The National Health Service (Personal Medical Services Agreements) Regulations 2015

• (2A) The contractor must, where the patient has nominated a dispenser, consult the patient, or the patient’s authorised person, as to their choice of dispenser in respect of each order for drugs, medicines or appliances made by a prescriber under regulation 49.

• (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (4) A contractor must not seek to persuade a patient, or a patient’s authorised person, to nominate a dispenser recommended by the prescriber or the contractor.

• (5) The contractor must direct the patient, or the patient’s authorised person, to the relevant information made available by NHS England about all chemists who are available in the patient’s chosen area and who are able to provide the required service where—

• (a) a patient does not have a nominated dispenser;

• (b) a patient, or a patient’s authorised person, asks the contractor to recommend a chemist whom the patient or the patient’s authorised person might nominate as the patient’s dispenser; or

• (c) the contractor refers a patient to a pharmaceutical service.

Repeatable prescribing services

52

• (1) The contractor may only provide repeatable prescribing services to a person on its lists of patients if the contractor—

• (a) satisfies the conditions specified in paragraph (2); and

• (b) has given notice in writing to NHS England of its intention to provide repeatable prescribing services in accordance with paragraphs (3) and (4).

• (2) The conditions specified in this paragraph are that—

• (a) the contractor has access to computer systems and software which enable it to issue non-electronic repeatable prescriptions and batch issues; and

• (b) the practice premises at which the repeatable prescribing services are to be provided are located in a local authority area in which there is also located the premises of at least one chemist who has undertaken to provide, or has entered into arrangements to provide, repeat dispensing services.

• (3) The notice given under paragraph (1)(b) must confirm that the contractor—

• (a) wants to provide repeatable prescribing services;

• (b) intends to begin providing those services from a specified date; and

• (c) satisfies the conditions specified in paragraph (2).

• (4) The date specified by the contractor under paragraph (3)(b) must be at least ten days after the date on which the notice under paragraph (1)(b) was given.

• (5) Nothing in this regulation requires a contractor or prescriber to provide repeatable prescribing services to any person.

• (6) A prescriber may only provide repeatable prescribing services to a person on a particular occasion if—

• (a) the person has agreed to receive such services on that occasion; and

• (b) the prescriber considers that it is clinically appropriate to provide such services to that person on that occasion.

• (7) The contractor may not provide repeatable prescribing services to any of its patients to whom a person specified in paragraph (8) is authorised or required by NHS England to provide pharmaceutical services in accordance with arrangements under section 126 (arrangements for pharmaceutical services) and section 132 (persons authorised to provide pharmaceutical services) of the Act.

• (8) The persons specified in this paragraph are—

• (a) a medical practitioner who is a party to the agreement;

• (b) in the case of an agreement with a qualifying body, any medical practitioner who is both a legal and beneficial shareholder in that body; or

• (c) any medical practitioner employed or engaged by the contractor.

Repeatable prescriptions

53

• (1) A prescriber who issues a non-electronic repeatable prescription must at the same time issue the appropriate number of batch issues.

• (2) Where a prescriber wants to make a change to the type, quantity, strength or dosage of drugs, medicines or appliances ordered on a person's repeatable prescription, the prescriber must—

• (a) in the case of a non-electronic repeatable prescription—

• (i) give notice to the person, and

• (ii) make reasonable efforts to give notice to the chemist providing repeat dispensing services to the person,

that the original repeatable prescription should no longer be used to obtain or provide repeat dispensing services and make arrangements for a replacement repeatable prescription to be issued to the person; or

• (b) in the case of an electronic repeatable prescription—

• (i) arrange with the Electronic Prescription Service for the cancellation of the original repeatable prescription, and

• (ii) create a replacement electronic repeatable prescription relating to the person and give notice to the person that this has been done.

• (3) Where a prescriber has created an electronic repeatable prescription for a person, the prescriber must, as soon as practicable, arrange with the Electronic Prescription Service for its cancellation if, before the expiry of that prescription—

• (a) the prescriber considers that it is no longer safe or appropriate for the person to receive the drugs, medicines or appliances ordered on the person's electronic repeatable prescription or it is no longer safe or appropriate for the person to continue to receive repeatable prescribing services;

• (b) the prescriber has issued the person with a non-electronic repeatable prescription in place of the electronic repeatable prescription; or

• (c) it comes to the prescriber's notice that the person has been removed from the list of patients of the contractor on whose behalf the prescription was issued.

• (4) Where a prescriber has cancelled an electronic repeatable prescription relating to a person in accordance with paragraph (3), the prescriber must give notice to the person as soon as possible to that effect.

• (5) A prescriber who has issued a non-electronic repeatable prescription in relation to a person must, as soon as possible, make reasonable efforts to give notice to the chemist that that repeatable prescription should no longer be used to provide repeat dispensing services to that person, if, before the expiry of that repeatable prescription—

• (a) the prescriber considers that it is no longer safe or appropriate for the person to receive the drugs, medicines or appliances ordered on the person's repeatable prescription or that it is no longer safe or appropriate for the person to continue to receive repeatable prescribing services;

• (b) the prescriber issues or creates a further repeatable prescription in respect of the person to replace the original repeatable prescription other than in the circumstances referred to in paragraph (2)(a) (for example, because the person wants to obtain the drugs, medicines or appliances from a different chemist); or

• (c) it comes to the prescriber's attention that the person has been removed from the list of patients of the contractor on whose behalf the prescription was issued.

• (6) Where the circumstances in paragraph (5)(a) to (c) apply, the prescriber must, as soon as practicable, give notice to a person that the person's repeatable prescription should no longer be used to obtain repeat dispensing services.

Prescribing for electronic repeat dispensing

53A

• (1) Subject to regulations 49, 50, 52 and 53(2)(b) to (4), where a prescriber orders a drug, medicine or appliance by means of an electronic repeatable prescription, the prescriber must issue the prescription in a format appropriate for electronic repeat dispensing where it is clinically appropriate to do so for that patient on that occasion.

• (2) In this regulation, “electronic repeat dispensing” means dispensing as part of pharmaceutical services or local pharmaceutical services which involves the provision of drugs, medicines or appliances accordance with an electronic repeatable prescription.

Restrictions on prescribing by medical practitioners

54

• (1) A medical practitioner, in the course of treating a patient to whom the practitioner is providing treatment under the agreement, must comply with the following paragraphs.

• (2) The medical practitioner must not order on a listed prescription items voucher, prescription form or a repeatable prescription a drug, medicine or other substance specified in any directions given by the Secretary of State under section 88 of the Act (GMS contracts: prescription of drugs etc) as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under a general medical services contract.

• (3) The medical practitioner must not order on a listed prescription items voucher, a prescription form or repeatable prescription a drug, medicine or other substance specified in any directions given by the Secretary of State under section 88 of the Act (GMS contracts: prescription of drugs etc) as being a drug, medicine or other substance which can be ordered for specified patients and specified purposes unless—

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

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

• (c) if the order is on a prescription form, the practitioner includes on the form—

• (i) the reference “SLS”, or

• (ii) if the order is under arrangements made by the Secretary of State or NHS England for the distribution of a listed prescription item free of charge, the reference “ACP”.

• (4) The medical practitioner must not order on a prescription form or repeatable prescription a restricted availability appliance unless—

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

• (b) the practitioner includes on the prescription form the reference “SLS”.

• (5) The medical practitioner must not order on a repeatable prescription a controlled drug within the meaning of section 2 of the Misuse of Drugs Act 1971 (controlled drugs and their classification for the purposes of that Act), other than a drug which is for the time being specified in Schedule 4 (controlled drugs subject to the requirements of regulations 22, 23, 26 and 27) or Schedule 5 (controlled drugs excepted from the prohibition on importation, exportation and possession and subject to the requirements of regulations 24 and 26) to the Misuse of Drugs Regulations 2001 .

• (6) Subject to regulation 18(2)(b) and to paragraph (7), nothing in the preceding paragraphs prevents a medical practitioner, in the course of treating a patient to whom this regulation refers, from prescribing a drug, medicine or other substance or, as the case may be, a restricted availability appliance or a controlled drug within the meaning of section 2 of the Misuse of Drugs Act 1971 (controlled drugs and their classification for the purposes of that Act) for the treatment of that patient under a private arrangement.

• (7) Where, under paragraph (6), a drug, medicine or other substance is prescribed under a private arrangement, if the order is to be transmitted as an electronic communication to a chemist for the drug, medicine or appliance to be dispensed—

• (a) if the order is not for a drug for the time being specified in Schedule 2 (controlled drugs subject to the requirements of regulations 14, 15, 16, 18, 19, 20, 21, 23, 26 and 27) or Schedule 3 (controlled drugs subject to the requirements of regulations 14, 15, 16, 18, 22, 23, 24, 26 and 27) to the Misuse of Drugs Regulations 2001 , it may be transmitted by the Electronic Prescription Service; but

• (b) if the order is for a drug for the time being specified in Schedule 2 (controlled drugs subject to the requirements of regulations 14, 15, 16, 18, 19, 20, 21, 23, 26 and 27) or Schedule 3 (controlled drugs subject to the requirements of regulations 14, 15, 16, 18, 22, 23, 24, 26 and 27) to the Misuse of Drugs Regulations 2001, it must be transmitted by the Electronic Prescription Service.

Restrictions on prescribing by supplementary prescribers

55

• (1) The contractor must have arrangements in place to secure that a supplementary prescriber may only—

• (a) issue or create a prescription for a prescription only medicine;

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

• (c) give directions for the administration of a prescription only medicine for parenteral administration,

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

• (2) The conditions set out in this paragraph are that—

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

• (b) the prescription only medicine is not specified in any directions given by the Secretary of State under section 88 of the Act (GMS contracts: prescription of drugs etc) as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under a general medical services contract; and

• (c) the prescription only medicine is not specified in any directions given by the Secretary of State under section 88 of the Act (GMS contracts: prescription of drugs) as being a prescription only medicine which can only be ordered for specified patients and specified purposes unless—

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

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

• (iii) if the supplementary prescriber is issuing or creating a prescription on a prescription form the prescriber includes on the form—

• (aa) the reference “SLS”, or

• (bb) in the case of a listed prescription item ordered under arrangements made by the Secretary of State or NHS England for the item’s distribution free of charge, the reference “ACP”.

• (3) Where the functions of a supplementary prescriber include prescribing, the contractor must have arrangements in place to secure that the person may only issue or create a prescription for—

• (a) an appliance; or

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

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

• (4) The conditions set out in this paragraph are that—

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

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

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

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

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

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

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

• (vii) the arrangements for giving notice of—

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

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

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

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

• (c) if it is a prescription for a prescription only medicine, that prescription only medicine is not specified in any directions given by the Secretary of State under section 88 of the Act (GMS contracts: prescription of drugs etc) as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under the agreement;

• (d) if it is a prescription for a prescription only medicine, that prescription only medicine is not specified in any directions given by the Secretary of State under section 88 of the Act (GMS contracts: prescription of drugs etc) as being a drug, medicine or other substance which can only be ordered for specified patients and specified purposes unless—

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

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

• (iii) when issuing or creating the prescription, the supplementary prescriber includes on the prescription form the reference “SLS”;

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

• (f) if it is a prescription for a restricted availability appliance—

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

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

• (iii) when issuing or creating the prescription, the supplementary prescriber includes on the prescription form the reference “SLS”.

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

• (a) the patient to whom the plan relates;

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

• (c) any supplementary prescriber who is to prescribe, give directions for administration or administer under the plan.

Bulk prescribing

56

• (1) A prescriber may use a single use non-electronic prescription form where—

• (a) a contractor is responsible under the agreement for the treatment of ten or more persons in a school or other institution in which at least 20 persons normally reside; and

• (b) the prescriber orders, for any two or more of those persons for whose treatment the contractor is responsible, drugs, medicines or appliances to which this regulation applies.

• (2) Where a prescriber uses a single non-electronic prescription form for the purpose mentioned in paragraph (1)(b), the prescriber must (instead of entering on the form the names of the persons for whom the drugs, medicines or appliances are ordered) enter on the form—

• (a) the name of the school or other institution in which those persons reside; and

• (b) the number of persons residing there for whose treatment the contractor is responsible.

• (3) This regulation applies to any drug, medicine or appliance which can be supplied as part of pharmaceutical services or local pharmaceutical services and which—

• (a) in the case of a drug or medicine, is not a prescription only medicine; or

• (b) in the case of an appliance, does not contain such a product.

Excessive prescribing

57

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

• (2) In considering whether a contractor has breached its obligations under paragraph (1), NHS England may, if the contractor consents, seek the views of the Local Medical Committee (if any) for the area in which the contractor provides services under the agreement.

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

58

• (1) Subject to paragraphs (2) and (3), a contractor—

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

• (b) may provide to a patient a drug, medicine or appliance, which is not a Scheduled drug, which the contractor personally administers or applies to the patient.

• (2) A contractor must only provide a restricted availability appliance if it is for a person or a purpose specified in the Drug Tariff.

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

PART 10 — Prescribing and dispensing: out of hours services

Supply of medicines etc. by contractors providing out of hours services

59

• (1) In this Part—

• “complete course” means the course of treatment appropriate to the patient's condition, being the same as the amount that would have been prescribed if the patient had been seen during core hours;

• “necessary drugs, medicines and appliances” means those drugs, medicines and appliances which the patient requires and for which, in the reasonable opinion of the contractor having regard to the patient's medical condition, it would not be reasonable in all the circumstances for the patient to wait to obtain them;

• “out of hours performer” means a prescriber, a person acting in accordance with a Patient Group Direction or any other health care professional employed or engaged by the contractor who can lawfully supply a drug, medicine or appliance, who is performing out of hours services under the agreement;

• “Patient Group Direction” has the meaning given in the regulation 213(1) of the Human Medicines Regulations 2012 (interpretation); and

• “supply form” means a form provided by NHS England and completed by or on behalf of the contractor for the purpose of recording the provision of drugs, medicines or appliances to a patient during the out of hours period.

• (2) Where a contractor whose agreement includes the provision of out of hours services has agreed with NHS England that its agreement should also include the supply of necessary drugs, medicines or appliances to patients at the time that it is providing them with out of hours services, the contractor must comply with the requirements of paragraphs (3) to (5).

• (3) The contractor must ensure that an out of hours performer—

• (a) only supplies necessary drugs, medicines and appliances;

• (b) supplies the complete course of the necessary medicine or drug to treat the patient; and

• (c) does not supply—

• (i) drugs, medicines or appliances which the contractor could not lawfully supply,

• (ii) appliances which are not listed in Part IX of the Drug Tariff,

• (iii) restricted availability appliances, except where the patient is a person, or it is for a purpose, specified in the Drug Tariff, or

• (iv) a drug, medicine or other substance listed in Schedule 1 to the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc) Regulations 2004 (drugs, medicines and other substances not to be ordered under a general medical services contract), or a drug listed in Schedule 2 to those Regulations (drugs, medicines and other substances that may be ordered only in certain circumstances), other than in the circumstances specified in that Schedule.

• (4) The out of hours performer—

• (a) must (except where sub-paragraph (b) applies) record on a separate supply form for each patient any drugs, medicines or appliances supplied to the patient; and

• (b) may complete a single supply form in respect of the supply of any necessary drugs, medicines or appliances to two or more persons in a school or other institution in which at least 20 persons normally reside, in which case the out of hours performer may write on the supply form the name of the school or institution rather than the name of each individual patient.

• (5) The out of hours performer must ask any person to produce satisfactory evidence of entitlement where that person makes a declaration that a patient does not have to pay any of the charges specified in regulations made under section 172 of the Act (charges for drugs, medicines or appliances, or pharmaceutical services) or section 174 of the Act (pre-payment certificates) in respect of dispensing services to the patient by virtue of either—

• (a) entitlement to exemption under regulations made under section 172 or 174 of the Act; or

• (b) entitlement to full remission of charges under regulations made under section 182 (remission and repayment of charges) or 183 (payment of travelling expenses) of the Act.

• (6) Paragraph (5) does not apply if, at the time of the declaration, satisfactory evidence of entitlement is already available to the out of hours service performer.

• (7) If, in accordance with paragraphs (5) and (6), no satisfactory evidence of entitlement is produced or no such evidence is otherwise already available to the out of hours performer, the out of hours performer must endorse the supply form to that effect.

• (8) Subject to paragraph (9), nothing in this regulation prevents an out of hours performer from supplying a Scheduled drug or a restricted availability appliance in the course of treating a patient under a private arrangement.

• (9) The provisions of regulation 18 which relates to fees and charges apply in respect of the supply of necessary drugs, medicines and appliances under this regulation as they apply in respect of prescriptions for any drugs, medicines and appliances.

PART10A — Vaccines and immunisations

Part 10A: interpretation

59A

In this Part—

• “GMS Statement of Financial Entitlements” means the directions given by the Secretary of State under section 87 of the Act (GMS contracts: payments);

• “vaccine and immunisations services” has the meaning given in regulation 3(7) of the General Medical Services Contracts Regulations.

Vaccines and immunisations: duty of co-operation

59B

• (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 their 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: standards

59C

• (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 59B(1)(a) of these Regulations;

• “the Vaccines and Immunisations Standards” means the standards determined by NHS England published on 15 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

59D

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

• (2) In this regulation “vaccines 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

59E

• (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 8.

Vaccines and immunisations: nominated person

59F

• (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 59B, and

• (c) overseeing compliance with the requirements of regulations 59B to 59E.

• (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

59G

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

PART 11 — Records and information

Patient records

60

• (1) The contractor must keep adequate records of its attendance on and treatment of patients.

• (2) A contractor which provides essential services must keep the records referred to in paragraph (1)—

• (a) on forms supplied to it for the purpose by NHS England; or

• (b) with the written consent of NHS England, by way of computerised records,

or in a combination of those two ways.

• (3) A contractor which provides essential services must include in the records referred to in paragraph (1), clinical reports sent in accordance with paragraph 7 of Schedule 2 or from any other health care professional who has provided clinical services to a person on the contractor's list of patients.

• (4) The consent of NHS England required by paragraph (2)(b) may not be withheld or withdrawn provided NHS England is satisfied, and continues to be satisfied, that—

• (a) the computer system upon which the contractor proposes to keep the records meets the requirements set out in the GPIT Operating Model;

• (b) the security measures, audit and system management functions incorporated into the computer system and compliant with the GPIT Operating Model have been enabled; and

• (c) the contractor is aware of, and has signed an undertaking that it will have regard to, the guidelines contained in “Digital Primary Care: Good Practice Guidelines for GP electronic patient records – (GPGv5)”, published on 20th September 2023.

• (5) Where the patient's records are computerised records, the contractor must, as soon as possible following a request from NHS England, allow NHS England to access the information recorded on the computer system on which those records are held by means of the audit function referred to in paragraph (4)(b) to the extent necessary for NHS England to confirm that the audit function is enabled and functioning correctly.

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

• (6A) Where a patient on a contractor’s list of patients has registered with another provider of primary medical services and the contractor receives a request from that provider for the complete records relating to that patient, the contractor must send to NHS England—

• (a) the complete records, or any part of the records, sent via the GP2GP facility in accordance with regulation 62 for which the contractor does not receive confirmation of safe and effective transfer via that facility; and

• (b) any part of the records held by the contractor only in paper form.

• (6B) Where a patient on a contractor’s list of patients—

• (a) is removed from that list at that patient’s request under paragraph 22 of Schedule 2, or by reason of the application of any of paragraphs 23 to 30 of that Schedule; and

• (b) the contractor has not received a request from another provider of medical services with which that patient has registered for the transfer of the complete records relating to that patient,

the contractor must send a copy of those records to NHS England.

• (6C) Where a contractor’s responsibility for a patient terminates in accordance with paragraph 31 of Schedule 2, the contractor must send any records relating to that patient that it holds to—

• (a) if known, the provider of primary medical services with which that patient is registered; or

• (b) in all other cases, NHS England.

• (6D) For the purposes of this regulation, “GP2GP facility” has the same meaning as in paragraph (2) of regulation 62.

• (7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (9) A contractor whose patient records are computerised records must not disable, or attempt to disable, either the security measures or the audit system management functions referred to in paragraph (4)(b).

• (10) In this regulation, “computerised records” means records created by way of entries on a computer.

Record of ethnicity information

60A

• (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

61

• (1) A contractor which provides essential services must, in any case where there is a change to the information included in a patient's medical record, enable the automated upload of summary information to the Summary Care Record, when the change occurs, using approved systems provided to it by NHS England.

• (2) In this regulation—

• “Summary Care Record” means the system approved by NHS England for the automated uploading, storing and displaying of patient data relating to medications, allergies, adverse reactions and, where agreed with the contractor and subject to the patient's consent, any other data (other than any information recorded in accordance with regulation 60A) or any information about ethnicity provided under regulation 64C taken from the patient's electronic record; and

• “summary information” means items of patient data that comprise the Summary Care Record.

Enabling access to patient records through GP Connect

61A

• (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 60(2)(b).

Electronic transfer of patient records between GP practices

62

• (1) A contractor which provides essential services must use the facility known as “GP2GP” for the safe and effective transfer of any patient records—

• (a) in a case where a new patient registers with the contractor's practice, to the contractor's practice from another provider of primary medical services (if any) with which the patient was previously registered; or

• (b) in a case where the contractor receives a request from another provider of primary medical services with which the patient has registered, in order to respond to that request.

• (2) In this regulation, “GP2GP facility” means the facility provided by NHS England to a contractor's practice which enables the electronic health records of a registered patient which are held on the computerised clinical systems of the contractor's practice to be transferred securely and directly to another provider of primary medical services with which the patient has registered.

• (3) The requirements of this regulation do not apply in the case of a temporary resident.

Transfer of patient records between GP practices: time limits

62A

• (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 62, and

• (b) send to NHS England in accordance with regulation 60(6A), 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;

• “GP2P facility” has the same meaning as in paragraph (2) of regulation 62.

Clinical correspondence: requirement for NHS number

63

• (1) A contractor must include the NHS number of a registered patient as the primary identifier in all clinical correspondence issued by the contractor which relates to that patient.

• (2) The requirement in paragraph (1) does not apply where, in exceptional circumstances outside of the contractor's control, it is not possible for the contractor to ascertain the patient's NHS number.

• (3) In this regulation—

• “clinical correspondence” means all correspondence in writing, whether in electronic form or otherwise, between the contractor and other health service providers concerning or arising out of the provision of a remote service or patient attendance and treatment at practice premises including referrals made by letter or by any other means; and

• “NHS number”, in relation to a registered patient, means the number, consisting of ten numeric digits, which serves as the national unique identifier used for the purpose of safely, efficiently and accurately sharing information relating to that patient across the whole of the health service in England.

Use of fax machines

63A

• (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

64

• (1) A contractor which provides essential services must promote and offer to its registered patients the facility for a patient to—

• (a) book, view, amend, cancel and print appointments online;

• (b) order repeat prescriptions for drugs, medicines or appliances online; and

• (c) view and print a list of any drugs, medicines or appliances in respect of which the patient has a repeat prescription,

in a manner which is capable of being electronically integrated with the computerised clinical systems of the contractor's practice using appropriate systems authorised by NHS England.

• (2) The requirements in paragraph (1) do not apply where the contractor does not have access to computer systems and software which would enable it to offer the online services described in that paragraph to its registered patients.

• (3) A contractor must when complying with the requirements in paragraph (1)(a)—

• (a) ensure that all of its directly bookable appointments are made available for online booking, whether or not those appointments are booked online, by telephone or in person, to include all appointments which must be made available for direct booking by NHS 111 in accordance with paragraph 16B of Part 2 of Schedule 2 to these Regulations; and

• (b) consider whether it is necessary, in order to meet the needs of its registered patients, to increase the proportion of appointments which are available for its registered patients to book online and, if so, increase that number.

• (3A) In the case of appointments required to be made available for direct booking by NHS 111, in accordance with paragraph 16B of Part 2 of Schedule 2 to these Regulations, those appointments can be released to be booked by a contractor’s registered patients by any means in the two hour period within core hours prior to the appointment time, or such other period agreed pursuant to a local arrangement, if they have not been booked by NHS 111 prior to this time.

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

• (5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (5A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

• (7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (8) ... The contractor must also promote and offer to its registered patients the facility referred to in paragraph (1)(a) and (b) on the home page (or equivalent) of its practice website or online practice profile.

• (9) In this regulation—

• (a) “local arrangement” means an arrangement between the contractor and NHS England as to the timeframe within which appointments not booked by NHS 111 can be released for booking by the contractor’s registered patients; and

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

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

64ZA

• (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 64ZB—

• (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 full digital medical record

64ZB

• (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 64ZA(1), or

• (b) any excepted information.

Patient online services: providing and updating personal or contact information

64ZC

• (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

64ZD

• (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 which satisfies the condition in paragraph (2A) and through which a patient, or an appropriate person acting on behalf of a person to whom paragraph (4) applies, may make—

• (a) a request for advice or information related to the patient’s health, or

• (b) a clinical or administrative request.

• (2A) The condition in this paragraph is that the online facility does not limit the number of requests using the online consultation tool that can be made during core hours or during any period of time within core hours.

• (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 64 to 64ZC, or

• (b) the communication method which the contractor is required to offer and promote under regulation 64ZE.

• (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

64ZE

• (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 the 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 which 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

64ZF

• (1) A contractor must offer and promote to its registered patients the facility of participating in their consultations with the contractor by video conference provided 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 64ZD, 64ZE and 64ZF

64ZG

• (1) For the purposes of regulations 64ZD, 64ZE and 64ZF software which is used to provide a method of communication or facility (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

64A

• (1) This regulation applies to any contractor which has less than ten per cent of its registered patients registered with the contractor’s practice to use the online services which the contractor is required under regulation 64 or regulation 64ZA(1) or (2) to promote, offer or, as the case may be, provide to its registered patients (“patient online services”).

• (2) A contractor to which this regulation applies must agree a plan with NHS England aimed at increasing the percentage of the contractor’s registered patients who are registered with the contractor’s practice to use patient online services.

Patient access: other availability of directly bookable appointments

64B

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

65

The contractor must nominate a person with responsibility for practices and procedures relating to the confidentiality of personal data held by it.

Requirement to have and maintain an online presence

66

• (1) A contractor must have—

• (a) a practice website, or

• (b) an online practice profile.

• (2) The contractor must publish on its practice website or profile (as the case may be) all the information which is required to be included in its practice leaflet.

• (3) The contractor must publish that information otherwise than by making its practice leaflet available for viewing or downloading.

• (4) The contractor must review the information available on its practice website or profile at least once in every period of 12 months.

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

• (a) a review under paragraph (4);

• (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 website or profile), 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.

• (5A) The contractor must also ensure there are links on its website or profile which direct people to—

• (a) its online consultation tool, ...

• (b) the symptom checker and self-care information available on the NHS website , and

• (c) the General Practice Patient Guidance published on the NHS England website.

• (5B) The links mentioned in paragraph (5A) must be displayed prominently on the home page (or equivalent) of its website or profile (as the case may be).

• (6) The requirements in this regulation are in addition to those in regulation 21 and paragraph 15(8) of Schedule 2.

• (7) In these Regulations, “online practice profile” means a profile—

• (a) which is on a website (other than the NHS website), or an online platform, provided by another person for use by a contractor, and

• (b) through which the contractor advertises the primary medical services it provides.

Requirement to maintain profile page on NHS website

66A

• (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 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

67

• (1) Subject to paragraph (2), the contractor must, at the request of NHS England, produce to NHS England, or to a person authorised in writing by NHS England, or allow NHS England, or a person authorised in writing by NHS England, to access—

• (a) any information which is reasonably required by NHS England for the purposes of or in connection with the agreement; and

• (b) any other information which is reasonably required in connection with NHS England’s functions.

• (2) The contractor is not be required to comply with any request made under paragraph (1) unless it has been made by NHS England in accordance with directions relating to the provision of information by contractors given to it by the Secretary of State under section 98A of the Act (exercise of functions).

• (3) The contractor must produce the information requested, or, as the case may be, allow NHS England, or a person authorised by NHS England, access to such information—

• (a) by such date as has been agreed as reasonable between the contractor and NHS England; or

• (b) in the absence of such agreement, before the end of the period of 28 days beginning with the date on which the request is made.

Provision of information: GP access data

67A

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

National Diabetes Audit

67B

• (1) A contractor must record any data required by NHS England for the purposes of the National Diabetes Audit in accordance with paragraph (2).

• (2) The data recorded under paragraph (1) must be appropriately coded by the contractor and uploaded onto the contractor’s computerised clinical systems in accordance with the requirements of guidance published by NHS Employers for these purposes.

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

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

67C

A contractor must allow the extraction from the contractor’s computerised clinical systems by NHS England of the information specified in the Table relating to clinical indicators which are no longer in the Quality and Outcomes Framework at such intervals during each financial year as are notified to the contractor by NHS England.

Indicator ID	Indicator Description
. . .
CHD003	The percentage of patients with coronary heart disease whose last measured cholesterol (measured in the preceding 12 months) is 5 mmol/l or less
CKD002	The percentage of patients on the CKD register in whom the last blood pressure reading (measured in the preceding 12 months) is 140/85 mmHg or less
CKD004	The percentage of patients on the CKD register whose notes have a record of a urine albumin: creatinine ratio (or protein: creatinine ratio) test in the preceding 12 months
NM84	The percentage of patients on the CKD register with hypertension and proteinuria who are currently treated with renin-angiotensin system antagonists
CVD-PP002	The percentage of patients diagnosed with hypertension (diagnosed after or on 1st April 2009) who are given lifestyle advice in the preceding 12 months for: smoking cessation, safe alcohol consumption and healthy diet
DM005	The percentage of patients with diabetes, on the register, who have a record of an albumin: creatinine ratio test in the preceding 12 months
DMO11	The percentage of patients with diabetes, on the register, who have a record of retinal screening in the preceding 12 months
EP002	The percentage of patients 18 or over on drug treatment for epilepsy who have been seizure free for the last 12 months recorded in the preceding 12 months
EP003	The percentage of women aged 18 or over and who have not attained the age of 55 who are taking antiepileptic drugs who have a record of information and counselling about contraception, conception and pregnancy in the preceding 12 months
LD002	The percentage of patients on the learning disability register with Down’s syndrome aged 18 or over who have a record of blood TSH in the preceding 12 months
MH004	The percentage of patients aged 40 or over with schizophrenia, bipolar affective disorder and other psychoses who have a record of total cholesterol: hdl ratio in the preceding 12 months
. . .	. . .
MH007	The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of alcohol consumption in the preceding 12 months
MH008	The percentage of women aged 25 or over and who have not attained the age of 65 with schizophrenia, bipolar affective disorder and other psychoses whose notes record that a cervical screening test has been performed in the preceding 5 years
PAD002	The percentage of patients with peripheral arterial disease in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less
PAD003	The percentage of patients with peripheral arterial disease in whom the last measured total cholesterol (measured in the preceding 12 months) is 5 mmol/l or less
PAD004	The percentage of patients with peripheral arterial disease with a record in the preceding 12 months that aspirin or an alternative anti-platelet is being taken
RA003	The percentage of patients with rheumatoid arthritis aged 30 or over and who have not attained the age of 85 who have had a cardiovascular risk assessment using a CVD risk assessment tool adjusted for RA in the preceding 12 months
RA004	The percentage of patients aged 50 or over and who have not attained the age of 91 with rheumatoid arthritis who have had an assessment of fracture risk using a risk assessment toll adjusted for RA in the preceding 24 months
SMOK001	The percentage of patients aged 15 or over whose notes record smoking status in the preceding 24 months
STIA005	The percentage of patients with a stroke shown to be non-haemorrhagic, or a history of TIA whose last measured total cholesterol (measured in the preceding 12 months) is 5 mmol/l or less
THY001	The contractor establishes and maintains a register of patients with hypothyroidism who are currently treated with levothyroxine
THY002	The percentage of patients with hypothyroidism, on the register, with thyroid function tests recorded in the preceding 12 months

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

67D

• (1) A contractor must allow the extraction by NHS England of the information specified in—

• (a) paragraph (2) in relation to alcohol related risk reduction; and

• (b) paragraph (3) in relation to dementia diagnosis and treatment,

from the record that the contractor is required to keep in respect of each registered patient under regulation 60 by such means, and at such intervals during each financial year, as are notified to the contractor by NHS England.

• (2) The information specified in this paragraph is information required in connection with the requirements under paragraph 14 of Schedule 2.

• (3) The information specified in this paragraph is information relating to any clinical interventions provided by the contractor in the preceding 12 months in respect of a patient who is suffering from, or who is at risk of suffering from, dementia.

NHS England Workforce Collection

67E

• (1) A contractor must record and submit any data required by NHS England for the purposes of the NHS Workforce Collection (known as the “Workforce Minimum Data Set”) in accordance with paragraph (2).

• (2) The data referred to in paragraph (1) must be—

• (a) appropriately coded, reviewed and updated by the contractor in line with agreed standards set out in guidance published by NHS England;

• (b) submitted to NHS England—

• (i) using the data entry module on the National Workforce Reporting Service, which is a facility provided by NHS England to the contractor for this purpose; and

• (ii) at such intervals during the financial year as are notified to the contractor by NHS England.

• (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Information relating to overseas visitors

67F

• (1) A contractor must—

• (a) record the information specified in paragraph (2) relating to overseas visitors, where that information has been provided to it by a newly registered patient on a form supplied to the contractor by NHS England for this purpose; and

• (b) where applicable in the case of a patient, record the fact that the patient is the holder of a document—

• (i) which is—

• (aa) a European Health Insurance Card;

• (bb) an S1 Healthcare Certificate; or

• (cc) a document which, for the purposes of a listed healthcare arrangement as defined in regulation 1(3) of the Healthcare (European Economic Area and Switzerland Arrangements) (EU Exit) Regulations 2019, is treated as equivalent to a document referred to in sub-paragraph (aa) (“EHIC equivalent document”) or (bb) (“S1 equivalent document”); and

• (ii) which has not been issued to or in respect of the patient by the United Kingdom,

in the medical record that the contractor is required to keep under regulation 60 in respect of the patient.

• (2) The information specified in this paragraph is—

• (a) in the case of a patient who holds a European Health Insurance Card or EHIC equivalent document which has not been issued to the patient by the United Kingdom, the information contained on that card or document in respect of the patient; and

• (b) in the case of a patient who holds a Provisional Replacement Certificate issued in respect of the patient’s European Health Insurance Card, the information contained on that certificate in respect of the patient.

• (3) The information referred to in paragraph (2) must be submitted by the contractor to NHS England—

• (a) electronically at nhsdigital.costrecovery@nhs.net;

• (b) by post in hard copy form to EHIC, PDS NBO, NHS Digital, Smedley Hydro, Trafalgar Road, Southport, Merseyside, PR8 2HH.