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

Type Statutory-Instrument

Publication 2015-11-06

Last updated 2026-07-10

State In force

Department Statute Law Database

Source legislation.gov.uk

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(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,

(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;

(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

(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

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.

(4) Where the patient is the holder of an S1 Healthcare Certificate or S1 equivalent document, the contractor must send that certificate or document, or a copy of that certificate or document, to the the NHS Business Services Authority—

(a) electronically to nhsbsa.faregistrationsohs@nhs.net, or

(b) by post in hard copy form to Cost Recovery, Overseas Healthcare Service, Bridge House, 152 Pilgrim Street, Newcastle Upon Tyne, NE1 6SN.

Medicines and Healthcare products Regulatory Agency Central Alerting System

67G

A contractor must—

(a) provide to the Medicines and Healthcare products Regulatory Agency (“the MHRA”) on request, an electronic mail address which is registered to the contractor’s practice;

(b) monitor that address;

(c) if that address ceases to be registered to the practice, notify the MHRA immediately of its new electronic mail address; and

(d) provide to the MHRA on request, one or more mobile telephone numbers for use in the event the contractor is unable to receive electronic mail.

Collection of data relating to appointments in general practice

67H

(1) A contractor must participate in the collection of anonymised data relating to appointments for its registered patients (“GP practice 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 GP practice 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 GP practice 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.

Collection of data relating to use of the online consultation tool and video consultations

67I

(1) The contractor must make available to NHS England such information as is specified by NHS England that is available to the contractor in connection with use of the online consultation tool under regulation 64ZD and video consultations under regulation 64ZF.

(2) The contractor must make information available to NHS England under paragraph (1) within such reasonable time frame as may be specified by NHS England.

Recording and reviewing patient safety events

67J

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

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

NHS staff surveys

67K

(1) The contractor must make available to NHS England such information as specified by NHS England in connection with staff surveys that relate to the contractor’s staff.

(2) The contractor must make information available to NHS England under paragraph (1) within such reasonable time frame as may be specified by NHS England.

Information relating to the Lung Cancer Screening Programme

67L

(1) A contractor must allow the extraction by NHS England, or by persons authorised by NHS England, of data reasonably required for the purpose of the Lung Cancer Screening Programme, from the record that the contractor is required to keep under regulation 60 by such means, and at such intervals, as are notified to the contractor by NHS England.

(2) The contractor must co-operate, in so far as is reasonable, with NHS England, or persons authorised by NHS England, in relation to data extractions under paragraph (1).

(3) In this regulation, “Lung Cancer Screening Programme” means the national programme arranged by NHS England of lung health checks for the purpose of detecting and diagnosing lung cancer, for persons identified by NHS England as recommended for such checks.

Inquiries about prescriptions and referrals

68

(1) The contractor must, subject to paragraphs (2) and (3), sufficiently answer any inquiries, whether oral or in writing, from NHS England concerning—

(a) any prescription form or repeatable prescription form issued or created by a prescriber;

(b) the considerations by reference to which prescribers issue such forms;

(d) the considerations by which the contractor makes such referrals or provides for them to be made on its behalf.

(2) An inquiry referred to in paragraph (1) may only be made for the purpose of obtaining information to assist NHS England to discharge its functions, or of assisting the contractor in the discharge of its obligations, under the agreement.

(3) The contractor is not obliged to answer any inquiry referred to in paragraph (1) unless it is made—

(a) in the case of paragraph (1)(a) or (b), by an appropriately qualified health care professional; or

(b) in the case of paragraph (1)(c) or (d), by an appropriately qualified medical practitioner.

(4) The appropriately qualified person referred to in paragraph (3)(a) or (b) must —

(a) be appointed by NHS England to assist it in the exercise of NHS England’s functions under this regulation; and

(b) produce on request, written evidence that they are authorised by NHS England to make such an inquiry on NHS England’s behalf.

Provision of information to a medical officer etc.

69

(1) The contractor must, if satisfied that the patient consents—

(a) supply in writing to any person specified in paragraph (3), (a “relevant person”), before the end of such reasonable period as that person may specify, such clinical information as any of the persons mentioned in paragraph (3)(a) to (d) considers relevant about a patient to whom the contractor, or a person acting on behalf of the contractor, has issued or has refused to issue a medical certificate; and

(b) answer any inquiries by a relevant person about—

(i) a prescription form or medical certificate issued or created by, or on behalf of, the contractor; or

(ii) any statement which the contractor, or a person acting on behalf of the contractor, has made in a report.

(2) For the purposes of being satisfied that a patient consents, a contractor may rely on an assurance in writing from a relevant person that the consent of the patient has been obtained, unless the contractor has reason to believe that the patient does not consent.

(3) For the purposes of this regulation, a “relevant person” is—

(a) a medical officer;

(b) a nursing officer;

(d) a physiotherapist; or

(e) an officer of the Department for Work and Pensions who is acting on behalf of, and at the direction of, any person specified in sub-paragraphs (a) to (d).

(4) In this regulation—

“medical officer” means a medical practitioner who is—employed or engaged by the Department for Work and Pensions; orprovided by an organisation under a contract entered into with the Secretary of State for Work and Pensions;

“nursing officer” means a health care professional who is registered on the Nursing and Midwifery Register and who is—employed by the Department for Work and Pensions; orprovided by an organisation under a contract with the Secretary of State for Work and Pensions;

“occupational therapist” means a health care professional who is registered in the part of the register maintained by the Health Professions Council under article 5 of the Health Professions Order 2001 (establishment and maintenance of register) relating to occupational therapists and who is—employed or engaged by the Department for Work and Pensions; orprovided by an organisation under a contact entered into with the Secretary of State for Work and Pensions; and

“physiotherapist” means a health care professional who is registered in the part of the register maintained by the Health Professions Council under article 5 of the Health Professions Order 2001 (establishment and maintenance of register) relating to physiotherapists and who is—employed or engaged by the Department for Work and Pensions; orprovided by an organisation under a contract entered into with the Secretary of State for Work and Pensions.

Annual return and review

70

(1) The contractor must submit to NHS England an annual return relating to the agreement which must require the same categories of information to be provided by all persons who hold agreements with NHS England and make available to NHS England a digital practice area map , for approval by NHS England.

(2) NHS England may request a return relating to the agreement at any time during each financial year in relation to such period (not including any period covered by a previous annual return) as may be specified in the request.

(3) The contractor must submit the completed return and make available the digital practice area map to NHS England—

(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 was made.

(4) Following receipt of the return referred to in paragraph (1), NHS England must arrange with the contractor an annual review of its performance in relation to the agreement.

(5) NHS England must prepare a draft record of the review referred to in paragraph (2) for comment by the contractor and, having regard to such comments, must produce a final written record of the review.

(6) NHS England must send a copy of the final record of the review referred to in paragraph (5) to the contractor.

Practice leaflet

71

(1) A contractor which provides essential services must compile a document (a “practice leaflet”) which must include the information specified in Part 6 of Schedule 2.

(2) The contractor must review its practice leaflet at least once in every period of 12 months and make any amendments necessary to maintain its accuracy.

(3) The contractor must make available a copy of the leaflet, and any subsequent updates, to its patients and prospective patients.

PART 12 — Complaints

Complaints procedure

72

(1) The contractor must establish and operate a complaints procedure to deal with complaints made in relation to any matter that is reasonably connected with the provision of services under the agreement.

(2) The complaints procedure must comply with the requirements of the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 .

Co-operation with investigations

73

(1) The contractor must co-operate with—

(a) the investigation of any complaint made in relation to a matter that is reasonably connected with the provision of services under the agreement by—

(i) NHS England, or

(ii) the Health Service Commissioner; and

(b) the investigation of any complaint made by an NHS body or local authority which relates to a patient or former patient of the contractor.

(2) In paragraph (1)—

“NHS body” means—in relation to England and Wales, NHS England or an integrated care board; andin relation to England and Wales, Scotland and Northern Ireland, an NHS Trust, an NHS foundation trust, a Local Health Board, a Health Board a Health and Social Services Board or a Health and Social Services Trust;

“local authority” means—a local authority within the meaning of section 1 of the Local Authority Social Services Act 1970 (local authorities);the Council of the Isles of Scilly; ...a council constituted under section 2 of the Local Government etc. (Scotland) Act 1994 (constitution of councils); or the council of a county or county borough in Wales; and

“Health Service Commissioner” means the person appointed as Health Service Commissioner for England in accordance with section 1 of, and Schedule 1 to, the Health Service Commissioners Act 1993 (The Commissioner).

(3) For the purposes of paragraph (1), co-operation includes—

(a) answering questions which are reasonably put to the contractor by NHS England;

(b) providing information relating to the complaint which is reasonably required by NHS England; and

(c) attending any meeting held to consider the complaint (if held at a reasonably accessible place and at a reasonable hour and if due notice has been given) if the contractor's presence at the meeting is reasonably required by NHS England.

PART 13 — Dispute resolution

Local resolution of agreement disputes

74

(1) The contractor and NHS England must make reasonable efforts to communicate and co-operate with each other with a view to resolving any dispute which arises out of or in connection with the agreement before referring the dispute for determination in accordance with the NHS dispute resolution procedure (or, where applicable, before commencing court proceedings).

(2) Paragraph (1) does not apply to a dispute relating to the assignment of patients to a closed list which falls to be dealt with under the NHS dispute resolution procedure by virtue of paragraph 41(1) of Schedule 2 where it is not practicable for the parties to attempt local resolution before the expiry of the period seven days specified in paragraph 41(4) of that Schedule.

Dispute resolution: non-NHS contracts

75

(1) Where an agreement is not an NHS contract, a dispute arising out of or in connection with the agreement, except any matter dealt with under the complaints procedure under Part 12, may be referred for consideration and determination by the Secretary of State—

(a) if it relates to a period when the contractor was treated as a health service body, by the contractor or by NHS England; or

(b) in any other case, by the contractor or, if the contractor agrees in writing, by NHS England.

(2) Where a dispute is referred to the Secretary of State under paragraph (1)—

(a) the procedure to be followed is the NHS dispute resolution procedure; and

(b) the parties agree to be bound by any determination made by the adjudicator.

NHS dispute resolution procedure

76

(1) The procedure specified in this regulation and in regulation 77 applies to a dispute arising out of or in connection with the agreement which is referred to the Secretary of State in accordance with—

(a) section 9(6) of the Act (where the agreement is an NHS contract); or

(b) regulation 75(1) (where the agreement is not an NHS contract).

(2) The procedure referred to in paragraph (1) does not apply where the contractor refers a matter for determination in accordance with paragraph 38 of Schedule 2 and, in such a case, the procedure specified in that paragraph applies instead.

(3) Where a party wants to refer a dispute for determination under the procedure specified in this regulation, it must send to the Secretary of State a written request for dispute resolution which must include or be accompanied by—

(a) the names and addresses of the parties to the dispute;

(b) a copy of the agreement; and

(4) Where a party wants to refer a dispute, it must send a request under paragraph (3) to the Secretary of State before the end of the period of three years beginning with the date on which the matter giving rise to the dispute occurred or should reasonably have come to the attention of that party.

(5) Where the dispute relates to an agreement which is not an NHS contract, the Secretary of State may—

(a) determine the dispute; or,

(b) if the Secretary of State considers it appropriate, appoint a person or persons to consider and determine the dispute.

(6) Before reaching a decision about who should determine the dispute, either under paragraph (5) or under section 9(6) of the Act, the Secretary of State must send a written request to the parties, before the end of the period of seven days beginning with the date on which the dispute was referred, inviting them to make any written representations that they may wish to make about the matter under dispute before the end of a specified period.

(7) The Secretary of State must give, with the notice given under paragraph (6), to a party other than the one who referred the matter for dispute resolution a copy of any document by which the matter was referred to dispute resolution.

(8) The Secretary of State must—

(a) give a copy of any representations received from a party to the other party to the dispute; and

(b) in each case, request in writing a party to whom a copy of the representations is given to make, within a specified period, any written observations which that party may wish to make regarding those representations.

(9) If the Secretary of State decides to appoint a person or persons (“the adjudicator”) to hear the dispute, the Secretary of State must—

(a) inform the parties in writing of the name of the adjudicator whom the Secretary of State has appointed; and

(b) pass to the adjudicator any documents received from the parties under or by virtue of paragraph (3), (6) or (8).

(10) The Secretary of State must comply with the requirement in paragraph (9)—

(a) following receipt of any representations received from the parties; or

(b) if no such representations are received before the end of the period for making those representations specified in the request sent under paragraph (6) or (8), at the end of that period.

(11) The adjudicator may, for the purpose of assisting in the consideration of the subject matter of the dispute—

(a) invite representatives of the parties to appear before, and make oral representations to, the adjudicator either together or, with the agreement of the parties, separately;

(b) in advance of hearing any oral representations, provide the parties with a list of matters or questions that the adjudicator would like the parties to give special consideration to; or

(12) Where the adjudicator consults another person under paragraph (11)(c), the adjudicator must—

(a) give notice in writing to the parties accordingly; and

(b) where the adjudicator considers that the interests of any party might be substantially affected by the result of the consultation, give to the parties such opportunity as the adjudicator considers reasonable in the circumstances to make observations on those results.

(13) In considering the matter, the adjudicator must have regard to—

(a) any written representations made in response to a request under paragraph (6), but only if they are made before the end of the specified period;

(b) any written observations made in response to a request under paragraph (8), but only if they are made before the end of the specified period;

(d) the results of any consultation under paragraph (11)(c); and

(e) any observations made in accordance with an opportunity given under paragraph (12).

(14) In this regulation, “specified period” means—

(a) such period as the Secretary of State specifies in the request being a period of not less than two or not more than four weeks beginning with the date on which the notice referred to is given; or

(b) such longer period as the Secretary of State may allow if the Secretary of State considers that there are good reasons for extending the period referred to in sub-paragraph (a) (even after that period has expired), and where the Secretary of State does so allow, a reference in this regulation to the specified period is to the period as so extended.

(15) The adjudicator may determine the procedure which is to apply to the dispute resolution in such manner as the adjudicator considers appropriate in order to ensure the just, expeditious, economical and final determination of the dispute subject to—

(a) the other provisions of this regulation;

(b) regulation 77; and

Determination of dispute

77

(1) The adjudicator's determination and the reasons for it must be recorded in writing and the adjudicator must give notice in writing of that determination (including the record of the reasons) to the parties.

(2) Where the adjudicator makes a direction as to payments under section 9(6) of the Act (as it has effect as a result of section 9 of the Act or regulation 77(1), that direction is to be enforceable in a county court (if the court so orders) as if it were a judgement or order of the court.

(3) Where a dispute is referred for determination in accordance with regulation 75(1)—

(a) section 9(12) and (13) of the Act apply in the same manner as those provisions apply to an agreement referred for determination in accordance with section 9(6) and (7) of the Act; and

(b) section 90(5) of the Act applies to any agreement which is not an NHS contract as if it were referred for determination in accordance with section 9(6) of the Act.

Interpretation of this Part

78

(1) In this Part, “any dispute arising out of or in connection with the agreement” includes any dispute arising out of or in connection with the termination of the agreement.

(2) A term of the agreement which makes provision in respect of the requirements of this Part is to survive even where the agreement has terminated.

PART 14 — Miscellaneous

Clinical governance

79

(1) The contractor must have in place an effective system of clinical governance which includes appropriate standard operating procedures in relation to the management and use of controlled drugs.

(2) The contractor must nominate a person who is to have responsibility for ensuring the effective operation of the system of clinical governance.

(3) The person nominated under paragraph (2) must be a person who performs or manages the performance of services under the agreement.

(4) In this regulation—

(a) “controlled drugs” has the meaning given in section 2 of the Misuse of Drugs Act 1971 (which relates to controlled drugs and their classification for the purposes of that Act); and

(b) “system of clinical governance” means a framework through which the contractor endeavours continuously to improve the quality of its services and safeguards high standards of care by creating an environment in which clinical excellence can flourish.

Friends and Family Test

80

(1) A contractor which provides essential services must give all patients who use the contractor's practice the opportunity to provide feedback about the service received from the contractor's practice through the Friends and Family Test .

(2) The contractor must—

(a) report the results of completed Friends and Family Tests to NHS England; and

(b) publish the results of such completed Tests .

(3) In this regulation, “Friends and Family Test” means the arrangements that a contractor which provides essential services is required by NHS England to implement to enable its patients to provide anonymous feedback about the patient experience at the contractor's practice.

Co-operation with NHS England

81

The contractor must co-operate with NHS England in the discharge of any of NHS England’s obligations, or the obligations of NHS England’s accountable officers, under the Controlled Drugs (Supervision and Management of Use) Regulations 2013 .

Co-operation with the Secretary of State and NHS England

82

The contractor must co-operate with—

(a) the Secretary of State in the discharge of the Secretary of State's duty under section 1F of the Act (duty as to education and training); and

(b) NHS England where NHS England is discharging the Secretary of State's duty under section 1F of the Act by virtue of its functions under section 97(1) of the Care Act 2014 (planning education and training for health workers etc.).

Insurance

83

(1) The contractor must at all times have in force in relation to it an indemnity arrangement which provides appropriate cover.

(2) The contractor may not sub-contract its obligations to provide clinical services under the agreement unless it is satisfied that the sub-contractor has in force in relation to it an indemnity arrangement which provides appropriate cover.

(3) In this regulation—

(a) “appropriate cover” means cover against liabilities that may be incurred by the contractor in the performance of clinical services under the agreement, which is appropriate, having regard to the nature and extent of the risks in the performance of such services;

(b) “indemnity arrangement” means a contract of insurance or other arrangement made for the purpose of indemnifying the contractor; and

(c) a contractor is to be regarded as holding insurance if it is held by a person employed or engaged by the contractor in connection with clinical services which that person provides under the agreement or, as the case may be, sub-contract.

Public liability insurance

84

The contractor must at all times hold adequate public liability insurance in relation to liabilities to third parties arising under or in connection with the agreement which are not covered by the indemnity agreement referred to in regulation 83.

Gifts

85

(1) The contractor must keep a register of gifts which—

(a) are given to any of the persons specified in paragraph (2) by or on behalf of—

(i) a patient,

(ii) a relative of a patient, or

(iii) any person who provided or would like to provide services to the contractor or its patients in connection with the agreement; and

(b) have, in the contractor's reasonable opinion, an individual value of more than £100.00.

(2) The persons specified in this paragraph are—

(a) the contractor;

(b) where the agreement is with a qualifying body—

(i) any person both legally and beneficially owning a share in the qualifying body, or

(ii) a director or secretary of the qualifying body;

(d) any general medical practitioner engaged by the contractor for the purposes of the agreement;

(e) any spouse or civil partner of a contractor (where the contractor is an individual medical practitioner) or of a person specified in sub-paragraphs (b) to (d); or

(f) any person whose relationship with a contractor (where the contractor is an individual medical practitioner) or with a person specified in sub-paragraphs (b) to (d) has the characteristics of the relationship between spouses.

(3) Paragraph (1) does not apply where—

(a) there are reasonable grounds for believing that the gift is unconnected with services provided or to be provided by the contractor;

(b) the contractor is not aware of the gift; or

(4) The contractor must take reasonable steps to ensure that it is informed of any gifts which fall within paragraph (1) and which are given to the persons specified in paragraph (2)(b) to (f).

(5) The register referred to in paragraph (1) must include the following information—

(a) the name of the donor;

(b) in a case where the donor is a patient, the patient's National Health Service number or, if the number is not known, the patient's address;

(d) the nature of the gift;

(e) the estimated value of the gift; and

(f) the name of the person or persons who received the gift.

(6) The contractor must make the register available to NHS England on request.

Compliance with legislation and guidance

86

The contractor must—

(a) comply with all relevant legislation; and

(b) have regard to all relevant guidance issued by NHS England, the Secretary of State or local authorities in respect of the exercise of their functions under the Act.

Third party rights

87

The agreement does not create any right enforceable by any person who is not a party to it.

PART 15 — General transitional provision and saving, consequential amendments and revocations

General transitional provision and saving

88

(1) This regulation applies to—

(a) the exercise by NHS England of any of its functions under the 2004 Regulations on or before the commencement date;

(b) any rights or liabilities of NHS England in respect of the exercise of any of its functions under the 2004 Regulations; and

(c) any rights or liabilities of a Primary Care Trust transferred to NHS England as a consequence of a property transfer scheme made under section 300 of the Health and Social Care Act 2012 (transfer schemes).

(2) Subject to paragraph (4), any act or omission concerning an agreement to which the 2004 Regulations applied immediately before the commencement date in respect of any of the matters specified in paragraph (1), is to be treated as an act or omission concerning an agreement to which these Regulations apply.

(3) Subject to paragraph (4), anything which, on or before the commencement date, is done or is in the process of being done under the 2004 Regulations concerning an agreement to which the 2004 Regulations applied immediately before that date in respect of any of the matters specified in paragraph (1), is to be treated as if done or in the process of being done under these Regulations.

(4) Notwithstanding paragraphs (2) and (3) and the revocations provided for by Schedule 4, where the 2004 Regulations contain a provision for which there is no equivalent provision in these Regulations (“the relevant provision”), the 2004 Regulations, as they were in force immediately before the commencement date are to continue to apply to the extent necessary for the purposes of—

(a) preserving any rights conferred or liabilities accrued by or under the relevant provision; or

(b) the assessment or determination of any rights or liabilities arising under or in accordance with the relevant provision.

(5) In this regulation—

(a) “the commencement date” means the date on which these Regulations come into force;

(b) “agreement” includes any agreement to which the 2004 Regulations applied immediately before the commencement date under which medical services were provided before 1st January 2005 (whether or not such services continued to be provided after that date); and

(c) references to the exercise by NHS England of any of its functions include the exercise by NHS England of any functions of a Primary Care Trust under Part 4 of the Act.

Consequential amendments

89

Schedule 3 makes provision in respect of the amendment to secondary legislation which are consequential upon the coming into force of these Regulations.

Revocations

90

Schedule 4 makes provision in respect of the revocation of the enactments specified in column 1 of the Table in that Schedule to the extent specified in column 2 of that Table.

SCHEDULE 1 — NHS England’sNHS England’sList of prescribed medical certificates

1

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

3

To secure registration of still-birth

4

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

5

To establish unfitness for jury service

6

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

7

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

8

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

9

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

SCHEDULE 2 — Other required terms

PART 1 — Provision of services

Services to registered patients

1

Where the agreement provides for a contractor to provide essential services, the contractor must—

(a) provide those services, and such other services that the contractor is required to provide to its patients, at such times, within core hours, as are appropriate to meet the reasonable needs of those patients; and

(b) have in place arrangements for the contractor's patients to access such services throughout the core hours in case of emergency.

Premises

2

(1) The contractor must ensure that the premises used for the provision of services under the agreement are—

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

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

(2) The requirement in sub-paragraph (1) is subject to any plan included in the agreement which sets out steps to be taken by the contractor to bring the premises up to the required standard.

Telephone services

3

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

(a) patients to contact the contractor's practice for a purpose related to the agreement; or

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

starts with the digits 087, 090 or 091 or consists of a personal number, unless the service is provided free of charge to the caller.

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

(3) The contractor must ensure that any new contract or other arrangement relating to relevant telephone services is procured under the Advanced Telephony Better Purchasing Framework.

(4) Where NHS England requires, the contractor must make available to NHS England, within such reasonable time frame as specified by NHS England, such information as specified by NHS England that is available to the contractor in relation to the handling of calls under relevant telephone services.

New telephone contract or arrangement

3A

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

Cost of relevant calls

4

(1) The contractor must not enter into, renew or extend a contract or other arrangement for telephone services unless it is satisfied that, having regard to the arrangement as a whole, persons will not have to pay more to make relevant calls to the contractor's practice than they would to make equivalent calls to a geographical number.

(2) Where it has not been possible for the contractor to take reasonable steps to ensure that persons will not pay more to make relevant calls to the contractor's practice than they would to make equivalent calls to a geographical number, the contractor must consider introducing a system under which, if a caller asks to be called back, the contractor will do so at the contractor's own expense.

(3) In this paragraph—

“geographical number” means a number which has a geographical area code as its prefix; and

“relevant calls” means—calls made by patients to the contractor's practice for any reason related to services provided at the contactor's practice under the agreement; andcalls made by persons, other than patients, to the contractor's practice in relation to services provided at the contractor's practice as part of the health service.

Attendance at practice premises

5

(1) The contractor must take steps to ensure that all of the following means of contacting the practice are available for patients throughout core hours—

(a) by attending the contractor’s practice premises;

(b) by telephone; and

(1A) The contractor must take steps to ensure that a patient who contacts the contractor through—

(a) any of the means listed in sub-paragraph (1)(a) to (c); or

(b) a relevant electronic communication method within the meaning given in regulation 64ZE(3);

is provided with an appropriate response in accordance with the following sub-paragraphs.

(2) Subject to sub-paragraph (2A), the appropriate response is that the contractor must—

(a) invite the patient for an appointment, either to attend the contractor’s practice premises or to participate in a telephone or video consultation, at a time which is appropriate and reasonable having regard to all the circumstances ...;

(b) provide appropriate advice or care to the patient by another method;

(c) invite the patient to make use of, or direct the patient towards, appropriate services which are available to the patient, including services which the patient may access themselves; or

(d) communicate with the patient—

(i) to request further information; or

(ii) as to when and how the patient will receive further information on the services that may be provided to them, having regard to the urgency of their clinical needs and other relevant circumstances.

(2A) The contractor must not ask a patient to contact the practice on another day.

(3) For matters which the contractor has identified as clinically urgent, the appropriate response must be provided—

(a) if the contact ... is made outside core hours, during the following core hours;

(b) in any other case, during the day on which the core hours fall.

(3A) For matters which the contractor has identified as not clinically urgent, the appropriate response must be provided before the end of the next working day after contact.

(4) The appropriate response must take into account—

(a) the needs of the patient , including the need to avoid jeopardising the patient’s health;

(b) where appropriate, the preferences of the patient ; and

(c) any benefits to the patient of providing for continuity of the health care professional involved in their care and treatment.

Attendance outside practice premises

6

(1) Where the medical condition of a patient is such that, in the reasonable opinion of the contractor—

(a) attendance on the patient is required; and

(b) it would be inappropriate for the patient to attend the contractor's practice premises,

the contractor must provide services to the patient at whichever of the places described in sub-paragraph (2) is, in the contractor's judgement, the most appropriate.

(2) The places described in this sub-paragraph are—

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

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

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

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

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

Clinical reports

7

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

(2) NHS England must send a report received in accordance with sub-paragraph (1) to—

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

(b) if the person referred to in paragraph (a) is not known to NHS England, or to the Local Health Board, Health Board or Health and Social Services Board, in whose area the patient is resident.

(3) This paragraph does not apply in relation to the provision of out of hours services by a contractor which is, by virtue of regulation 22, required to comply with the quality standards or requirements referred to in that regulation.

Storage of vaccines

8

The contractor must ensure that all—

(a) vaccines are stored in accordance with the manufacturer's instructions; and

(b) refrigerators in which vaccines are stored have a maximum/minimum thermometer and that temperature readings are taken on all working days.

Infection control

9

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

Duty of co-operation

10

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

(a) a particular service , except in relation to one provided under the Network Contract Directed Enhanced Service Scheme which is a scheme provided for by the Primary Medical Services (Directed Enhanced Services) Directions; or

(b) out of hours services, either at all or in respect of some periods or some services,

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

(2) The requirements specified in this sub-paragraph are that the contractor must—

(a) co-operate in so far as is reasonable with any person responsible for the provision of that service or those services;

(b) comply in core hours with any reasonable request for information from such a person or from NHS England relating to the provision of that service or those services; and

(i) take reasonable steps to ensure that any patient who contacts the contractor's practice ... during the out of hours period is provided with information about how to obtain services during that period;

(ii) ensure that the clinical details of all out of hours consultations received from the out of hours provider are reviewed by a clinician within the contractor's practice on the same working day as those details are received by the practice or, exceptionally, on the next working day;

(iii) ensure that any information requests received from the out of hours provider in respect of any out of hours consultations are responded to by a clinician within the contractor's practice on the same day as those requests are received by the practice, or on the next working day;

(iv) take all reasonable steps to comply with any systems which the out of hours provider has in place to ensure the rapid, secure and effective transmission of patient data in respect of out of hours consultations; and

(v) agree with the out of hours provider a system for the rapid, secure and effective transmission of information about registered patients who, due to chronic disease or terminal illness, are predicted as more likely to present themselves for treatment during the out of hours period.

(3) Nothing in this paragraph requires a contractor whose agreement does not include the provision of out of hours services to make itself available during the out of hours period.

Duty of co-operation: Primary Care Networks

10A

(1) A contractor must comply with the requirements in sub-paragraph (2) where it is—

(a) signed up to the Network Contract Directed Enhanced Scheme (“the Scheme”); or

(b) not signed up to the Scheme but its registered patients or temporary residents, are provided with services under the Scheme (“the services”) by a contractor which is a member of a primary care network.

(2) The requirements specified in this sub-paragraph are that the contractor must—

(a) co-operate, in so far as is reasonable, with any person responsible for the provision of the services;

(b) comply in core hours with any reasonable request for information from such a person or from NHS England relating to the provision of the services;

(d) participate in primary care network meetings, in so far as is reasonable;

(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 ...

Duty to have regard to Armed Forces Covenant principles

10B

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

Cessation of service provision: information requests

11

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

(a) a particular service; or

(b) out of hours services, either at all or in respect of some periods or some services,

the contractor must comply with any reasonable request for information relating to the provision of that service or those services made by NHS England or by any person with whom NHS England intends to enter into an agreement for the provision of such services.

Co-operation with NHS England: performance management

11A

The contractor must co-operate with NHS England, in so far as is reasonable, in relation to the performance and improvement of services provided under the agreement, including co-operating with the provision of any support, performance review or improvement activity.

PART 2 — Patients: general

General provision

12

This Part only applies to a contractor which provides essential services.

List of patients

13

(1) NHS England must prepare and keep up to date a list of the patients who have been—

(a) accepted by the contractor for inclusion in the contractor’s list of patients under 17, 18, 18A, 31D or 31F and who have not been subsequently removed from that list under paragraphs 22 to 30; and

(b) assigned by NHS England to the Contractor’s list of patients under—

(i) paragraph 38(1)(a), or

(ii) paragraph 38(1)(b) (by virtue of a determination of the assessment panel under paragraph 40(8) which has not subsequently been overturned by a determination of the Secretary of State under paragraph 41 or by a court).

(2) The contractor must, upon receipt of a reasonable written request by NHS England—

(a) take appropriate steps as soon as is reasonably practicable to correct and update patient data held on the practice’s computerised clinical systems, and where necessary register or deregister patients to ensure that the patient list is accurate; and

(b) provide information relating to its list of patients as soon as is reasonably practicable and, in any event, no later than 30 days from the date on which the request was received by the contractor, in order to assist NHS England in the exercise of its duties under paragraph (1), contacting patients where reasonably necessary to confirm that their patient data is correct.

Newly registered patients – alcohol dependency screening

14

(1) Where a patient has been—

(a) accepted onto the contractor's list of patients; or

(b) assigned to that list by NHS England,

the contractor must take action to identify any such patient over the age of 16 who is drinking alcohol at increasing or higher risk levels with a view to seeking to reduce the alcohol related health risks to that patient.

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