify the person either orally or in writing and its responsibility for that patient will cease 7 days after the date on which the notification was given.

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

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

14

(1) The contractor may only refuse an application made under paragraph 12 or 13 if it has reasonable grounds for doing so which do not relate to the applicant’s race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

(2) Subject to sub-paragraph (5), the reasonable grounds referred to in paragraph (1) may, in the case of applications made under paragraph 12, include the ground that the applicant does not live in the contractor’s practice area.

(3) A contractor which refuses an application made under paragraph 12 or 13 must, within 14 days of its decision, notify the applicant (or, in the case of a child or incapable adult, the person making the application on their behalf) in writing of the refusal and the reason for it.

(4) The contractor must keep a written record of refusals of applications made under paragraph 12 and of the reasons for them and must make this record available to the Health Board on request.

(5) For the purpose of sub-paragraph (2), “reasonable grounds” do not include refusal of an application from a person who—

(a) at the time of making the application, is detained in a prison, a young offenders institution or the state hospital, and

(b) will live after their release from detention in the contractor’s practice area.

(6) For the purpose of sub-paragraph (5)—

“young offenders institution” has the meaning given in section 19(1)(b) of the Prisons (Scotland) Act 1989, and

“state hospital” has the meaning given in section 102 of the National Health Service (Scotland) Act 1978.

Patient preference of practitioner

15

(1) Where the contractor has accepted an application for inclusion in its list of patients, it must—

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

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

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

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

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

Removal from the list at the request of the patient

16

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

(2) Where the Health Board—

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

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

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

(3) A removal in accordance with sub-paragraph (2) will take effect on whichever is the earlier of the following dates—

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

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

(4) The Health Board must, as soon as practicable, notify in writing—

(a) the patient; and

(b) the contractor,

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

(5) In this paragraph and in paragraphs 17(1)(b) and (10), 18(6) and (7), 20 and 23, a reference to a request received from or advice, information or notification required to be given to a patient includes a request received from or advice, information or notification required to be given to—

(a) in the case of a patient who is a child, a parent or other person referred to in paragraph 12(4)(a); or

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

Removal from the list at the request of the contractor

17

(1) Subject to paragraph 18, a contractor which has reasonable grounds for wishing a patient to be removed from its list of patients which do not relate to the applicant’s race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition must—

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

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

(2) Where, in the reasonable opinion of the contractor—

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

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

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

(3) Except in the circumstances described in sub-paragraph (4), a contractor may only request a removal under sub‑paragraph (1) if, within the period of twelve months prior to the date of its request to the Health Board it has warned the patient that the patient is at risk of removal and explained to the patient the reasons for this.

(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

(4) The circumstances referred to in sub‑paragraph (3) are that—

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

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

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

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

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

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

(b) in the case of a contract with a partnership, a partner in that partnership;

(d) in the case of a contract with a company, a member of that company;

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

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

(g) any other person present—

(i) on the practice premises; or

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

(6) The contractor must record in writing—

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

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

(7) The contractor must keep a written record of removals under this paragraph which includes—

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

(b) the circumstances of the removal; and

and must make this record available to the Health Board on request.

(8) A removal requested in accordance with sub-paragraph (1) will, subject to sub‑paragraph (9) take effect from whichever is the earlier of the following dates—

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

(b) the eighth day after the Health Board receives the notice referred to in sub‑paragraph (1)(a).

(9) Where, on the date on which the removal would take effect under sub-paragraph (8), the contractor is treating the patient at intervals of less than 7 days, the contractor must notify the Health Board in writing of the fact and the removal will take effect on whichever is the earlier of the following dates—

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

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

(10) The Health Board must notify in writing—

(a) the patient; and

(b) the contractor,

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

Removal from the list of patients who are violent

18

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

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

(b) the contractor has reported the incident to the police or the Procurator Fiscal,

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

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

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

(b) in the case of a contract with a partnership, a partner in that partnership;

(d) in the case of a contract with a company, a member of that company;

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

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

(g) any other person present—

(i) on the practice premises; or

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

(3) Notification under sub-paragraph (1) may be given by any means including telephone and must be confirmed in writing within 7 days (and for this purpose transmission by electronic means is not a written one).

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

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

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

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

(6) Where, pursuant to this paragraph, the contractor has notified the Health Board that it wishes to have a patient removed from the contractor’s list of patients with immediate effect, it must inform the patient concerned unless—

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

(b) it has reasonable grounds for believing that to do so would—

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

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

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

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

Removals from the list of patients registered elsewhere

19

(1) The Health Board must remove a patient from the contractor’s list of patients if—

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

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

(2) A removal in accordance with sub-paragraph (1) will take effect—

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

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

(3) The Health Board must notify the contractor in writing of patients removed from its list of patients under sub‑paragraph (1).

Removals from the list of patients who have moved

20

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

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

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

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

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

Removals from the list of patients who have moved

21

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

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

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

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

22

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

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

(b) is in Her Majesty’s Forces;

(d) has died.

(2) A removal in accordance with sub-paragraph (1) will take effect—

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

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

(3) The Health Board must notify the contractor in writing of patients removed from its list of patients under sub‑paragraph (1).

Removals from the list of patients accepted elsewhere as temporary residents

23

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

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

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

(2) The Health Board must notify in writing of a removal under sub‑paragraph (1)—

(a) the contractor; and

(b) where practicable, the patient.

(3) A notification to the patient under sub‑paragraph (2)(b) must inform the patient of—

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

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

Removals from the list of pupils etc. of a school

24

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

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

(3) The Health Board must notify the contractor in writing of patients removed from its list of patients under sub‑paragraph (1).

Termination of responsibility for patients not registered with the contractor

25

(1) Where a contractor—

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

(i) from a person who is not included in its list of patients; or

(ii) from a person whom the contractor has not accepted as a temporary resident; or

(iii) on behalf of a person mentioned in (i) or (ii) above, from one of the persons specified in paragraph 12(4); and

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

its responsibility for that patient will be terminated in one of the circumstances referred to in sub‑paragraph (2).

(2) The circumstances referred to in sub‑paragraph (1) are—

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

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

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

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

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

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

(5) A termination under sub‑paragraph (2)(b) will take effect—

(a) from the date on which the notice is given where the grounds for termination are those specified in paragraph 18(1); or

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

Closure of lists of patients

26

(1) A contractor which wishes to close its list of patients must notify the Health Board in writing to that effect.

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