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

• (e) take reasonable steps to provide information to its registered patients about the services, including information on how to access the services and any changes to them; and

• (f) ensure that it has in place suitable arrangements to enable the sharing of data to support the delivery of the services, business administration and analysis activities.

• (3) For the purposes of this paragraph, “primary care network” means a network of contractors and other providers of services which has been approved by NHS England, serving an identified geographical area....

Cessation of service provision: information requests

Use of NHS primary care logo

48A

Where a contractor chooses to apply the NHS primary care logo to signage, stationery, leaflets, posters, its practice website or to any other form of written representation relating to the primary care services it provides, it must have regard to guidance concerning use of the NHS primary care logo produced by Do you want .

Marketing campaigns

48B

The contractor must participate in a manner reasonably requested by NHS England in up to 6 marketing campaigns in each financial year.

Advertising private services

48C

The contractor must not advertise the provision of private services, either itself or through any other person, whether the contractor provides the services itself or they are provided by another person, by any written or electronic means where the same are used to advertise the primary medical services it provides.

Variation of core hours while a disease is or in anticipation of a disease being imminently pandemic etc.

3A

• (1) In these Regulations, “core hours” means the period beginning at 8.00am and ending at 6.30pm on any day from Monday to Friday in circumstances where, in order to assist in the management of a serious or potentially serious risk to human health arising as a consequence of a disease being, or in anticipation of a disease being imminently—

• (a) pandemic; and

• (b) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement to the effect that the core hours of contractors in the area specified in the announcement are to include Good Friday and bank holidays in the circumstances specified, and for the duration of the period specified, in the announcement.

• (2) In these Regulations, in the circumstances described in paragraph (1), “out of hours period means—

• (a) the period beginning at 6.30pm on any day from Monday to Friday and ending at 8.00am on the following day; and

• (b) the period beginning at 6.30pm on Friday and ending at 8.00am on the following Monday.

Amendment and withdrawal of announcements and advice in respect of pandemics etc.

3B

In these Regulations, where reference is made to an announcement or advice of NHS England that relates to a disease being, or in anticipation of a disease being imminently—

• (a) pandemic; and

• (b) a serious risk or potentially serious risk to human health,

it is to that announcement or advice, which may be withdrawn at any time, as amended from time to time.

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

32A

• (1) Any term that is part of a contract as a consequence of action taken under this Part, or by agreement between the parties or by virtue of regulation 47(2) of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (terms of service of dispensing doctors: general) is temporarily not part of that contract, in the particular circumstances mentioned in sub-paragraph (c)(ii) and during the period mentioned in sub-paragraph (c)(iii), in the following circumstances—

• (a) as a consequence of a disease being, or in anticipation of a disease being imminently—

• (i) pandemic, and

• (ii) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement in respect of the prioritisation of services to be provided in, or in any part of, England as part of the health service;

• (b) the prioritisation is in order to assist in the management of the serious risk or potentially serious risk to human health;

• (c) as part of the announcement, NHS England with the agreement of the Secretary of State has issued advice to the effect that contractors are not to comply with a specified type of term of general medical services contracts—

• (i) in the area to which the announcement relates,

• (ii) in the particular circumstances specified in the announcement, and

• (ii) during the period specified in the announcement; and

• (d) the contractor is situated in the area to which the announcement relates and compliance with the term (it being of the specified type) would, but for the effect of this paragraph, be a requirement of the contractor’s contract.

• (2) NHS England must not take enforcement action, as provided for in a contract, in respect of a breach of a term of the contract in the following circumstances—

• (a) as a consequence of a disease being, or in anticipation of a disease being imminently—

• (i) pandemic, and

• (ii) a serious risk or potentially a serious risk to human health,

NHS England with the agreement of the Secretary of State has made an announcement in respect of the prioritisation of services to be provided in, or in any part of, England as part of the health service;

• (b) the prioritisation is in order to assist in the management of the serious risk or potentially serious risk to human health;

• (c) as part of the announcement, NHS England with the agreement of the Secretary of State has issued advice to the effect that contractors need not comply with a specified type of term of general medical services contracts—

• (i) in the area to which the announcement relates,

• (ii) in the particular circumstances specified in the announcement, and

• (ii) during the period specified in the announcement; and

• (d) the contractor—

• (i) is situated in the area to which the announcement relates, and

• (ii) has not complied with the term (it being of the specified type) in the particular circumstances mentioned in sub-paragraph (c)(ii) and during the period mentioned in sub-paragraph (c)(iii).

Prescribing for electronic repeat dispensing

Use of fax machines

70A

• (1) Where a contractor can transmit information by electronic means (other than facsimile transmission) securely and directly to a relevant person, the contractor must not—

• (a) transmit any information to that person by facsimile transmission, or

• (b) agree to receive any information from that person by facsimile transmission.

• (2) Paragraph (1) does not apply to any information which relates solely to the provision of clinical services or treatment to a patient under a private arrangement.

• (3) In this regulation, “relevant person” means—

• (a) an NHS body,

• (b) another health service provider,

• (c) a patient, or

• (d) a person acting on behalf of a patient.

Patient online services : appointments and prescriptions

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

71ZA

• (1) Where the contractor holds the medical record of a registered patient (“P”) on its computerised clinical systems, the contractor must—

• (a) provide P with the facility to access online information entered onto P’s medical record on or after the relevant date (the “prospective medical record”); and

• (b) promote and offer to P, in accordance with paragraph (2), the facility to access online the information from P’s medical record held in coded form.

• (2) For the purposes of paragraph (1)(b), the contractor is taken to be—

• (a) promoting the facility to P where P is encouraged to utilise the practice’s digital services and to interact with the practice via online access;

• (b) offering the facility to P where it is freely available to P if P shows interest in the facility or requests access in writing to their medical records held in coded form.

• (3) Where a person (“R”) applies to become a registered patient of the contractor, the contractor must, as part of the registration process—

• (a) make information available to R about the practice’s digital services and about how R may interact with the practice via online access; and

• (b) inform R in writing that on becoming a registered patient, R will be provided with the facility to access R’s prospective medical record (unless R chooses not to be provided with that facility).

• (4) The contractor must configure its computerised clinical systems so as to allow its registered patients the facility to access online information entered onto their medical record.

• (5) In this regulation, “relevant date” means—

• (a) if the contractor has not provided P with the facility to access online P’s prospective medical record under this regulation as in force immediately before 15th May 2023, the day on which the contractor does provide the facility under paragraph (1)(a); or

• (b) 31st October 2023,

whichever is the earlier.

• (6) Where—

• (a) the contractor has not, before 15th May 2023, provided P with the facility to access online P’s prospective medical record; and

• (b) P makes a request in writing to the contractor on or after 15th May 2023 but before 31st October 2023, to be provided with that facility,

the contractor must provide that facility to P by the end of the compliance period or by 31st October 2023 whichever is the earlier.

• (7) Where—

• (a) the contractor has not, before 1st November 2023, for whatever reason, provided P with the facility to access online P’s prospective medical record; and

• (b) P makes a request in writing to the contractor on or after 31st October 2023 to be provided with that facility,

the contractor must provide P with that facility by the end of the compliance period.

• (8) Subject to paragraph (9), the contractor must not remove the facility of a registered patient to access online their medical record provided under—

• (a) this regulation as in force immediately before 15th May 2023; or

• (b) paragraph (1).

• (9) Nothing in this regulation requires the contractor to provide P with the facility to access—

• (a) online information entered onto the medical record where that information is excepted information;

• (b) online information entered onto P’s prospective medical record where P has informed the contractor that they do not, or no longer, wish to be provided with that facility; or

• (c) information referred to in paragraph (1)(b) which the contractor’s computerised systems cannot separate from any free-text entry in P’s medical record.

• (10) For the purposes of this regulation and regulation 71ZB—

• (a) “the compliance period” means the period specified in Article 12 of the UK GDPR for compliance with a request made in exercise of a right under Article 15 of the UK GDPR;

• (b) information is “excepted information” if the contractor would not be required to disclose it in response to a request made in exercise of a right under Article 15 of the UK GDPR.

• (11) For the purposes of paragraph (10), “UK GDPR” has the meaning given in section 3(10) of the Data Protection Act 2018.

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

71ZB

• (1) A contractor must provide a registered patient (“P”) with the facility to access online relevant medical information if—

• (a) its computerised clinical systems ... allow it to do so, and

• (b) P requests, in writing, that it provide that facility.

• (1A) Where P makes a request under paragraph (1)(b), the contractor must provide P with the facility by the end of the compliance period.

• (1B) The contractor must configure its computerised clinical systems so as to allow its registered patients the facility to access online their relevant medical information.

• (2) In this regulation “relevant medical information” means any information entered on P’s medical record other than—

• (a) any information which P can access online via a facility provided in accordance with regulation 71ZA(1), or

• (b) any excepted information.

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

73A

• (1) A contractor must review the information available on its profile page on the NHS website at least once in every period of 12 months.

• (2) The contractor must make any amendments necessary to maintain the accuracy of the information on its profile page following—

• (a) a review under paragraph (1);

• (b) a change to—

• (i) the address of any of the contractor’s practice premises,

• (ii) the contractor’s telephone number,

• (iii) the contractor’s electronic-mail address (if made available on its profile page), or

• (iv) any other stated means by which a patient may contact the contractor to book or amend an appointment, or to order repeat prescriptions for drugs, medicines or appliances.

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 Census

Information relating to overseas visitors

Medicines and Healthcare products Regulatory Agency Central Alerting System

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet

NHS Digital Workforce Collections

Collection of data relating to appointments in general practice

74H

• (1) A contractor must participate in the collection of anonymised data relating to appointments for its registered patients (“practice appointments data”) in accordance with the “GP Appointments Data Collection in Support of Winter Pressures” referred to in the Health and Social Care Information Centre (Establishment of Information Systems for NHS Services: General Practice Appointments Data Collection in Support of Winter Pressures) Directions 2017 (the functions of the Health and Social Care Information Centre under the Directions were transferred to NHS England by the Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023).

• (2) The contractor must ensure that all practice appointments data relating to the provision of primary medical services under its contract is recorded within the appointment book in accordance with the guidance.

• (3) The contractor must ensure that the practice appointments data is uploaded onto its computerised clinical systems and available for collection by NHS England at such intervals during each financial year as notified to the contractor by NHS England.

• (4) For the purposes of this regulation, “appointment book” means a capability provided by the contractor’s computerised clinical systems and software supplier which supports the administration, scheduling, resourcing and reporting of appointments.

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet

Direct booking by NHS 111 or via a connected service

Assignment of patients from outside practice area

40A

Where NHS England has assigned a person to a contractor’s list of patients in accordance with this Part, and that person resides outside a contractor’s practice area, regulation 30(4), (5) and (6) (variation of contracts: registered patients from outside practice area) are to apply as if the contractor had accepted that patient onto its list of patients in accordance with regulation 30(1) unless a contractor chooses to include that person in its list of patients for its practice area on assignment by NHS England.

Assignments to closed lists: composition and determinations of the assessment panel

Assignment to closed lists: NHS dispute resolution procedure relating to determinations of the assessment panel

Assignments to closed lists: assignments of patients by NHS England

Record of ethnicity information

67A

• (1) This regulation applies if a contractor, or a person acting on behalf of a contractor, makes a request to a patient (“P”) for P to disclose their ethnicity to the contractor so that information can be recorded in P’s medical record (a “relevant request”).

• (2) If P, or where P is a person to whom paragraph (4) applies, an appropriate person acting on behalf of P, discloses P’s ethnicity in response to the relevant request, the contractor must record P’s ethnicity in P’s medical record.

• (3) If P, or where P is a person to whom paragraph (4) applies, an appropriate person acting on behalf of P, indicates that they would prefer not to disclose P’s ethnicity in response to the relevant request, the contractor must record that response in P’s medical record.

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

• (a) are a child, or

• (b) lack the capacity to respond to the relevant request.

• (5) Any information recorded in accordance with this regulation may only be processed if the processing is necessary for medical purposes.

• (6) Nothing in this regulation authorises the processing of personal data in a manner inconsistent with any provision of the data protection legislation.

• (7) In this regulation—

• ...

• “data protection legislation”, “personal data” and “processing” have the same meanings as in the Data Protection Act 2018 (see section 3 of that Act);

• “medical purposes” has the meaning given for the purposes of section 251 of the Act.

Summary Care Record

Electronic transfer of patient records between GP practices

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 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

Inquiries about prescriptions and referrals

Provision of information to a medical officer etc.

Annual return and review

Practice leaflet

PART 9A — Vaccines and immunisations

Vaccines and immunisations: duty of co-operation

66A

• (1) The contractor must co-operate, in so far as is reasonable, with relevant persons—

• (a) to understand the current uptake, and barriers to uptake, of offers to provide or administer vaccines and immunisations of the type specified in the GMS Statement of Financial Entitlements (“relevant vaccines and immunisations”) to patients, and

• (b) to develop (if necessary) a strategy for improving the contractor’s immunisation programme.

• (2) For the purposes of paragraph (1) “relevant persons” means—

• (a) other persons who administer relevant vaccines and immunisations to patients;

• (b) NHS England;

• (c) the Secretary of State;

• (d) local authorities.

• (e) integrated care boards.

Vaccines and immunisations: appointments

66B

• (1) A contractor must ensure that they have in place a system for delivering appointments at which relevant vaccines or immunisations are administered to patients (“immunisation appointments”) which meets the Vaccines and Immunisations Standards.

• (1A) A contractor must comply with the standards contained in the Vaccines and Immunisations Standards on the processing of data relating to patients.

• (2) In this regulation—

• “processing” has the meaning given by section 3(4) of the Data Protection Act 2018;

• “relevant vaccine or immunisation” has the same meaning as in regulation 66A(1)(a) of these Regulations;

• “the Vaccines and Immunisations Standards” means the standards determined by NHS England published on 15th April 2024 and which a contractor is required to meet in relation to the following matters—the invitation of patients for immunisation appointments when they first become eligible for relevant vaccines or immunisations (“newly eligible patients”);the steps to be taken if no response is received to an invitation falling within sub-paragraph (a);the provision of immunisation appointments to newly eligible patients;the steps to be taken if a newly eligible patient does not attend an immunisation appointment;requests for relevant vaccines or immunisations made by patients who are eligible for them but have not previously received them for any reason;the identification of gaps in the vaccination records of registered patients, and the offer, and provision of, immunisation appointments to those patients;the processing of records relating to patient vaccinations and immunisations, including records relating to the administration of vaccines and patient vaccination status.

Vaccines and immunisations: catch-up campaigns

66C

• (1) The contractor must participate in a manner reasonably required by NHS England in one vaccine and immunisations catch-up campaign in each financial year.

• (2) In this regulation “vaccine and immunisations catch-up campaign” means a campaign which is aimed at maximising the uptake of a particular vaccine or immunisation by patients who are eligible for it but have not received that vaccine or immunisation for any reason (other than a decision to refuse the vaccine or immunisation).

Vaccines and immunisations: additional staff training

66D

• (1) The contractor must ensure that all staff involved in the administration of vaccines and immunisations are trained in the recognition and initial treatment of anaphylaxis.

• (2) This regulation does not affect the contractor’s obligations under Part 7.

Vaccines and immunisations: nominated person

66E

• (1) The contractor must nominate a person (a “V & I lead”) who is to have responsibility for—

• (a) overseeing the provision of vaccine and immunisation services by the contractor,

• (b) carrying out, on behalf of the contractor, any of the contractor’s functions under regulation 66A, and

• (c) overseeing compliance with the requirements of regulations 66A to 66D.

• (2) The contractor must ensure that the V & I lead—

• (a) has regard to all guidance issued by NHS England which is relevant to that role, and

• (b) if they are not a health care professional, is directly supervised in that role by a healthcare professional.

Vaccines and immunisations: exception for private arrangements

66F

Nothing in this Part applies in relation to the offer or administration of any vaccine or immunisation to a patient under a private arrangement.

Minor surgery

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

22A

• (1) Subject to paragraph (6), a contract must contain a term which requires the contractor to respond to a valid exemption confirmation request if it is made at a relevant time.

• (2) An exemption confirmation request—

• (a) is a request to confirm whether a relevant patient (“P”), for clinical reasons—

• (i) should neither be tested for coronavirus nor vaccinated with an authorised vaccine, or

• (ii) should not be vaccinated with an authorised vaccine, and

• (b) is valid if it is made in accordance with the process approved by the Secretary of State .

• (2A) A valid exemption confirmation request is made at a relevant time if, at the time the request is made to the contractor—

• (a) legislation in force in England requires a person or class of person to be vaccinated against coronavirus unless they can show that, for clinical reasons, they are exempt from vaccination with an authorised vaccine, or

• (b) guidance issued by, or on behalf of, the Secretary of State provides that a person or class of person should be vaccinated against coronavirus unless they can show that, for clinical reasons, they are exempt from vaccination with an authorised vaccine.

• (3) An exemption confirmation request may be made by—

• (a) P, or

• (b) where P is a person to whom paragraph (4) applies, an appropriate person acting on behalf of P.

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

• (a) are a child, or

• (b) lack the capacity to make a request under paragraph (1).

• (5) The contractor must respond to a valid exemption confirmation request made at a relevant time—

• (a) free of charge to P or the appropriate person, and

• (b) by recording its response on an information hub using a method approved by the Secretary of State.

• (6) A contractor is not required to respond to a valid exemption confirmation request if—

• (a) for the medical condition which may mean that P should neither be tested for coronavirus nor vaccinated with an authorised vaccine, or should not be vaccinated with an authorised vaccine, P is being attended by a medical practitioner who is not—

• (i) engaged or employed by the contractor,

• (ii) in the case of a contract with two or more persons practising in partnership, one of those persons, or

• (iii) in the case of a contract with a company limited by shares, one of the persons legally or beneficially owning shares in that company, and

• (b) that medical condition is not one to which paragraph (7) applies.

• (7) This paragraph applies to a medical condition if no person with that condition should be—

• (a) tested for coronavirus or vaccinated with an authorised vaccine, or

• (b) vaccinated with an authorised vaccine.

• (8) In this regulation—

• “authorised vaccine” means a medicinal product—authorised for supply in the United Kingdom in accordance with a marketing authorisation, orauthorised by the licensing authority on a temporary basis under regulation 174 of the Human Medicines Regulations 2012 (supply in response to spread of pathogenic agents etc),for vaccination against coronavirus;

• “coronavirus” means severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);

• “licensing authority”, “marketing authorisation” and “medicinal product” have the meanings given in the Human Medicines Regulations 2012 (see regulations 6, 8 and 2, respectively, of those Regulations);

• “relevant patient” means—a registered patient, ora temporary resident.

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

27A

• (1) A contract which is with a contractor who is an individual medical practitioner or a partnership must contain the term specified in paragraph (2).

• (2) The term is—

• (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—