The National Health Service (General Medical Services Contracts) Regulations 2015

• (a) if the contract is with a contractor who is an individual medical practitioner, a term which requires the contractor to comply with the disclosure obligation for each relevant financial year in which—

• (i) they are a contractor, and

• (ii) their NHS earnings exceed the relevant threshold;

• (b) if the contract is with a contractor who is partnership, a term which requires each partnership member to comply with the disclosure obligation for each relevant financial year in which—

• (i) the partnership is a contractor, and

• (ii) the partnership member’s NHS earnings exceed the relevant threshold.

• (3) In this regulation—

• (a) the disclosure obligation, in relation to a relevant financial year, is the requirement for an individual (“I”) to submit the following information for publication to NHS England by the disclosure date—

• (i) I’s name,

• (ii) I’s job title,

• (iii) the details of each organisation from which I has derived NHS earnings in that financial year, and

• (iv) the amount of I’s NHS earnings for that financial year;

• (b) ... “relevant financial year” means a financial year ending—

• (i) on or after 31st March 2022, but

• (ii) on or before 31st March 2024;

• (ba) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (c) “relevant threshold” means—

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

• (ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (iii) for the financial year ending on 31st March 2022, £156,000;

• (iv) for the financial year ending on 31st March 2023, £159,000;

• (v) for the financial year ending on 31st March 2024, £163,000.

• (4) For the purposes of paragraph (3)(a) “the disclosure date”, in relation to a relevant financial year, is 30th April in the financial year which begins immediately after the end of the next financial year.

• (5) For the purposes of paragraph (4) “the next financial year”, in relation to a financial year (“FY1”), is the financial year which begins immediately after the end of FY1 ....

• (6) A contract must also include a term which prevents the contractor from sub-contracting any of its obligations to provide clinical services under the contract unless—

• (a) where the sub-contractor is an individual, the sub-contract entered into by the contractor requires the individual to comply with the disclosure obligation for each relevant financial year in which the individual’s NHS earnings exceed the relevant threshold;

• (b) where the sub-contractor is a partnership, the sub-contract entered into by the contractor requires each sub-contractor partnership member to comply with the disclosure obligation for each relevant financial year in which the sub-contractor partnership member’s NHS earnings exceed the relevant financial threshold;

• (c) in all cases, the sub-contract prohibits the sub-contractor (“S”) from sub-contracting, where permitted by paragraph 44(9A) of Schedule 3, any of the clinical services S has agreed with the contractor to provide under the sub-contract unless—

• (i) where the sub-contractor is an individual (“I”), the sub-contract entered into by S requires I to comply with the disclosure obligation for each financial year in which I’s NHS earnings exceed the relevant threshold;

• (ii) where the sub-contractor is a partnership, the sub-contract entered into by S requires each sub-contractor partnership member of that partnership to comply with the disclosure obligation for each relevant financial year in which the sub-contractor partnership member’s NHS earnings exceed the relevant threshold.

• (7) A contract must also include a term requiring the contractor to use reasonable endeavours to ensure that any relevant sub-contract is amended to contain the terms specified in paragraph (9).

• (8) For the purposes of paragraph (7) “relevant sub-contract” means a sub-contract—

• (a) for the provision of any of the clinical services which the contractor is required to provide under the contract by any other person, and

• (b) which is in force at the time when the term in paragraph (7) is incorporated into the contract.

• (9) The terms are—

• (a) a term which requires—

• (i) the sub-contractor (“S”), where S is an individual, or

• (ii) each sub-contractor partnership member, where S is a partnership,

to comply with the disclosure obligation for each relevant financial year in which the individual’s, or as the case may be, sub-contractor partnership member’s NHS earnings exceed the relevant threshold, ...

• (b) a term which prevents S from sub-contracting obligations to provide clinical services under the contract, where permitted by paragraph 44(9A) of Schedule 3, unless—

• (i) where the sub-contractor is an individual (“I”), the sub-contract entered into by S requires I to comply with the disclosure obligation in relation to each financial year in which I’s NHS earnings exceed the relevant threshold;

• (ii) where the sub-contractor is a partnership, the sub-contract entered into by S requires each sub-contractor partnership member of that partnership to comply with the disclosure obligation in relation to each relevant financial year in which the sub-contractor partnership member’s NHS earnings exceed the relevant threshold , and

• (c) a term which requires S to use reasonable endeavours to ensure that any sub-contract entered into before the term in sub-paragraph (b) was incorporated into that sub-contract is amended to—

• (i) include the term in paragraph (i) of sub-paragraph (b) in a sub-contract between S and I, and

• (ii) include the term in paragraph (ii) of sub-paragraph (b) in a sub-contract between S and a partnership.

• (10) Nothing in paragraph (6), (7) or (9) requires any individual to comply with the disclosure obligation for any relevant financial year which—

• (a) ends before the individual or partnership (as the case may be) enters into a sub-contract with the contractor or a sub-contractor;

• (b) begins after the individual’s, or, as the case may be, partnership’s, sub-contract with the contractor or sub-contractor has terminated.

• (11) In this regulation—

• “locum practitioner” has the meaning given in Schedule 15 to the National Health Service Pension Scheme Regulations 2015 ;

• “NHS earnings” has the meaning given in regulation 27B;

• “partnership member”, in relation to a contractor who is a partnership, means an individual who is a partner in that partnership;

• “sub-contractor” means a person to whom any rights or duties under the contract in relation to clinical matters are, or have been, sub-contracted under paragraph 44(1) of Schedule 3, and includes an individual who is a locum practitioner;

• “sub-contractor partnership member”, in relation to a sub-contractor who is a partnership, means an individual who is a partner in that partnership.

Calculation of NHS earnings for the purposes of regulation 27A

27B

• (1) This regulation sets out how an individual’s NHS earnings are to be calculated for the purposes of regulations 27A and 27AA.

• (2) An individual’s NHS earnings for a relevant financial year are those earnings which constitute relevant income in respect of that financial year.

• (3) In this regulation “relevant income”—

• (a) in relation to an individual who is an active member of the Scheme and is a medical practitioner (other than a locum practitioner) or a non-GP provider, means income (including any form of remuneration and any salary, wages, fees, director’s remuneration or dividends) which is practitioner income as determined under Schedule 10 to the NHS Pension Scheme Regulations, as modified in accordance with paragraph (4), in respect of the financial year in question;

• (b) in relation to a person (“P”) who is an active member of the Scheme and a locum practitioner, means—

• (i) any income which is locum practitioner income as determined under paragraph 7 of Schedule 10 to the NHS Pension Scheme Regulations in respect of the financial year in question, and

• (ii) any other income (including any form of remuneration and salary, wages, fees, director’s remuneration or dividends) received by P in the financial year in question from any organisation which would have been treated as practitioner income under Schedule 10 to the NHS Pension Scheme Regulations, as modified in accordance with paragraph (4), if P had been a medical practitioner but not a locum practitioner;

• (ba) in relation to a jobholder who does not fall within sub-paragraph (a) or (b), means—

• (i) any remuneration, salary, wages, fees, director’s remuneration or dividends received in respect of the financial year in question under the contract of engagement and any other contract of engagement under which the jobholder provides services in respect of a contract or an agreement for primary medical services made under section 83(2) or 92 of the Act, and

• (ii) any other income which would be treated as practitioner income under Schedule 10 to the NHS Pension Scheme Regulations as modified in accordance with paragraph (4) in respect of the financial year in question if the jobholder—

• (aa) were an active member of the scheme, and

• (bb) a medical practitioner or non-GP provider;

• (c) in relation to any other person (“P”), means income (including any form of remuneration and any salary, wages, fees, director’s remuneration or dividends) received by P in the financial year in question from any organisation which would have been treated as practitioner income under Schedule 10 to the NHS Pension Scheme Regulations, as modified in accordance with paragraph (4), if P had been—

• (i) an active member of the Scheme, and

• (ii) a medical practitioner or non-GP provider.

• (4) For the purposes of determining a person’s relevant income under paragraph (3)(a), (b)(ii) or (c), Schedule 10 to the NHS Pension Scheme Regulations applies as if the following provisions of that Schedule were omitted—

• (a) paragraph 2(1)(b) and the “and” immediately preceding it, and

• (b) paragraph 3, ...

• (c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (4A) For the purposes of this regulation, where a contractor has sub-contracted any obligations under the contract, any payments made—

• (a) under the sub-contract, or

• (b) under any sub-contract which the sub-contractor has entered into with another person, as permitted by paragraph 44(9A) of Schedule 3,

are to be treated as income derived from the contract.

• (5) In this regulation—

• “the NHS Pension Scheme Regulations” means the National Health Service Pension Scheme Regulations 2015 and “active member”, “locum practitioner”, “medical practitioner”, “member” and “non-GP provider” have the meanings given for the purposes of those Regulations;

• “relevant financial year” has the meaning given in regulation 27A;

• “the Scheme” means the National Health Service Pension Scheme established by the NHS Pension Scheme Regulations.

Sub-contracting

Variation of contracts

Variation of contracts: integrated care provider contracts

Variation of contracts: registered patients from outside practice area

Termination of a contract

Other contractual terms

Suspension of contract terms or of enforcement of contract terms while a disease is or in anticipation of a disease being imminently pandemic etc.

Opt outs: minor surgery

Minor surgery: temporary opt outs and permanent opt outs following temporary opt outs

Minor surgery: permanent opt outs

Transfer of patient records between GP practices: time limits

69A

• (1) This regulation applies where—

• (a) a patient on a contractor’s list of patients has registered with another provider of primary medical services, and

• (b) the contractor receives a request from that provider for the complete records relating to that patient.

• (2) The contractor must, before the end of the period of 28 days beginning with the day on which it receives the request from the provider—

• (a) send the complete records (other than any part of the records held only in paper form) to the provider via the GP2GP facility in accordance with regulation 69, and

• (b) send to NHS England in accordance with regulation 67(5A), the complete records, or any part of the records—

• (i) for which the contractor does not receive a confirmation, or

• (ii) held only in paper form.

• (3) In this regulation—

• “confirmation”, in relation to records sent via the GP2GP facility, means confirmation of safe and effective transfer via that facility;

• “GPG2P facility” has the same meaning as in paragraph (2) of regulation 69.

Clinical correspondence: requirement for NHS number

Use of fax machines

Patient online services : appointments and prescriptions

Patient online services: provision of online access to coded information in medical record and prospective medical records

Patient online services: providing and updating personal or contact information

71ZC

• (1) A contractor must offer and promote to its registered patients a facility for providing their personal or contact information, or informing the contractor of a change to that information, which meets the condition in paragraph (2).

• (2) A facility meets the condition in this paragraph if it enables—

• (a) P, or

• (b) where P is a person to whom paragraph (3) applies, an appropriate person acting on behalf of P,

to provide the contractor with, or inform it of any change to, P’s personal or contact information in P’s medical record, either online or by other electronic means.

• (3) This paragraph applies to a person if they—

• (a) are a child, or

• (b) lack the capacity to provide the contractor with their personal or contact information or to authorise a person to provide such information on their behalf.

• (4) For the purposes of this regulation, P’s personal and contact information is—

• (a) their name;

• (b) their ethnicity;

• (c) their address;

• (d) their telephone number or mobile telephone number (if any);

• (e) their electronic mail address (if any).

Patient online services: provision of an online consultation tool

71ZD

• (1) A contractor must offer and promote an online consultation tool to its registered patients.

• (2) An “online consultation tool” is an online facility provided using appropriate software—

• (a) through which—

• (i) a patient, or

• (ii) where the patient is a person to whom paragraph (4) applies, an appropriate person acting on behalf of the patient,

may, in writing in electronic form, seek advice or information related to the patient’s health or make a clinical or administrative request, but

• (b) which does not require the response to be given by the contractor in real time.

• (3) An online consultation tool may incorporate—

• (a) any of the facilities which the contractor is required to offer , promote or, as the case may be, provide under regulations 71 to 71ZC, or

• (b) the communication method which the contractor is required to offer and promote under regulation 71ZE.

• (4) This paragraph applies to a person if they—

• (a) are a child, or

• (b) lack the capacity to communicate with the contractor through an online facility or to authorise a person to communicate with the contractor through such a facility on their behalf.

Secure electronic communications

71ZE

• (1) A contractor must—

• (a) offer and promote to its registered patients a relevant electronic communication method, and

• (b) use the relevant electronic communication method to communicate with—

• (i) a registered patient, or

• (ii) where the registered patient is a person to whom paragraph (4) applies, an appropriate person acting on behalf of that patient.

• (2) But paragraph (1)(b) does not require the contractor to use the relevant electronic communication method where—

• (a) it would not be clinically appropriate to do so for the patient on that occasion, or

• (b) it is otherwise not appropriate to the needs or circumstances of the patient.

• (3) For the purposes of this regulation, a “relevant electronic communication method” is a method of electronic communication which is provided using appropriate software and can be used—

• (a) by the contractor to respond, in writing in electronic form, to requests made through the online consultation tool, and

• (b) by the contractor and its registered patients or appropriate persons acting on behalf of registered patients (as the case may be) to otherwise communicate with each other in writing in electronic form.

• (4) This paragraph applies to a person if they—

• (a) are a child, or

• (b) lack the capacity to communicate with the contractor using the relevant electronic communication method or to authorise a person to do so on their behalf.

Video consultations

71ZF

• (1) A contractor must offer and promote to its registered patients the facility of participating in their consultations with the contractor by video conference using appropriate software (“video consultations”).

• (2) But paragraph (1) does not require the contractor to offer a patient a video consultation where—

• (a) it would not be clinically appropriate to do so for the patient on that occasion, or

• (b) it is otherwise not appropriate to the needs or circumstances of the patient.

• (3) The contractor must not be party to a contract or other arrangement under which the software mentioned in paragraph (1) is provided unless—

• (a) it is satisfied that any software which a patient needs to participate in a video consultation with the contractor’s practice is available free of charge to the patient, and

• (b) it has taken reasonable steps, having regard to the arrangement as a whole and disregarding the costs of any software, to satisfy itself that patients will not have to pay more to participate in video consultations with the contractor’s practice than they would to participate in a meeting by video conference with any other person in the contractor’s area.

Meaning of “appropriate software” for the purposes of regulations 71ZD, 71ZE and 71ZF

71ZG

• (1) For the purposes of regulations 71ZD, 71ZE and 71ZF the software used for the purposes of providing a facility or method of communication (as the case may be) is appropriate if the software meets—

• (a) the requirements in the GPIT Operating Model relevant to that software, or

• (b) requirements which are equivalent in their effect to the relevant requirements in the GPIT Operating Model.

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

Patient access to online services

Confidentiality of personal data: nominated person

Requirement to have and maintain an online presence

Requirement to maintain profile page on NHS website

Provision of information

Provision of information: GP access data

National Diabetes Audit

Information relating to indicators no longer in the Quality and Outcomes Framework

Information relating to alcohol related risk reduction and dementia diagnosis and treatment

NHS Digital Workforce Collections

Information relating to overseas visitors

Medicines and Healthcare products Regulatory Agency Central Alerting System

Collection of data relating to appointments in general practice

Collection of data concerning use of online consultation tools and video consultations

74I

A contractor must submit to NHS England such anonymised data relating to the use of its online consultation tool and video consultation facility as NHS England may require.

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet

PART 2A — List of patients: Crown servants posted overseas and their family members

CHAPTER 1 — Interpretation of Part 2A

Meaning of “qualifying person”

32A

• (1) A person (“P”) is a qualifying person for the purposes of this Part of this Schedule if—

• (a) P is returning, or has returned, to the United Kingdom, and

• (b) sub-paragraph (2), (3), (4) or (5) applies to P.

Civil servants posted overseas2This sub-paragraph applies to P if—aP is a civil servant who is, or, immediately before their return to the United Kingdom, was, posted overseas, orbwhere P is returning, or has returned, to the United Kingdom for more than three months, P—iwas a civil servant who was posted overseas, andiiis returning, or has returned, to the United Kingdom (other than temporarily) for the first time since ceasing to be a civil servant.

Family members of Crown servants posted overseas3This sub-paragraph applies to P if P—ais a relevant family member of a person to whom sub-paragraph (2) applies (“R”), andbis, or, immediately before their return to the United Kingdom, was, accompanying R on the posting mentioned in that sub-paragraph.4This sub-paragraph applies to P if P—ais a relevant family member of a civil servant (“C”) who—iis posted overseas, oriiwhere C is deceased, was at the time of their death posted overseas, andbis, or, immediately before their return to the United Kingdom, was, accompanying C on the posting mentioned in paragraph (a).5This sub-paragraph applies to P if—aP is a relevant family member of a person (“M”) who—iis a member of the armed forces of the Crown who is, or, immediately before their return to the United Kingdom, was, posted overseas,iiwhere M is returning, or has returned, to the United Kingdom for more than three months—aawas a member of the armed forces of the Crown who was posted overseas, andbbis returning, or has returned, to the United Kingdom (other than temporarily) for the first time since ceasing to be a member of those forces, oriiiwhere M is deceased, was at the time of their death a member of the armed forces of the Crown posted overseas, andbP is, or, immediately before their return to the United Kingdom, was, accompanying M on the posting mentioned in paragraph (a).6In this paragraph—“civil servant” means a person employed in the civil service of the State;“Crown servant” means—a civil servant, ora member of the armed forces of the Crown.7For the purposes of this paragraph “relevant family member”, in relation to a Crown servant (including a Crown servant who is deceased) (“C”), means—aC’s spouse or civil partner;ba person whose relationship with C has the characteristics of a relationship between spouses or civil partners;cC’s former spouse or former civil partner;da person whose relationship with C had the characteristics of a relationship between spouses or civil partners but which has ended (for any reason);eC’s widow, widower or surviving civil partner;fa dependent child.8For the purposes of sub-paragraph (7)(f), a person is a “dependent child” of a Crown servant if they are a child of the Crown servant and—athey—ihave not, or, when they departed the United Kingdom, had not, attained the relevant age, andiiare, or, where the Crown servant is deceased, were, wholly or mainly financially dependent on the Crown servant whilst accompanying the Crown servant on their overseas posting, orbthey are, or, where the Crown servant is deceased, were, wholly or mainly financially dependent on the Crown servant because of a disability (within the meaning of section 6 of the Equality Act 2010 ).9For the purposes of sub-paragraph (8)(a)(i) “relevant age”—ain relation to a child of a civil servant, means the age of 21;bin relation to a child of a member of the armed forces of the Crown, means the age of 25.

Qualifying persons to be treated as previous patients of contractors

32B

• (1) For the purposes of this Part of this Schedule, a qualifying person (“P”) is required to be treated as a previous patient of a contractor if—

• (a) where sub-paragraph (2) of paragraph 32A applies to P, P was removed from the contractor’s, or a predecessor contractor’s, list of patients under paragraph 29(1)(a) or (d) following the posting mentioned in paragraph 32A(2) or a previous overseas posting;

• (b) where sub-paragraph (3) of paragraph 32A applies to P, R (within the meaning of that sub-paragraph) was removed from the contractor’s, or a predecessor contractor’s, list of patients under paragraph 29(1)(a) or (d) following the posting mentioned paragraph 32A(2) or a previous overseas posting;

• (c) where sub-paragraph (4) of paragraph 32A applies to P, C (within the meaning of that sub-paragraph) was removed from the contractor’s, or a predecessor contractor’s, list of patients under paragraph 29(1)(a) or (d) following the posting mentioned in paragraph 32A(4) or a previous overseas posting;

• (d) where sub-paragraph (5) of paragraph 32A applies to P, P was removed from the contractor’s, or a predecessor contractor’s, list of patients under paragraph 29(1)(a) or (d) following P accompanying M (within the meaning of sub-paragraph (5) of paragraph 32A) on the posting mentioned in paragraph 32A(5) or on a previous overseas posting.

• (2) For the purposes of this paragraph “predecessor contractor”, in relation to a contractor (“A”)—

• (a) where A’s status as a contractor is that of a partnership following a variation in accordance with paragraph 58, means the individual medical practitioner referred to in sub-paragraph (1) of that paragraph;

• (b) where A’s status as a contractor is that of an individual medical practitioner following a variation in accordance with sub-paragraph (11) of paragraph 59, means the partnership referred to in sub-paragraph (1) or (4) (as the case may be) of that paragraph;

• (c) where otherwise than as set out in paragraph (a) or (b), A assumes any of the obligations of another contractor (“B”) to provide services originally provided by B under B’s contract, means B.

General interpretation of Part 2A

32C

• (1) In this Part of this Schedule—

• “child” means—a natural child,an adopted child, ora step-child;

• “planned return date” means the date on which a person intends to return to the United Kingdom;

• “qualifying person” has the meaning given in paragraph 32A;

• “relevant family member” has the meaning given in paragraph 32A.

• (2) For the purposes of this Part of this Schedule, a Crown servant is posted overseas if—

• (a) they are performing overseas (but not in Northern Ireland) the duties of a civil servant or member of the armed forces of the Crown (as the case may be), and

• (b) they were, immediately before their posting or the first of consecutive postings, ordinarily resident in the United Kingdom.

• (3) For the purposes of this Part of this Schedule, a relevant family member of a Crown servant who has not resided in the United Kingdom and is coming, or has come, to the United Kingdom for the first time is to be treated as if they—

• (a) are returning, or have returned, to the United Kingdom, and

• (b) departed the United Kingdom on the day on which they became a relevant family member of the Crown servant.

• (4) For the purposes of this part of this Schedule, a person is to be regarded as temporarily resident in a place if, when that person arrives in that place, they intend to stay for more than 24 hours but not for more than three months.

CHAPTER 2 — Crown servants and family members returning to the United Kingdom: registering with original or successor practice

Crown servants and family members returning to the United Kingdom for more than three months: inclusion in list of original or successor practice

32D

• (1) Subject to sub-paragraph (4), a contractor must include a qualifying person (“P”) in the contractor’s list of patients if—

• (a) P is not registered as a patient with a provider of primary medical services,

• (b) P is required to be treated as a previous patient of the contractor,

• (c) P is returning, or has returned, to the United Kingdom for a period of more than three months, and

• (d) either—

• (i) P makes an application for inclusion in the contractor’s list of patients (a “list application”), or

• (ii) where P is a person to whom sub-paragraph (2) applies, a list application is made on their behalf by an appropriate person.

• (2) This sub-paragraph applies to a person if they—

• (a) have not attained the age of 16 years, or

• (b) lack the capacity to make a list application or to authorise a person to make such an application on their behalf.

• (3) For the purposes of sub-paragraph (1) it does not matter whether the contractor’s list of patients is open or closed.

• (4) A list application—

• (a) may be made on or after the date which is one month before the planned return date, but

• (b) must be made before the end of the period of three months beginning with the day on which the person returns to the United Kingdom.

• (5) Paragraph 29(1)(a) or (d) does not apply in respect of a qualifying person who is included in the contractor’s list of patients by virtue of sub-paragraph (1) before their return to the United Kingdom.

• (6) Where a contractor accepts a list application, the contractor—

• (a) must give notice in writing to NHS England of that acceptance (including the planned return date, where the application is made and accepted before that date) as soon as possible, but

• (b) is not required to provide primary medical services to the qualifying person before they return to the United Kingdom.

• (7) NHS England must, on receipt of a notice given under sub-paragraph (6)(a)—

• (a) include the qualifying person in the contractor’s list of patients from the relevant date, and

• (b) give notice in writing to the qualifying person or the appropriate person (as the case may be) of the acceptance.

• (8) For the purposes of paragraph (7)(a) “the relevant date” is—

• (a) where the relevant list application is made after a person’s return to the United Kingdom, the date on which NHS England receives the notice given under sub-paragraph (7)(a);

• (b) where the relevant list application is made before a person’s return to the United Kingdom, the later of—

• (i) the planned return date, and

• (ii) the date on which NHS England receives the notice given under sub-paragraph (7)(a).

• (9) This paragraph is subject to paragraph 32H.

Persons returning to the United Kingdom for three months or less: temporary registration with original or successor practice

32E

• (1) A contractor must accept a qualifying person to whom sub-paragraph (2) applies (“P”) as a temporary resident provided that the contractor is satisfied that—

• (a) if P is in the United Kingdom, P is not being provided with essential services (or their equivalent) under any other arrangement in the locality where P is temporarily residing, or

• (b) if P is not yet in the United Kingdom, when P arrives in the United Kingdom, P will not be provided with essential services (or their equivalent) under any other arrangement in the locality where P will be temporarily residing.

• (2) This sub-paragraph applies to a qualifying person if—

• (a) they are returning, or have returned, to the United Kingdom for a period of more than 24 hours but not more than three months,

• (b) they are required to be treated as a previous patient of the contractor, and

• (c) either—

• (i) they make an application to be accepted as a temporary resident by the contractor (a “temporary resident application”), or

• (ii) where they are a person to whom sub-paragraph (3) applies, a temporary resident application is made on their behalf by an appropriate person.

• (3) This sub-paragraph applies to a person if they—

• (a) have not attained the age of 16 years, or

• (b) lack the capacity to make a temporary resident application or to authorise a person to make such an application on their behalf.

• (4) For the purposes of sub-paragraph (1) it does not matter whether the contractor’s list of patients is open or closed.

• (5) A temporary resident application may be made on or after the date which falls one month before the planned return date.

• (6) Where a contractor accepts a temporary resident application, the contractor’s responsibility for the relevant qualifying person does not begin until the relevant date.

• (7) Where a contractor wants to terminate its responsibility for a qualifying person accepted by it as a temporary resident under this paragraph before the end of the temporary residence period—

• (a) the contractor must give notice, either orally or in writing, of that fact to the qualifying person or an appropriate person (as the case may be), and

• (b) the contractor’s responsibility for the qualifying person is to cease seven days after the date on which the notice mentioned in paragraph (a) is given.

• (8) The contractor must give notice in writing to NHS England of its acceptance of a qualifying person as a temporary resident—

• (a) at the end of the period of three months beginning with the relevant date, or

• (b) if the contractor’s period of responsibility for that person as a temporary resident came to an end earlier than the end of the three month period referred to in paragraph (a), at the end of that period.

• (9) In this paragraph—

• “relevant date” means the later of—the date on which the contractor accepts the qualifying person as a temporary resident, andthe date on which the qualifying person returns to the United Kingdom;

• “the temporary residence period”, in relation to a qualifying person, means—the period of three months beginning with the relevant date, orsuch shorter period for which the contractor agreed to accept that person as a temporary resident.

• (10) This paragraph is subject to paragraph 32H.

CHAPTER 3 — Crown servants and family members returning to the United Kingdom: registration with a new practice

Crown servants and family members returning to the United Kingdom for more than three months: inclusion in list of patients of a new practice

32F

• (1) A contractor must, if the contractor’s list of patients is open, include a qualifying person (“P”) in the contractor’s list of patients if—

• (a) P is not registered as a patient with a provider of primary medical services,

• (b) P is returning, or has returned, to the United Kingdom for a period of more than three months,

• (c) P is not required to be treated as a previous patient of the contractor, and

• (d) either—

• (i) P makes an application for inclusion in that list (a “list application”), or

• (ii) where P is a person to whom sub-paragraph (2) applies, a list application is made on their behalf by an appropriate person.

• (2) This sub-paragraph applies to a person if they—

• (a) have not attained the age of 16 years, or

• (b) lack the capacity to make a list application or to authorise a person to make such an application on their behalf.

• (3) A list application may be made during the period commencing one month prior to the planned return date and ending 24 hours prior to that date.

• (4) Where a contractor’s list of patients is closed, the contractor may, by virtue of this sub-paragraph, accept a list application if the applicant is an immediate family member of a registered patient.

• (5) Paragraph 29(1)(a) or (d) does not apply in respect of a qualifying person who is included in the contractor’s list of patients by virtue of sub-paragraph (1) before their return to the United Kingdom.

• (6) Where a contractor accepts a list application, the contractor—

• (a) must give notice in writing to NHS England of that acceptance (including the planned return date) as soon as possible, but

• (b) is not required to provide primary medical services to the qualifying person before they return to the United Kingdom.

• (7) NHS England must, on receipt of a notice given under sub-paragraph (6)(a)—

• (a) include the qualifying person in the contractor’s list of patients from the relevant date, and

• (b) give notice in writing to the qualifying person or the appropriate person (as the case may be) of the acceptance.

• (8) For the purposes of sub-paragraph (7)(a) “the relevant date” is the later of—

• (a) the date on which NHS England receives the notice given under sub-paragraph (6)(a), and

• (b) the planned return date.

• (9) This paragraph is subject to paragraph 32H.

Crown servants and family members returning to the United Kingdom for three months or less: temporary registration with new practice

32G

• (1) A contractor must, if the contractor’s list of patients is open, accept a qualifying person to whom sub-paragraph (2) applies (“P”) as a temporary resident provided that the contractor is satisfied that—

• (a) if P is in the United Kingdom, P is not being provided with essential services (or their equivalent) under any other arrangement in the locality where P is temporarily residing, or

• (b) if P is not yet in the United Kingdom, when P arrives in the United Kingdom, P will not be provided with essential services (or their equivalent) under any other arrangement in the locality where P will be temporarily residing.

• (2) This sub-paragraph applies to a qualifying person if—

• (a) they are returning, or have returned, to the United Kingdom for a period of at least 24 hours but not more than three months,

• (b) they are not required to be treated as a previous patient of the contractor, and

• (c) either—

• (i) they make an application to be accepted as a temporary resident by the contractor (a “temporary resident application”), or

• (ii) where they are a person to whom sub-paragraph (3) applies, a temporary resident application is made on their behalf by an appropriate person.

• (3) This sub-paragraph applies to a person if they—

• (a) have not attained the age of 16 years, or

• (b) lack the capacity to make a temporary resident application or to authorise a person to make such an application on their behalf.

• (4) A temporary resident application may be made on or after the date which falls one month before the planned return date.

• (5) Where a contractor accepts a temporary resident application, the contractor’s responsibility for the relevant qualifying person does not begin until the relevant date.

• (6) Where a contractor wants to terminate its responsibility for a qualifying person accepted by it as a temporary resident under this paragraph before the end of the temporary residence period—

• (a) the contractor must give notice, either orally or in writing, of that fact to the qualifying person or an appropriate person (as the case may be), and

• (b) the contractor’s responsibility for the qualifying person is to cease seven days after the date on which the notice mentioned in paragraph (a) is given.

• (7) The contractor must give notice in writing to NHS England of its acceptance of the qualifying person as a temporary resident—

• (a) at the end of the period of three months beginning with the relevant date, or

• (b) if the contractor’s period of responsibility for that person as a temporary resident came to an end earlier than the end of the three month period referred to in paragraph (a), at the end of that period.

• (8) In this paragraph—

• “relevant date” means the later of—the date on which the contractor accepts the qualifying person as a temporary resident, andthe date on which the qualifying person returns to the United Kingdom;

• “the temporary residence period”, in relation to a qualifying person, means—the period of three months beginning with the relevant date, orsuch shorter period for which the contractor agreed to accept that person as a temporary resident.

• (9) This paragraph is subject to paragraph 32H.

CHAPTER 4 — Refusal of applications under this Part

Refusal of an application under paragraphs 32D to 32G

32H

• (1) The contractor may refuse a list application, or a temporary residence application, if (and only if) the contractor has reasonable grounds for doing so which do not relate to the qualifying person’s age, appearance, disability or medical condition, gender or gender reassignment, marriage or civil partnership, pregnancy or maternity, race, religion or belief, sexual orientation or social class.

• (2) The reasonable grounds referred to in sub-paragraph (1) may, in the case of a list application, include the ground that the qualifying person will not, on or after the planned return date, live in, or does not intend to live in, either of the following areas—

• (a) the contractor’s practice area, or

• (b) the outer boundary area (the area referred to in regulation 20(3)).

• (3) Where a contractor refuses a list application, or temporary resident application, the contractor must give a refusal notice to the relevant person before the end of the period of 14 days beginning with the date of the decision to refuse the application.

• (4) For the purposes of sub-paragraph (3), the relevant person is—

• (a) the applicant, or

• (b) where the application was made on behalf of a person who has not attained the age of 16 years or a person who lacks capacity, the person who made the application on their behalf.

• (5) The contractor must—

• (a) keep a written record of—

• (i) the refusal of any list application, and

• (ii) its reasons for that refusal, and

• (b) make such records available to NHS England on request.

• (6) In this paragraph—

• “list application” means an application under paragraph 32D or 32F;

• “refusal notice” means a notice which—is in writing, andincludes the reasons for the decision to refuse the relevant application;

• “temporary residence application” means an application under paragraph 32E or 32G.

Services: remote provision outside practice premises

20A

• (1) Without prejudice to regulation 17(7) (essential services) and paragraph 5 of Schedule 3 (attendance outside practice premises), the contractor and any sub-contractor may provide a remote service from a location which does not constitute practice premises, if the requirements in paragraph (2) are met.

• (2) The requirements referred to in paragraph (1) are that—

• (a) the service is provided from an appropriate location;

• (b) the service is provided through an appropriate digital or telecommunications method; and

• (c) the service is appropriate for provision outside of practice premises.

• (3) For the purposes of paragraph (2)(a), a location is not appropriate if—

• (a) the location or its environment is not conducive to ensuring the confidentiality of patient information, in connection with the service to be provided from that location;

• (b) the location or its environment is not conducive to ensuring appropriate provision of the service from that location.

• (4) For the purposes of paragraph (2)(b), a digital or telecommunications method is appropriate if it meets—

• (a) the requirements in the GPIT Operating Model relevant to that method, including any requirements as to software, or

• (b) requirements which are equivalent in their effect to the relevant requirements in the GPIT Operating Model.

• (5) For the purposes of paragraph (2)(c) the service is not appropriate for provision outside of practice premises if—

• (a) it would not be clinically appropriate for the patient on that occasion; or

• (b) it is otherwise not appropriate to the needs or circumstances of the patient.

• (6) For the purposes of paragraph (3)(a), “patient information” means information which relates to the physical or mental health or condition of a patient, to the diagnosis of their condition, to their care and treatment, or information which is to any extent derived, directly or indirectly, from such information.

Membership of a CCG

Certificates

Patients who should not be tested for, or vaccinated against, coronavirus: confirmation of exemption

Finance

Fees and charges

Circumstances in which fees and charges may be made

Patient participation

Publication of earnings information

Disclosure of information about NHS earnings: contractors and sub-contractors

Disclosure of information about NHS earnings: jobholders

27AA

• (1) In this regulation—

• (a) “disclosure obligation”, “relevant financial year”, “relevant threshold”, “the disclosure date” and “sub-contractor” have the meanings given in regulation 27A;

• (b) “NHS earnings” has the meaning given in regulation 27B.

• (2) In this regulation and, where applicable, in regulation 27B—

• “contract of engagement” means a contract of employment or other agreement under which a jobholder is engaged;

• “jobholder” means—an individual employed by a relevant person;an individual engaged by a relevant person under a contract for services to provide services which enable the relevant person to fulfil its obligations under the contract or sub-contract, as the case may be;an individual engaged by a third party to provide clinical services;where the relevant person is a company, a director or company secretary of that company;

• “relevant person” means—the contractor;a sub-contractor;a person to whom the sub-contractor has sub-contracted obligations as permitted by paragraph 44(9A) of Schedule 3 (“P”);

• “third party contract” means a contract or other agreement under which a relevant person is provided with a jobholder to provide clinical services under the contract or sub-contract, as the case may be, and which is between—a contractor and a person other than a jobholder or sub-contractor,a sub-contractor and a person other than a jobholder, the contractor, or a person (“P”) to whom the sub-contractor has sub-contracted obligations as permitted by paragraph 44(9A) of Schedule 3, orP and a person other than a jobholder or sub-contractor;

• “third party” is to be construed in accordance with the definition of “third party contract”.

• (3) A contract must contain a term which prevents the contractor from entering into a contract of engagement unless it requires the jobholder to comply with the disclosure obligation for each relevant financial year in which the jobholder’s NHS earnings exceed the relevant threshold.

• (4) A contract must also contain a term which prevents the contractor from sub-contracting any of its obligations to provide clinical services under the contract unless—

• (a) the sub-contract entered into by the contractor requires the sub-contractor (“S”) to—

• (i) include the term specified in paragraph (6) in any contract of engagement S enters into with a jobholder on or after entering into the sub-contract, and

• (ii) use reasonable endeavours to include that term in any contract of engagement which S has entered into prior to entering into the sub-contract, and

• (b) the sub-contract prevents S from sub-contracting to P any of the clinical services S has agreed with the contractor to provide under the sub-contract unless the sub-contract S enters into with P includes the term specified in paragraph (5).

• (5) The term requires P to—

• (a) include the term specified in paragraph (6) in any contract of engagement which P enters into with a jobholder on or after entering into the sub-contract with S, and

• (b) use reasonable endeavours to include that term in any contract of engagement which P has entered into prior to entering into that sub-contract.

• (6) The term requires the jobholder to comply with the disclosure obligation for each relevant financial year in which the jobholder’s NHS earnings exceed the relevant threshold.

• (7) A contract must also contain a term requiring the contractor to use reasonable endeavours to ensure that any contract of engagement, which the contractor entered into before the term in paragraph (3) is incorporated into the contract is amended to include the term specified in paragraph (6).

• (8) A contract must also contain a term requiring the contractor to use reasonable endeavours to ensure that any sub-contract which the contractor entered into before the term in paragraph (4) is incorporated into the contract is amended to include the terms specified in paragraph (9).

• (9) The terms are—

• (a) a term which requires S to—

• (i) include the term specified in paragraph (6) in any contract of engagement S enters into with a jobholder on or after the amendment of the sub-contract,

• (ii) use reasonable endeavours to include the term specified in paragraph (6) in any contract of engagement which S entered into before the amendment of the sub-contract, and

• (iii) use reasonable endeavours to include the term specified in paragraph (5) in any sub-contract which S has entered into with P before the amendment of the sub-contract pursuant to paragraph (8);

• (b) a term which prevents S from sub-contracting to P obligations to provide clinical services under the contract unless the sub-contract entered into by S includes the term specified in paragraph (5).

• (10) A contract must also contain a term requiring the contractor to use reasonable endeavours to include in a third party contract (whenever entered into) a term requiring the third party (“T”) —

• (a) to include the term specified in paragraph (6) in any contract of engagement which T enters into with a jobholder on or after entering into the contract with the contractor;

• (b) to use reasonable endeavours to include that term in any contract of engagement which T has entered into prior to entering into the contract with the contractor.

• (11) A contract must also contain a term which prevents the contractor from sub-contracting any of its obligations to provide clinical services under the contract, unless the sub-contract requires S to use reasonable endeavours to—

• (a) include in a third party contract (whenever entered into) a term requiring T —

• (i) to include the term specified in paragraph (6) in any contract of engagement which T enters into with a jobholder on or after entering into the contract with S;

• (ii) to use reasonable endeavours to include that term in any contract of engagement which T has entered into prior to entering into the contract with S; and

• (b) include in any sub-contract between S and P a term requiring P to use reasonable endeavours to include in any third party contract (whenever entered into) the term specified in paragraph (12).

• (12) The term is one which requires T—

• (a) to include the term specified in paragraph (6) in any contract of engagement which T enters into with a jobholder on or after entering into the contract with P;

• (b) to use reasonable endeavours to include that term in any contract of engagement which T has entered into prior to entering into the contract with P.

• (13) Nothing in this regulation requires a jobholder to comply with the disclosure obligation for any relevant financial year which—

• (a) ends before the jobholder enters into a contract of engagement;

• (b) begins after the jobholder’s contract of engagement has terminated.

Calculation of NHS earnings for the purposes of regulations 27A and 27AA

Sub-contracting

Variation of contracts

Variation of contracts: integrated care provider contracts

Variation of contracts: registered patients from outside practice area

Termination of a contract

Other contractual terms

Suspension of contract terms or of enforcement of contract terms while a disease is or in anticipation of a disease being imminently pandemic etc.

Patient access: other availability of directly bookable appointments

71B

A contractor must ensure that all of its directly bookable appointments are made available for booking by telephone or in person.

Confidentiality of personal data: nominated person

Requirement to have and maintain an online presence

Requirement to maintain profile page on NHS website

Provision of information

Provision of information: GP access data

National Diabetes Audit

Information relating to indicators no longer in the Quality and Outcomes Framework

Information relating to alcohol related risk reduction and dementia diagnosis and treatment

NHS Digital Workforce Collections

Information relating to overseas visitors

Medicines and Healthcare products Regulatory Agency Central Alerting System

Collection of data relating to appointments in general practice

Collection of data concerning use of online consultation tools and video consultations

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet

NHS England Workforce Collections

Prescribing software and supply shortages etc. of medicines

55A

• (1) This paragraph applies where—

• (a) the Secretary of State, in the exercise of the Secretary of State’s obligations, duties or powers in respect of ensuring that adequate supplies of English health service medicines are available—

• (i) has acquired information under Part 6 of the Health Service Products (Provision and Disclosure of Information) Regulations 2018 (information about price and availability of health service medicines) about a particular English health service medicine, and

• (ii) authorises the disclosure of information derived from that information (“relevant communications information”) to contractors for the purpose of ensuring, by the appropriate and effective management of—

• (aa) a supply shortage of that particular English health service medicine, or

• (bb) the discontinuation of the production of that particular English health service medicine,

that adequate supplies of English health service medicines are available;

• (b) the contractor wishes to receive relevant communications information via the prescribing software that it has to support the issuing of prescriptions for English health service medicines (in addition to the other ways in which it may access that information); and

• (c) there is a software programme available to the contractor from its supplier of prescribing software (“SPS”) that would enable that.

• (2) Where paragraph (1) applies, the contractor must ensure that the arrangements it makes with a SPS to support the issuing of prescriptions for English health service medicines—

• (a) include appropriate provision requiring the updating of the software to take account of relevant communications information about supply shortages of, or the discontinuation of the production of, particular English health service medicines; and

• (b) are, as regards that inclusion, consistent with the authorisation referred to in paragraph (1)(a)(ii).

• (3) The disclosure of relevant communications information by the Secretary of State or a person acting on the Secretary of State’s behalf to a SPS, or by a SPS to a contractor in a manner that is consistent with the authorisation referred to in paragraph (1)(a)(ii), is not a disclosure of confidential or commercially sensitive information affected by section 264B(2)(b) of the Act, in a case where but for this paragraph it would be, if the disclosure is—

• (a) for the purpose of ensuring, by the appropriate and effective management by the Secretary of State (and persons acting on the Secretary of State’s behalf) of—

• (i) a supply shortage of the particular English health service medicine in question, or

• (ii) the discontinuation of the production of the particular English health service medicine in question,

that adequate supplies of English health service medicines are available; and

• (b) proportionate to that purpose.

• (4) A disclosure of relevant communications information as mentioned in paragraph (3) may be by way of permitting access to that information rather than proactive disclosure.

• (5) A disclosure of relevant communications information that is as mentioned in paragraph (3) is to be treated as neither constituting a breach of confidence nor prejudicing commercial interests in any case where, but for this paragraph, it would be so treated.

• (6) Section 264B(3)(f) of the Act applies to the contractor in respect of relevant communications information received as part of the arrangements mentioned in paragraph (2) as it would if the Secretary of State had disclosed that information to the contractor directly instead of via an intermediary.

• (7) A SPS must not disclose relevant communications information, other than as provided for in paragraph (3), if it is confidential or commercially sensitive information that, when disclosed to a contractor by the Secretary of State, is subject to the disclosure restriction in section 264B(2)(b) of the Act.

Orders for drugs, medicines or appliances

Electronic prescriptions

Nomination of dispensers for the purposes of electronic prescriptions

Repeatable prescribing services

Repeatable prescriptions

Prescribing for electronic repeat dispensing

Restrictions on prescribing by medical practitioners

Restrictions on prescribing by supplementary prescribers

Bulk prescribing

Excessive prescribing

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

New telephone contract or arrangement

2A

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

Cost of relevant calls

Contact with the practice

Attendance outside practice premises

Newly registered patients

Newly registered patients – alcohol dependency screening

Patients living with frailty

Accountable GP

Patients not seen within three years

Patients aged 75 and over

Patients aged 75 and over: accountable GP

NHS e-Referral Service (e-RS)

Direct booking by NHS 111 or via a connected service

Clinical reports

Storage of vaccines

Infection control

Duty of co-operation

Duty of co-operation: Primary Care Networks

Cessation of service provision: information requests

Co-operation with NHS England

Notices to NHS England

Entry and inspection by NHS England

Termination by NHS England: general

Termination by NHS England for breach of conditions in regulation 5

Termination by NHS England for the provision of untrue etc. information

Other grounds for termination by NHS England

Termination by NHS England where patients' safety is seriously at risk or where there is risk of material financial loss to Board

Termination by NHS England for unlawful sub-contracting

Termination by NHS England: remedial notices and breach notices

Termination by NHS England: additional provisions specific to contracts with two or more persons practising in partnership and companies limited by shares

Vaccines and immunisations: standards

Duty to have regard to Armed Forces Covenant principles

15B

When providing services under the contract, the contractor must have due regard to the principles contained in section 343AA(1)(a) to (c) of the Armed Forces Act 2006 in relation to its patients and prospective patients.

Cessation of service provision: information requests

Recording and reviewing patient safety events

74J

• (1) The contractor must register for, and maintain an account with, the LFPSE Service that has administrator rights.

• (2) In this regulation, “LFPSE Service” refers to the centralised system provided by NHS England to record information and provide data and analysis about events involving patient safety.

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet

Enabling access to patient records through GP Connect

68A

• (1) Where the contractor holds a patient’s record on its computerised clinical systems, the contractor must ensure that its computerised clinical systems are configured to enable—

• (a) GP Connect Access Record HTML and GP Connect Access Record Structured; and

• (b) GP Connect Update Record.

• (2) A contractor must take all reasonable steps to ensure that the functionality referred to in paragraph (1) is operational at all times.

• (3) In this regulation—

• “GP Connect” means the national service known as GP Connect provided by NHS England which facilitates interconnectivity between computerised clinical systems;

• “GP Connect Access Record HTML” means the functionality within GP Connect that allows records to be viewed in Hypertext Markup Language by other users of GP Connect for the purpose of direct care to a patient;

• “GP Connect Access Record Structured” means the functionality within GP Connect that allows records to be viewed in a structured and coded format that is machine readable by other users of GP Connect for the purpose of direct care to a patient;

• “GP Connect Update Record” means the functionality within GP Connect that allows consultation summaries to be sent electronically to the contractor by other users of GP Connect for integration into the patient’s record; and

• “patient’s record” means computerised records kept in relation to a patient in accordance with regulation 67(1)(b).

Electronic transfer of patient records between GP practices

Transfer of patient records between GP practices: time limits

Clinical correspondence: requirement for NHS number

Use of fax machines

Patient online services : appointments and prescriptions

Patient online services: provision of online access to full digital medical record

Patient online services: providing and updating personal or contact information

Patient online services: provision of an online consultation tool

Secure electronic communications

Video consultations

Meaning of “appropriate software” for the purposes of regulations 71ZD, 71ZE and 71ZF

Patient access to online services

Patient access: other availability of directly bookable appointments

Confidentiality of personal data: nominated person

Requirement to have and maintain an online presence

Requirement to maintain profile page on NHS website

Provision of information

Provision of information: GP access data

National Diabetes Audit

Information relating to indicators no longer in the Quality and Outcomes Framework

Information relating to alcohol related risk reduction and dementia diagnosis and treatment

NHS England Workforce Collections

Information relating to overseas visitors

Medicines and Healthcare products Regulatory Agency Central Alerting System

Collection of data relating to appointments in general practice

Collection of data concerning use of online consultation tools and video consultations

Recording and reviewing patient safety events

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet