The National Health Service (General Medical Services) (Scotland) Regulations 1995

• (14) A doctor acting as a deputy for another doctor may not treat the other doctor’s patients at any place approved under paragraph 27 unless it is so approved for the other doctor.

• (15) A deputy or assistant (other than a partner or assistant whose name is included on the medical list or an associate) shall, in addition to signing with his own name any certificate, prescription form or other document issued by him under these terms of service, insert therein if it does not already appear the name of the doctor for whom he is acting as deputy or assistant.

• (16) For the purposes of this paragraph the word “partner” shall include any partner who is otherwise deemed under the Regulations to be an assistant and the word “assistant” shall not include such a person.

19

• (1) Before entering into regular or standing arrangements with a deputising service for the provision of a deputy or deputies, a doctor shall—

• (a) obtain the written agreement of the deputising service that any doctor provided to him by the deputising service will be suitably experienced within the meaning of section 21 of the Act (other than by virtue of being a restricted services principal) or will have the acquired right specified in regulation 5(1)(d) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994[^f00027]; and

• (b) obtain the consent of the Board.

• (2) The Board shall refuse its consent if the doctor has not obtained the written agreement of the deputising service as referred to in sub-paragraph (1)(a).

• (3) In giving such consent the Board shall impose the condition that the agreement referred to in sub-paragraph (1)(a) remain in force, and may impose such other conditions, including conditions in relation to the standards and the facilities provided by the deputising service, having regard to the advice of the Area Medical Committee on these standards and facilities, as it considers necessary or expedient to ensure—

• (a) that the doctor’s patients will receive all proper and necessary treatment, and

• (b) that the arrangements with the deputising service will have due regard to the provisions of these terms of service.

• (4) References below in this paragraph to refusing consent and to conditions do not include refusing consent under sub-paragraph (2) or the condition set out in sub-paragraph (3).

• (5) Before refusing or withdrawing such consent or imposing or varying such conditions, the Board shall consult the Area Medical Committee.

• (6) The Board may at any time, and shall periodically, review in consultation with the Area Medical Committee any such consent given or conditions imposed and may withdraw such consent or vary such conditions.

• (7) Where the Board decides to withdraw consent given to a doctor under this paragraph, it shall so far as is reasonably practicable, give the doctor not less than 30 days' notice of the date on which the Board’s decision is to come into effect; but the Board may dispense with such notice if it is satisfied that it is in the interests of patients to do so.

• (8) A doctor may appeal to the Secretary of State against the refusal of consent or the imposition of a condition or against withdrawal of consent or variation of conditions under this paragraph by sending to him notice of appeal within 30 days from the date on which the Board notifies the doctor of its decision.

• (9) In determining an appeal under this paragraph the Secretary of State may substitute for the Board’s decision such decision and conditions as he thinks fit.

20

• (1) A doctor shall not engage another doctor as a deputy, or employ one as an assistant (other than as a trainee general practitioner), unless the other doctor—

• (a) is suitably experienced within the meaning of section 21 of the Act (other than by virtue of being a restricted services principal); or

• (b) has the acquired right specified in regulation 5(1)(d) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994.

• (2) A doctor shall from time to time, and at any time when there are grounds for doing so, take reasonable steps to satisfy himself that a deputising service with which he has entered into arrangements for the provision of any deputy continues to comply with the agreement referred to in paragraph 19(1)(a).

• (3) If the Board so requests, a doctor shall furnish it with evidence that such a deputising service is continuing to comply with that agreement.

21

• (1) Nothing in paragraphs 18, 19 and 20 requires a doctor to terminate or vary any existing contract of employment or contract for services, or any existing arrangement he has with a deputising service, before he has the right to do so under the terms of the contract or arrangement.

• (2) In paragraph (1), “existing” means existing on 1st January 1995.

Employees

22

• (1) A doctor, before employing any person to assist him in the provision of general medical services, shall take reasonable care to satisfy himself that the person in question is both competent and suitably qualified to discharge the duties for which he is to be employed.

• (2) The duty imposed by sub-paragraph (1) is in addition to the duty imposed by paragraph 19(1) so far as it relates to assistants.

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

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

• (b) that person’s training and his experience in employment;

• (c) any guidance issued by the Board in accordance with regulation 38.

• (4) A doctor shall afford to each employee reasonable opportunities to undertake appropriate training with a view to maintaining that employee’s competence.

Arrangements at practice premises

23

• (1) A doctor shall—

• (a) provide proper and sufficient accommodation—

• (i) at his practice premises, having regard to the circumstances of his practice, and

• (ii) at any other premises at which the Board, in accordance with paragraph 27, has agreed he may treat his patients; and

• (b) on receipt of a written request from the Board, allow inspection of those premises at a reasonable time by a member or officer of the Board or the Area Medical Committee or both, authorised by the Board for the purpose.

• (2) The accommodation referred to in sub-paragraph (1) shall not except with the consent of the Board or, on appeal, of the Secretary of State, be in premises occupied by a pharmacist.

• (3) Where a doctor proposes to cease to practise at an address in respect of which he is included in the medical list, he shall inform the Board whether or not in the event of consent being given, he would propose to give notice under regulation 21(10) for the removal of the persons who would attend for treatment at that address. Approval may be given subject to such conditions as seem necessary to the Board or in the case of appeal, the Secretary of State, to enable the doctor to carry out his obligations under these terms of service and to a condition that the doctor inform his patients, at his own expense, of any special arrangements for the conduct of his practice or of any changes in his practice arrangements.

• (4) A doctor shall obtain the approval of the Board (who shall consult the Area Medical Committee) or, on appeal, the Secretary of State to the introduction of an appointment system.

• (5) Without prejudice to sub-paragraph (4) a doctor who succeeds to a practice where an appointment system is in force shall be required only to notify the Board that he intends to continue to operate an appointment system.

• (6) A doctor whose name is included in the medical list shall notify the Board in writing of any change in his place of residence not later than 30 days after such change takes place.

Doctors' availability to patients

24

• (1) Any doctor whose name is included in a medical list shall—

• (a) be available normally at such times and places as, following an application by the doctor, the Board shall approve after consultation with the Area Medical Committee, or, on appeal the Secretary of State shall determine in his case, in accordance with the requirements of the following provisions of this paragraph; and

• (b) inform his patients about his availability in such manner as the Board may require in accordance with sub-paragraph (16).

• (2) Subject to sub-paragraphs (3), (4), (5) and (6), a Board shall not approve any application submitted by a doctor in relation to the times at which he is to be available unless it is satisfied that—

• (a) the times proposed are such that the doctor will be available normally—

• (i) in 42 weeks in any period of 12 months;

• (ii) for no less than the number of hours in any such week which are specified in the condition in relation to him under regulation 15; and

• (iii) on 5 days in any such week; and

• (b) the hours for which the doctor will be available normally in any week are to be allocated between the days on which he will be available normally in that week in such a manner as is likely to be convenient to his patients;

• (c) where the doctor is a three-quarter-time doctor or a half-time doctor, he is practising in partnership with—

• (i) another doctor whose name is included in the medical list and who is himself a full-time doctor; or

• (ii) two job-sharing doctors whose names are included in the medical list and whose hours are aggregated for the purpose of head (d) of this sub-paragraph;

• (d) where the doctor is a job-sharing doctor—

• (i) he is practising in partnership with another doctor whose name is included in the medical list, and

• (ii) the hours for which both doctors will be available normally will in aggregate be not less than 26 hours in any week referred to in head (a)(i) of this sub-paragraph.

• (3) On any application made pursuant to sub-paragraph (1) by a three-quarter-time doctor or a half-time doctor—

• (a) head (a)(iii) of sub-paragraph (2) shall not apply; and

• (b) any approval of the application shall be subject to the condition that the approval shall lapse after the expiry of a period of 6 months from the date on which that doctor ceases to satisfy sub-paragraph (2)(c).

• (4) On any application made pursuant to sub-paragraph (1) by a job-sharing doctor—

• (a) head (a)(iii) of sub-paragraph (2) shall apply so as to require either the job-sharing doctor or the other doctor referred to in sub-paragraph (2)(d) to be available normally on each of the days mentioned in that head; and

• (b) any approval of the application shall be subject to the condition that the approval shall lapse after the expiry of a period of 6 months from the date on which the doctor ceases to satisfy sub-paragraph (2)(d).

• (5) On any application made pursuant to sub-paragraph (1) by a doctor who is a restricted list principal or a restricted services principal, sub-paragraph (2)(a)(i) and (iii), (c) and (d) shall not apply.

• (6) The Board may, in relation to the application of any full-time doctor who seeks to be available normally on only 4 days in any week referred to in sub-paragraph (2)(a)(i), excuse the doctor from the requirement of head (a)(iii) of that sub-paragraph and approve the application to the extent allowed by paragraph 25.

• (7) In this paragraph and in paragraphs 25 and 26, “available” means, in relation to a doctor, available to provide general medical services to his patients, and for the purposes of calculating the times at which the doctor is to be regarded as available—

• (a) account may be taken of any period when the doctor is attending at his practice premises or at any clinic provided by him for his own patients, and of any time spent when he is making a domiciliary visit; but

• (b) no account shall be taken of time spent by the doctor when he is holding himself in readiness to make a domiciliary visit if required by any patient;

and “availability” shall be construed accordingly.

• (8) An application by a doctor in relation to any place at which he is to be available shall not be approved by the Board unless it is satisfied that the place at which the doctor proposes to be available normally is likely to be convenient to his patients.

• (9) An application for approval pursuant to sub-paragraph (1) shall be made in writing to the Board and shall—

• (a) include the information specified in Part I of Schedule 6; and

• (b) where appropriate, also include—

• (i) in the case of a doctor to whom sub-paragraph (3) applies, the additional information specified in Part II of that Schedule,

• (ii) in the case of a doctor to whom sub-paragraph (4)(a) applies, the additional information specified in Part III of that Schedule.

• (10) The Board shall decide an application under sub-paragraph (1) within 30 days of receiving it.

• (11) In deciding upon any application, the Board shall either—

• (a) grant approval;

• (b) grant approval subject to such conditions as the Board sees fit to impose for the purpose of securing that the doctor is available at such times and places as are convenient to his patients; or

• (c) refuse approval.

• (12) The Board shall notify the doctor in writing of its decision, and, where it refuses an application or grants an application subject to conditions, it shall send the doctor a statement in writing of the reasons for its decision and of the doctor’s right of appeal under sub-paragraph (13).

• (13) A doctor may within 30 days of receiving a notification pursuant to sub-paragraph (12) appeal in writing to the Secretary of State against any refusal of approval or against any condition imposed pursuant to sub-paragraph (11)(b).

• (14) The Secretary of State may, when determining the appeal, either confirm the decision of the Board or substitute his own determination for the decision of the Board.

• (15) The Secretary of State shall give written notice to the doctor of his determination and of his reasons therefor.

• (16) The Board may, as it considers appropriate, require a doctor to inform his patients, either by displaying a notice in his waiting room or by sending notices to them, about the times and places at which he is available.

Doctors available for only 4 days a week

25

• (1) Subject to sub-paragraph (3), where the Board is satisfied that, by reason of a doctor’s participation in health-related activities (other than the provision of general medical services to his patients) he would be likely to suffer an unreasonable degree of inconvenience if paragraph 24(2)(a)(iii) applied in his case, it may give its approval for the doctor to be available normally on only 4 days in any week referred to in sub-paragraph (2)(a) of that paragraph.

• (2) For the purposes of sub-paragraph (1), “health-related activities” means activities connected with—

• (a) the organisation of the medical profession or the training of its members;

• (b) the provision of medical care or treatment;

• (c) the improvement of the quality of such care or treatment; or

• (d) the administration of services under Part I of the Act, or of arrangements pursuant to section 19 of the Act for the provision of general medical services,

and in reaching a decision as to whether any activity is a health-related activity, the Board shall have regard to the illustrative list in Part IV of Schedule 6.

• (3) The Board shall not give its approval in accordance with sub-paragraph (1) if, in its opinion—

• (a) the effectiveness of the doctor’s services to his patients is likely to be significantly reduced; or

• (b) his patients are likely to suffer significant inconvenience,

by reason of the doctor’s having been relieved from the requirements of paragraph 24(2)(a)(iii).

Variation of doctors' availability to patients

26

• (1) A doctor may apply to a Board for a variation of the times and places at which, in accordance with a determination under paragraph 24 (“the earlier determination”), he is required to be available normally, and sub-paragraphs (2) to (15) of that paragraph shall apply for the making and determination (“the subsequent determination”) of an application under this paragraph as if it were the first application by that doctor for the purposes of this paragraph.

• (2) Where an application made under sub-paragraph (1) is approved or is approved subject to conditions, for the purposes of sub-paragraphs (1) and (16) of paragraph 24 the earlier determination shall cease to have effect and the subsequent determination shall have effect instead—

• (a) where the subsequent determination is made by a Board and no appeal is made from that determination, from the day falling 60 days after the date on which the doctor receives notification of that Board’s determination;

• (b) where the subsequent determination is made on appeal, from the day falling 60 days after the date on which the doctor receives notification of the Secretary of State’s determination.

• (3) Where it appears to a Board that a doctor’s hours of availability are allocated for the purposes of paragraph 24(2)(b) in a manner which may no longer be convenient to his patients, it may, subject to sub-paragraph (10), review the terms of—

• (a) any approval granted under sub-paragraph (11)(a) or (b) of paragraph 24; or

• (b) any direction given under sub-paragraph (9)(a),

by the Board or the Secretary of State as to such allocation.

• (4) On any review under sub-paragraph (3) the Board shall—

• (a) give notice to the doctor of its proposed re-allocation of his hours of availability; and

• (b) allow him 30 days within which to make representations to that Board about its proposals.

• (5) After considering any representations made in accordance with sub-paragraph (4)(b), the Board shall either—

• (a) direct the doctor to revise the allocation of his hours of availability in the manner specified in the direction; or

• (b) confirm that the existing allocation of the doctor’s hours of availability continues to be convenient to his patients.

• (6) A Board shall notify the doctor in writing of its determination under sub-paragraph (5), and where it gives a direction under head (a) of that sub-paragraph, it shall include with the notice a statement in writing of the reasons for its determination and of the doctor’s right of appeal under sub-paragraph (7).

• (7) A doctor may, within 30 days of receiving notification under sub-paragraph (6), appeal in writing to the Secretary of State against a direction under sub-paragraph (5)(a).

• (8) Without prejudice to the generality of sub-paragraph (1), sub-paragraphs (14) and (15) of paragraph 24 shall apply to any appeal made under sub-paragraph (7).

• (9) A doctor in respect of whom a direction is given under sub-paragraph (5) shall revise the allocation of his hours of availability so as to give effect to the direction—

• (a) where the direction is given by a Board and no appeal is made, not later than 60 days after the date on which he receives notification under sub-paragraph (6);

• (b) where the direction is given or confirmed on appeal, not later than 60 days after the date on which he receives notification of the Secretary of State’s decision,

and the allocation of hours as so revised shall be regarded as having been approved for the purposes of sub-paragraphs (1) and (15) of paragraph 24.

• (10) No Board shall undertake a review under sub-paragraph (3) on more than one occasion in any period of 2 years.

Availability to patients outside normal hours

27

• (1) Subject to the provisions of this paragraph, a doctor may apply to the Board for approval to treat patients at premises other than his practice premises outside the hours for which he is normally available pursuant to paragraph 24 (in this paragraph referred to as “normal hours”).

• (2) An application under sub-paragraph (1) shall be made in writing and shall state the address of the premises.

• (3) An application under sub-paragraph (1) shall not be approved by the Board unless it is satisfied that—

• (a) having regard to the fact that the premises are for the treatment of patients outside normal hours and to all other relevant circumstances, the premises to which the application relates are likely to be reasonably convenient to the doctor’s patients; and

• (b) the location of those premises is in accordance with any condition imposed in relation to the doctor making the application pursuant to section 23(4)(b)[^f00028] of the Act (distribution of general medical services).

• (4) Sub-paragraphs (1) to (16) of paragraph 24 shall apply to an application under sub-paragraph (1) of this paragraph as they apply to an application under paragraph 24(1).

• (5) Where the Board determines an application under sub-paragraph (1) by granting approval (with or without conditions), the doctor shall inform his patients by displaying a notice at his practice premises, stating the address of the premises for which approval has been granted.

• (6) A doctor may apply to the Board for a variation of any approval granted under this paragraph, and any such application shall be made and determined as if it were the first application for the purposes of this paragraph.

• (7) Where it appears to the Board that premises which it has approved under this paragraph may no longer be reasonably convenient to the doctor’s patients, it may give notice to the doctor that it proposes to review the terms of the approval.

• (8) On any review under sub-paragraph (7), the Board shall allow the doctor a period of 30 days beginning with the date on which he receives the notice within which to make representations to the Board about its proposals.

• (9) After considering any representations made in accordance with sub-paragraph (8), the Board may determine to—

• (a) continue its approval;

• (b) continue its approval subject to such new or varied conditions as it sees fit to impose; or

• (c) withdraw its approval.

• (10) The Board shall notify the doctor in writing of its determination under sub-paragraph (9); and where it determines to withdraw its approval or to continue it subject to new or varied conditions, it shall include with the notice a statement in writing of the reasons for its determination and of the doctor’s right of appeal under sub-paragraph (11).

• (11) A doctor may, within the period of 30 days beginning with the date on which he receives the notice referred to in sub-paragraph (10), appeal in writing to the Secretary of State against the withdrawal of approval or against any condition imposed pursuant to sub-paragraph (9); and sub-paragraphs (14) and (15) of paragraph 24 shall apply to any such appeal as they apply to an appeal under that paragraph.

Practice area

28

• (1) Subject to sub-paragraph (2) a doctor may at any time with the consent of the Board or, on appeal, the Secretary of State alter the extent of his practice area.

• (2) A doctor shall not, contrary to any condition imposed by the Medical Practices Committee, or, on appeal, the Secretary of State under section 23(4) or 23(5), as the case may be, of the Act, extend his practice area or open practice premises in any area or part of an area where, at the time of his application to open such premises, the Medical Practices Committee is of the opinion that the number of doctors undertaking to provide general medical services in that area or part is already adequate.

Prescribing and dispensing

29

• (1) A doctor shall supply any drugs, not being a scheduled drug, or appliances for the immediate treatment of a patient if such treatment is necessary before a supply can be obtained otherwise, and he may supply any other drug, not being a scheduled drug, which he administers in person, or an appliance listed in the Drug Tariff or a pessary which is an appliance.

• (2) A doctor, who is required by the Board to supply drugs and appliances under regulation 34 to a patient, in the course of treating that patient under these terms of service—

• (a) shall, subject to paragraph 31, record on a prescription form completed in accordance with paragraph 30(2), an order for supply of any drugs or appliances which are needed for the treatment of that patient, but shall not be required to issue that form to that patient;

• (b) shall supply those drugs and appliances for that patient under regulation 34 but—

• (i) shall not supply under regulation 34 for that patient any scheduled drug except that, where he has ordered a drug which has an appropriate non-proprietary name either by that name or by its formula, he may supply a drug which has the same specification notwithstanding that it is a scheduled drug (but, in the case of a drug which combines more than one drug, only if the combination has an appropriate non-proprietary name);

• (ii) shall supply under regulation 34 for that patient a drug specified in Schedule 11 only where the conditions in paragraph 31 are satisfied;

• (c) may supply for that patient with his consent, in respect of that treatment but otherwise than under regulation 34, any scheduled drug.

• (3) A doctor shall comply with any arrangements made by the Secretary of State, or made by the Board after consultation with the Area Medical Committee and the Area Pharmaceutical Committee and approved by the Secretary of State, under which he may obtain and have available any drugs or appliances which he is required or entitled to supply in terms of this paragraph.

• (4) A drug supplied by a doctor unless administered in person shall be supplied in a suitable container.

30

• (1) Subject to paragraphs 29 and 31 a doctor shall order any drugs or appliances which are needed for the treatment of any patient to whom he is providing treatment under these terms of service by issuing for that patient a prescription form, and such a form shall not be used in any other circumstances.

• (2) A prescription form shall be signed by the doctor with his own hand and shall not be written in such a manner as to necessitate reference on the part of the person supplying the drugs or appliances to a previous order, and in the case of an appliance which requires to be of a size suitable for the individual patient shall include the necessary measurements. A separate prescription form shall be used for each patient.

• (3) In a case of urgency a doctor may request a pharmacist to dispense a drug, or an appliance, before a prescription form is issued, only if—

• (a) that drug is not a scheduled drug;

• (b) that drug is not a controlled drug within the meaning of the Misuse of Drugs Act 1971[^f00029] other than a drug which is for the time being specified in Schedule 5 to the Misuse of Drugs Regulations 1985[^f00030]; and

• (c) in any case, the doctor undertakes to furnish the pharmacist, within 72 hours, with a prescription form completed in accordance with sub-paragraphs (1) and (2).

31

• (1) In the course of treating a patient to whom he is providing treatment under these terms of service, a doctor shall not order on a prescription form a scheduled drug, but may with the consent of the patient otherwise prescribe such a drug or other substance for that patient in the course of that treatment.

• (2) In the course of treating such a patient, a doctor shall not order on a prescription form a drug specified in Schedule 11 unless—

• (a) that patient is a person mentioned in column 2 of that entry; and

• (b) that drug is prescribed for that patient only for the purpose specified in column 3 of that entry; and

• (c) the doctor endorses the face of that form with the reference “SLS”, but may with the consent of the patient otherwise prescribe such a drug for that patient in the course of that treatment.

Records

32

• (1) A doctor is required—

• (a) to keep records of the illnesses of his patients and of his treatment of them in such form as the Secretary of State may from time to time determine after consultation with an organisation which is in his opinion representative of the general body of doctors;

• (b) to send such records with reasonable promptness when they are called for by the Board;

• (c) upon knowledge of the death of a person on his list to send such record to the Board within 30 days.

• (2) Records to be kept by a doctor providing maternity medical services shall contain such particulars, including particulars of the services rendered by the doctor, as may be determined by the Secretary of State after such consultation as is mentioned in sub-paragraph (1).

33

Where a doctor provides general medical services for pupils or staff at a school or for inmates or staff at a residential institution he shall on signing such person’s medical card or form of application for acceptance indicate that person’s status at such school or institution, and if the Board, after consultation with the Area Medical Committee, request him to give the names of persons on his list who are pupils, staff or inmates of such school or institution on a specific date he shall within 30 days give such particulars to the Board.

Reports to the medical officer

34

A doctor is required—

• (a) to furnish in writing to the medical officer within such reasonable period as the latter may specify any information which he may require with regard to the case of any patient to whom the doctor has issued or declined to issue a medical certificate,

• (b) to meet the medical officer, at his request, for the purpose of examining in consultation any patient in respect of whom the doctor has sought the advice of the medical officer, and

• (c) to make available to the medical officer, upon notice being given, the records kept by the doctor under these terms of service and to furnish to the medical officer any information desired by him with regard to any entry therein or with regard to any prescription or certificate issued by the doctor under these terms of service.

Annual reports

35

• (1) A doctor whose name is included in the medical list shall, in accordance with the provisions of this paragraph, provide annually to each Board in whose medical list his name is included, a report relating to the provision by him of personal medical services (in this paragraph called an “annual report”).

• (2) An annual report shall contain—

• (a) the information specified in paragraphs 1 and 2 of Schedule 7;

• (b) where the Board, having considered whether the information is available from another source, and having consulted the Area Medical Committee, so requests, the information specified in paragraph 3 of Schedule 7; and

• (c) where the Board so requests, in the case of a doctor who is not already supplying that information to the Board in order to qualify for payments in respect of health promotion or disease management, the information specified in paragraph 4 of Schedule 7.

• (3) An annual report shall be compiled in respect of each year ending on 31st March and shall be sent to the Board not later than 30th June of that year.

• (4) In the case of a doctor who practises in partnership with other doctors whose names are included in the medical list the information referred to in sub-paragraph (2) may alternatively be provided in the form of an annual report in respect of the partnership as a whole instead of by each doctor in the partnership individually and in such a case a doctor may, if he so wishes, also provide his own annual report.

• (5) When a Board requires that the information referred to in sub-paragraph (2) be provided on a form supplied by the Board the doctor shall provide that information on that form.

• (6) A Board shall not disclose any annual report to any person unless empowered or required in accordance with any provision or rule of law to do so.

Acceptance of fees

36

• (1) A doctor shall not demand or accept any fee, remuneration or charge, other than payments due to him under these Regulations, or any charge payable in accordance with the National Health Service (Charges for Drugs and Appliances) (Scotland) Regulations 1989[^f00031], in respect of any treatment rendered or any drug or appliance supplied, whether under these terms of service or not, to a patient of his or of his partner or assistant, except—

• (a) under paragraph 10 of these terms of service;

• (b) from any statutory body for services rendered for the purpose of that body’s statutory functions;

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

• (d) for treatment not included within the range of service defined in paragraph 11 given—

• (i) pursuant to the provisions of section 57 of the Act,[^f00032], or

• (ii) in a registered nursing home which is not providing services under the Act,

if in either case the doctor is serving on the staff of a hospital providing services under the Act as a specialist providing treatment of the kind required by the patient and if within 7 days after the date on which the treatment is given he gives the Board, on a form to be supplied by it for the purpose, such information about the treatment as it may require;

• (e) under section 158 of the Road Traffic Act 1988[^f00033];

• (f) from a dental practitioner in respect of the provision at his request of an anaesthetic for a person for whom the dental practitioner is providing general dental services;

• (g) from a partner or assistant in respect of the provision of an anaesthetic to a patient of the partner or assistant;

• (h) for attending and examining (but not otherwise treating) a patient at his request at a police station;

• (i) for treatment consisting of an immunisation in connection with travel abroad when no fee is payable by the Board under the Statement referred to in regulation 35(1);

• (j) for circumcising a patient for whom such an operation is requested on religious grounds and is not needed on any medical ground;

• (k) for providing a prescription (other than by way of an order under paragraph 30 of these terms of service) for drugs for chemoprophylaxis or for medicine for a patient who intends to take the medicine abroad in circumstances where the medicine is required solely in respect of an ailment that might occur while the patient is abroad and that will then,

• (i) be occurring for the first time, or

• (ii) has previously occurred but from which the patient is not suffering at the time of going abroad;

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

• (m) where the doctor has been required by the Board to supply any drugs and appliances for a patient under regulation 34 and he supplies for that patient in accordance with paragraph 29(2)(c) any scheduled drug;

• (n) where the person is not one to whom any of paragraphs (a), (b) and (c) of section 26(1) of the Act[^f00034] applies, including any person to whom any of those paragraphs does not apply by virtue of regulations made under section 26(1E) of the Act[^f00035], for testing the sight of that person;

• (o) pursuant to an arrangement with him for the provision of services in accordance with regulation 18 of the National Health Service (Fund-Holding Practices) (Scotland) Regulations 1993[^f00036];

• (p) for prescribing or providing drugs for malaria chemoprophylaxis.

• (2) A doctor shall take all practicable steps to ensure that any partner, deputy or assistant of his, whether or not such partner, deputy or assistant is providing general medical services, shall not demand or accept any fee, remuneration or charge in respect of treatment rendered, or any drug or appliance supplied to the doctor’s patients unless the partner, deputy or assistant would have been entitled to payment if the patient had been on his own list.

• (3) In this paragraph, the expression “treatment” includes the provision of personal medical services during and following pregnancy and labour in respect of conditions arising therefrom.

SCHEDULE 2

PART I — information and undertakings to be included in an application for inclusion in the medical list

PART II — information to be included in an application for the variation of a condition imposed in connection with inclusion in a medical list

PART III — form of application to provide contraceptive services

PART IV — information to be supplied by doctor applying for inclusion in a child health surveillance list

PART V — information to be supplied by doctor applying for inclusion in a minor surgery list

SCHEDULE 3 — CHILD HEALTH SURVEILLANCE SERVICES

1

The services referred to in regulation 29(4)(a) shall comprise—

• (a) the monitoring—

• (i) by the consideration of information concerning the child received by or on behalf of the doctor, and

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

of the health, well-being and physical, mental and social development (all of which characteristics for the purpose of child health surveillance shall be referred to as “development”) of the child while under the age of 5 years with a view to detecting any deviations from normal development;

• (b) the examination of the child by or on behalf of the doctor on so many occasions and at such intervals as shall be determined by the Board in whose area the child resides for the purposes of the provision of child health surveillance services generally in that area.

2

The records mentioned in regulation 29(4)(b) shall comprise 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 mentioned in paragraph 1(b) of this Schedule and, where appropriate, amended following each subsequent examination mentioned in that sub-paragraph; and

• (b) the responses if any to offers made to an appropriate person for the child to undergo any examination referred to in paragraph 1(b) of this Schedule.

3

The information mentioned in regulation 29(4)(c) shall comprise—

• (a) a statement, to be prepared and dispatched to the Board referred to in paragraph 1(b) of this Schedule as soon as is reasonably practicable following any examination referred to in the said paragraph 1(b), of the procedures undertaken in the course of that examination and of the doctor’s findings in relation to each such procedure;

• (b) such further information regarding the development of the child while under the age of 5 years as that Board may request.

SCHEDULE 4 — MINOR SURGERY PROCEDURES

Injections	intra articular peri articular varicose veins haemorrhoid
Aspirations	joints cysts bursae hydrocele
Incisions	abscesses cysts thrombosed piles
Excisions	sebaceous cysts lipoma skin lesions for histology intradermal naevi, papilloma, dermatofibroma and similar conditions warts removal of toe nails (partial and complete)
Curette, cautery and cryocautery	warts and verrucae other skin lesions (eg molluscum contagiosum)
Other	removal of foreign bodies nasal cautery

SCHEDULE 5 — INFORMATION TO BE INCLUDED IN PRACTICE LEAFLETS

Personal and Professional Details of Doctor

1

Full name.

2

Sex.

3

Medical qualifications registered by the General Medical Council.

4

Date and place of first registration as medical practitioner.

Practice Information

5

The times approved by the Board during which the doctor is normally personally available for consultation by his patients at his practice premises.

6

Whether an appointment system is operated by the doctor for surgery consultations at his practice premises.

7

If there is an appointment system, the method of obtaining a non-urgent appointment and the method of obtaining an urgent appointment.

8

The method of obtaining a non-urgent domiciliary visit and the method of obtaining an urgent domiciliary visit.

9

The doctor’s arrangements for providing personal medical services when he is not personally available.

10

The address of any premises approved under paragraph 23 of Schedule 1 at which patients may be invited to attend for treatment outside the hours for which the doctor is normally available pursuant to paragraph 24 of that Schedule.

11

The method by which patients may obtain repeat prescriptions from the doctor.

12

Whether the doctor’s practice is a dispensing practice, and if so, the arrangements for dispensing prescriptions.

13

Whether the doctor provides clinics for his patients, and if so, their frequency, duration and purpose.

14

The numbers of staff, other than doctors, assisting the doctor in his practice, and a description of their roles.

15

Whether the doctor provides (1) maternity medical services, (2) contraceptive services, (3) child health surveillance services, or (4) minor surgery services.

16

Whether the doctor works single-handed, in partnership, part-time or on a job share basis, or within a group practice.

17

Details of any arrangements whereby the doctor or his staff receive comments by patients on the provision by him of general medical services.

18

The geographical boundary of his practice area by reference to a sketch, diagram or plan of an appropriate scale.

19

Whether the doctor’s practice premises have suitable access for all disabled patients and, if not, the limitations on access for particular types of disability.

20

Personal and professional details as in paragraphs 1 to 4 in relation to any assistant or associate general practitioner who is employed.

21

If the practice either—

• (a) is a general practitioner training practice for the purposes of the National Health Service (Vocational Training) (Scotland) Regulations 1980[^f00037], or

• (b) undertakes the teaching of undergraduate medical students,

details of any arrangements for drawing this to the attention of patients.

SCHEDULE 6 — DOCTORS' HOURS

PART I — information to be included with any application under paragraph 24 of schedule i

1

The address of the proposed practice premises.

2

The days in each week during which the doctor will be in attendance normally at the practice premises and available for consultation by his patients.

3

The hours of each such attendance by the doctor.

4

The hours of any attendance by the doctor on those occasions when he is not usually available to provide the full range of services specified in paragraph 11 of the terms of service (for example, for providing emergency treatment only).

5

The frequency, duration and purpose of any clinic provided by the doctor.

6

The estimated total time to be spent each week making any domiciliary visits.

7

The doctor’s proposals for notifying patients of the times and places approved by the Board at which he will be available to patients for consultation.

8

In the case of a doctor to whom paragraph 17(2) of the terms of service does not apply, his proposals for discharging his continuous responsibility for his patients.

PART II — additional information to be included in any application by a doctor who is a restricted services principal or a restricted list principal

1

In the case of a restricted services principal—

• (a) the proposed allocation, between each category of services provided, of the total number of hours for which he is to be available normally in any week; and

• (b) where different services are to be provided at different places, the place at which each category of services is to be provided.

2

In the case of a restricted list principal, the name, address and nature of the establishment(s) or organisation(s) with which his patients are connected.

PART III — additional information to be included in any application by a doctor who seeks to be available normally on only 4 days in each week

1

A brief description of each health-related activity with reference to which the application is made.

2

The days in each week during which the doctor will be undertaking that activity.

3

The number of hours in each week which are likely to be occupied in the course of such activity.

PART IV — illustrative list of health-related activities

1

Appointments concerning medical education or training.

2

Medical appointments within the health service other than in relation to the provision of general medical services.

3

Medical appointments under the Crown, with Government Departments or Agencies, or public or local authorities.

4

Appointments concerning the regulation of the medical profession or the Medical Practices Committee.

SCHEDULE 7 — INFORMATION TO BE PROVIDED IN ANNUAL REPORTS

1

Particulars of the doctor’s other commitments as a medical practitioner, including—

• (a) a description of any posts held, and

• (b) a description of all works undertaken,

and including, in each case, the annual hourly commitment, except that where a doctor has notified the Board of such other commitments in a previous annual report, the report need only contain information relating to any changes in those commitments.

2

As respects orders for drugs and appliances, the doctor’s arrangements for the issue of repeat prescriptions to patients.

3

Information relating to the referral of patients to other services under the National Health Service (Scotland) Act 1978 during the period of the report—

• (a) as respects those by the doctor to specialists—

• (i) the total number of patients referred as in-patients;

• (ii) the total number of patients referred as out-patients;

by reference in each case to which clinical specialty applies, and specifying in each case the name of the hospital concerned; and

• (b) the total number of cases of which the doctor is aware (by reference to the clinical specialty) in which a patient referred himself to services under the National Health Service (Scotland) Act 1978.

4

Information relating to the numbers of patients on the doctor’s list—

• (a) who are diabetic;

• (b) who are asthmatic; and

• (c) to whom the doctor has given advice, in accordance with paragraph 11(2)(b) of Schedule 1, about—

• (i) the patient’s weight;

• (ii) the use of tobacco; or

• (iii) the consumption of alcohol.

SCHEDULE 8

FORM OF CERTIFICATE TO BE ISSUED BY SCOTTISH MEDICAL PRACTICES COMMITTEE UNDER SCHEDULE 9 TO THE NATIONAL HEALTH SERVICE (SCOTLAND) ACT 1978

Regulation 18

SCHEDULE 9 — LIST OF PRESCRIBED MEDICAL CERTIFICATES

1

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

2

To establish pregnancy for the purpose of obtaining welfare foods

3

To establish fitness to receive inhalational analgesia in childbirth

4

To secure registration of still-birth

5

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

6

To establish unfitness for jury service

7

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

8

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

9

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

10

To support a claim by or on behalf of a severely mentally impaired person for exemption from liability to pay the community charge

11

To support a claim by or on behalf of a severely mentally impaired person for exemption from liability to pay the council tax or eligibility for a discount in respect of the amount payable

SCHEDULE 10 — DRUGS AND OTHER SUBSTANCES NOT TO BE SUPPLIED BY GENERAL MEDICAL PRACTITIONERS OR PRESCRIBED FOR SUPPLY UNDER PHARMACEUTICAL SERVICES