Legalize / United Kingdom / Wales / Welsh-Statutory-Instrument

The National Health Service (General Medical Services Contracts) (Wales) Regulations 2023

Type Welsh-Statutory-Instrument

Publication 2023-09-01

Last updated 2026-03-28

State In force

Jurisdiction Wales

Department King's Printer of Acts of Parliament

Source legislation.gov.uk

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(d) a member of the contractor’s staff,

(e) a person engaged by the contractor to perform or assist in the performance of services under the contract, or

(f) any other person present—

(i) on the practice premises, or

(ii) in the place where services are being provided to the patient under the contract.

(6) The contractor must keep a written record of—

(a) the date of any warning given in accordance with sub-paragraph (3)(a) and the reasons for giving such a warning as explained to the person concerned, or

(b) the reason why no such warning was given.

(7) The contractor must keep a written record of removal of any person from its list of patients under this paragraph which includes—

(a) the reason for removal,

(b) the circumstances of the removal, and

and the contractor must make this record available to the Local Health Board on request.

(8) The removal of a person from the contractor’s list of patients must, subject to sub-paragraph (9), take effect from whichever is the earlier of—

(a) the date on which the Local Health Board is given notice of the registration of that person with another provider of unified services (or their equivalent),

(b) the eighth day after the Local Health Board gives notice to the contractor of its approval of the removal, or

(c) the twenty-eighth day after the date on which the Local Health Board receives the notice from the contractor, if the Local Health Board has neither approved nor rejected the notice during that period.

(9) Where, on the date on which the removal would take effect under sub-paragraph (8), the contractor is treating that person at intervals of less than 7 days, the contractor must give notice in writing to the Local Health Board of that fact and the removal takes effect on whichever is the earlier of—

(a) the eighth day after the Local Health Board is given notice by the contractor that the person no longer needs such treatment, or

(b) the date on which the Local Health Board is given notice of the registration of the person with another provider of unified services (or their equivalent).

(10) If a person is to be removed from the contractor’s list of patients pursuant to sub-paragraph (8) or (9), the Local Health Board must give notice in writing to—

(a) the person in respect of whom the removal is approved, and

(b) the contractor,

that the person’s name has been or is to be removed from the contractor’s list of patients on the date referred to in sub-paragraph (8) or (9).

Removals from the list of patients who are violent

30

(1) Where a contractor wants a person to be removed from its list of patients on the grounds that—

(a) the person has committed an act of violence against any of the persons specified in sub-paragraph (2) or has behaved in such a way that any of those persons has feared for their safety, and

(b) the contractor has reported the incident to the police,

the contractor must give notice to the Local Health Board in accordance with sub-paragraph (3) requesting that the person be removed from its list of patients.

(2) The persons specified in this sub-paragraph are—

(a) the contractor, where the contractor is an individual medical practitioner,

(b) in the case of a contract with two or more persons practising in partnership, a partner in the partnership,

(c) in the case of a contract with a company limited by shares, a person who is both a legal and beneficial owner of shares in that company,

(d) a member of the contractor’s staff,

(e) a person engaged by the contractor to perform or assist in the performance of services under the contract, or

(f) any other person present—

(i) on the contractor’s practice premises, or

(ii) in the place where services were provided to the person under the contract.

(3) Notification under sub-paragraph (1) must be in writing and include the crime reference number allocated to the incident by the police.

(4) A removal requested in accordance with sub-paragraph (1) takes effect from whichever is the earlier of—

(a) the date on which the Local Health Board is given notice of the registration of that person with another provider of unified services (or their equivalent),

(b) the day after the day on which the Local Health Board gives notice to the contractor of its approval of the removal, or

(c) the seventh day after the date on which the Local Health Board receives the notice from the contractor, if the Local Health Board has neither approved nor rejected the notice within that period.

(5) Where, pursuant to this paragraph, the contractor has given notice to the Local Health Board that it wants to have a patient removed from its list of patients and that request has taken effect under sub-paragraph (4), the contractor must inform that person of that fact unless—

(a) it is not reasonably practicable for the contractor to do so, or

(b) the contractor has reasonable grounds for believing that to do so would—

(i) be harmful to that person’s physical or mental health, or

(ii) put the safety of any person specified in sub-paragraph (2) at risk.

(6) Where a person is removed from the contractor’s list of patients under this paragraph, the Local Health Board must give that person notice in writing of that removal.

(7) The contractor must record the removal of any person from its list of patients under this paragraph and the circumstances leading to that removal in the medical records of the person removed.

Removal from lists if patients registered elsewhere

31

(1) The Local Health Board must remove a person from the contractor’s list of patients if—

(a) the person has subsequently been registered with another provider of unified services (or their equivalent) in the area of the Local Health Board, or

(b) it has received notice from another Local Health Board, NHS England, a Health Board or a Health and Social Care Trust that the patient has subsequently been registered with a provider of unified services (or their equivalent) outside the area of the Local Health Board.

(2) A removal in accordance with sub-paragraph (1) is to take effect—

(a) on the date on which the Local Health Board is given notice of the person’s registration with the new provider, or

(b) with the consent of the Local Health Board, on such other date as has been agreed between the contractor and the new provider.

(3) The Local Health Board must give notice in writing to the contractor of any person removed from its list of patients under sub-paragraph (1).

Removal from the list of patients who have moved

32

(1) Subject to sub-paragraph (2), where the Local Health Board is satisfied, or is notified by the contractor, that a person on the contractor’s list of patients has moved and no longer resides in that contractor’s practice area, the Local Health Board must—

(a) inform both the person and the contractor that the contractor is no longer obliged to visit and treat the person,

(b) advise the person in writing to either obtain the contractor’s agreement to that person’s continued inclusion on the contractor’s list of patients or to apply for registration with another provider of unified services (or their equivalent), and

(c) inform the person that if, after the period of 30 days beginning with the date on which the advice mentioned in paragraph (b) was given, that person has not acted in accordance with that advice and informed the Local Health Board accordingly, that person is to be removed from the contractor’s list of patients.

(2) If, at the end of the period of 30 days mentioned in sub-paragraph (1)(c), the Local Health Board has not been informed by the person of the action taken, the Local Health Board must remove that person from the contractor’s list of patients and inform that person and the contractor of that removal.

Removal from the list of patients whose address is unknown

33

Where the address of a person who is on the contractor’s list of patients is no longer known to the Local Health Board and the Local Health Board reasonably believes this is not due to the patient being unable to provide proof of their address the Local Health Board may—

(a) give notice in writing to the contractor that it intends, at the end of the period of 6 months beginning with the date on which the notice was given, to remove the person from the contractor’s list of patients, and

(b) at the end of the period referred to in sub-paragraph (a), remove the person from the contractor’s list of patients unless, before the end of that period, the contractor satisfies the Local Health Board that the person is a patient to whom it is still responsible for providing unified services.

Removal from the list of patients absent from the United Kingdom etc.

34

(1) The Local Health Board must remove a person from a contractor’s list of patients where it receives notice to the effect that the person—

(a) intends to be away from the United Kingdom for a period of at least 12 weeks,

(b) is in the armed forces of the Crown (except in the case of a patient to which paragraph 24 applies),

(c) is serving a term of imprisonment of more than 2 years or more than one term of imprisonment totalling, in the aggregate more than 2 years,

(d) has been absent from the United Kingdom for a period of more than 12 weeks, or

(e) has died.

(2) The removal of a person from a contractor’s list of patients under this paragraph takes effect from—

(a) where sub-paragraph (1)(a) to (c) applies, whichever is the latest of—

(i) the date of the person’s departure, enlistment or imprisonment, or

(ii) the date on which the Local Health Board first receives notice of the person’s departure, enlistment or imprisonment, or

(b) where sub-paragraph (1)(d) and (e) applies, the date on which the Local Health Board is given notice of the person’s absence or death.

(3) The Local Health Board must give notice in writing to the contractor of the removal of any person from the contractor’s list of patients under this paragraph.

Removal from the list of patients accepted elsewhere as temporary residents

35

(1) The Local Health Board must remove a person from the contractor’s list of patients where the person has been accepted as a temporary resident by another contractor or other provider of unified services (or their equivalent) where the Local Health Board is satisfied, after due inquiry that—

(a) the person’s stay in the place of temporary residence has exceeded 12 weeks, and

(b) the person has not returned to their normal place of residence or to any other place within the contractor’s practice area.

(2) The Local Health Board must give notice in writing of the removal of a person from a contractor’s list of patients under this paragraph—

(a) to the contractor, and

(b) where practicable, to that person.

(3) A notice given under sub-paragraph (2)(b) must inform the person of—

(a) that person’s entitlement to make arrangements for the provision to that person of unified services (or their equivalent), including by the contractor by which that person has been treated as a temporary resident; and

(b) the name, postal and electronic mail address and telephone number of the Local Health Board.

Removal from the list of pupils etc. of a school

36

(1) Where the contractor provides unified services under the contract to persons on the grounds that they are pupils at, or staff or residents of, a school, the Local Health Board must remove any person from a contractor’s list of patients who does not appear on the particulars provided by that school of persons who are pupils at, or staff or residents of, that school.

(2) Where the Local Health Board has requested a school to provide the particulars referred to in sub-paragraph (1) and has not received those particulars, the Local Health Board must consult the contractor as to whether it should remove from the contractor’s list of patients any persons appearing in that list as pupils at, or staff or residents of, that school.

(3) The Local Health Board must give notice in writing to the contractor of the removal of any person from the contractor’s list of patients under this paragraph.

Termination of responsibility for patients not registered with the contractor

37

(1) Where the contractor has—

(a) received an application for the provision of medical services other than unified services—

(i) from a person who is not included (and who is not applying to be included) in the contractor’s list of patients,

(ii) from a person that the contractor has not accepted as a temporary resident, or

(iii) made on behalf of a person referred to in sub-paragraph (i) or (ii), by a person specified in paragraph 23(4), and

(b) accepted the person making the application or on whose behalf the application is made as a patient for the provision of the service in question,

the contractor’s responsibility for that person terminates in the circumstances described in sub-paragraph (2).

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

(a) the contractor is informed that the person no longer wishes the contractor to be responsible for the provision of the service in question, or

(b) it comes to the contractor’s attention that the person—

(i) no longer resides in the area for which the contractor has agreed to provide the service in question, or

(ii) is no longer included in the list of patients of another contractor to whose registered patients the contractor has agreed to provide that service.

(3) The contractor must keep a written record of terminations under this paragraph and of the reasons for those terminations and must make this record available to the Local Health Board on request.

PART 3 — List of patients: closure, etc.

Application for closure of list of patients

38

(1) Where a contractor wants to close its list of patients, the contractor must send a written application to that effect (“the application”) to the Local Health Board.

(2) The application must include the following information—

(a) the period of time, being a period of not less than 12 weeks and not more than 1 year, during which the contractor proposes its list of patients is to be closed,

(b) the current number of the contractor’s registered patients,

(c) the number of registered patients (lower than the current number of such patients, and expressed either in absolute terms or as a percentage of the number of such patients specified pursuant to paragraph (b)) which, if that number were reached, would trigger the re-opening of the contractor’s list of patients,

(d) the number of registered patients (expressed either in absolute terms or as a percentage of the number of such patients specified pursuant to paragraph (b)) which, if that number were reached, would trigger the re-closure of the contractor’s list of patients,

(e) any withdrawal from or reduction in provision of any supplementary services which had previously been provided under the contract, and

(f) any other information which the contractor considers ought to be drawn to the attention of the Local Health Board.

(3) The Local Health Board must acknowledge receipt of the application before the end of the period of 7 days beginning with the date on which the Local Health Board received the application.

(4) The Local Health Board must consider the application and may request such information from the contractor as the Local Health Board requires in order to enable it to determine the application.

(5) The Local Health Board must enter into discussions with the contractor concerning—

(a) the support which the Local Health Board may give to the contractor, or

(b) any changes which the Local Health Board or the contractor may make,

which would enable the contractor to keep its list of patients open.

(6) The Local Health Board and the contractor must, throughout the period of the discussions referred to in sub-paragraph (5), use reasonable endeavours to achieve the aim of keeping the contractor’s list of patients open.

(7) The Local Health Board or the contractor may, at any stage during the discussions, invite the Local Medical Committee (if there is one) for the area in which the contractor provides services under the contract to attend any meetings arranged between the Local Health Board and the contractor to discuss the application.

(8) The Local Health Board may consult such persons as it appears to the Local Health Board may be affected by the closure of the contractor’s list of patients and, if the Local Health Board does so, it must provide to the contractor a summary of the views expressed by those persons consulted in respect of the application.

(9) The Local Health Board must enable the contractor to consider and comment on all the information before the Local Health Board makes a decision in respect of the application.

(10) A contractor may withdraw the application at any time before the Local Health Board makes a decision in respect of that application.

(11) The Local Health Board must, before the end of the period of 21 days beginning with the date on which the application was received by the Local Health Board (or within such longer period as the parties may agree), make a decision to—

(a) approve the application and determine the date from which the closure of the contractor’s list is to take effect, or

(b) reject the application.

(12) The Local Health Board must give notice in writing to the contractor of its decision to—

(a) approve the application in accordance with paragraph 39, or

(b) reject the application in accordance with paragraph 40.

(13) A contractor may not submit more than one application to close its list of patients in any period of 1 year beginning with the date on which the Local Health Board makes its decision on the application unless—

(a) paragraph 40(3) applies, or

(b) there has been a change in the circumstances of the contractor which affects its ability to deliver services under the contract.

Approval of an application to close a list of patients

39

(1) Where the Local Health Board approves an application to close a contractor’s list of patients, the Local Health Board must—

(a) give notice in writing to the contractor of its decision as soon as possible and the notice (“the closure notice”) must include the details specified in sub-paragraph (2), and

(b) at the same time as the Local Health Board gives notice to the contractor, send a copy of the closure notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the contract, and

(ii) any person who the Local Health Board consulted in accordance with paragraph 38(8).

(2) The closure notice must include—

(a) the period of time for which the contractor’s list of patients is to be closed which must be—

(i) the period specified in the application, or

(ii) where the Local Health Board and the contractor have agreed in writing to a different period, that different period, and

in either case, the period must not be less than 12 weeks and not more than 1 year,

(b) the date on which the closure of the list of patients is to take effect (“the closure date”), and

(3) Subject to paragraph 41, a contractor must close its list of patients with effect from the closure date and the list of patients must remain closed for the duration of the closure period as specified in the closure notice.

Rejection of an application to close a list of patients

40

(1) Where the Local Health Board rejects an application to close a contractor’s list of patients it must—

(a) give notice in writing to the contractor of its decision as soon as possible, including the Local Health Board’s reasons for rejecting the application, and

(b) at the same time as it gives notice to the contractor, send a copy of the notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the contract, and

(ii) any person who the Local Health Board consulted in accordance with paragraph 38(8).

(2) Subject to sub-paragraph (3), if the Local Health Board rejects an application from a contractor to close its list of patients, the contractor must not make a further application to close its list of patients until whichever is the later of—

(a) the end of the period of 12 weeks beginning with the date on which the Local Health Board’s decision to reject the application was made, or

(b) in a case where a dispute arising from the Local Health Board’s decision to reject the application has been referred to the NHS dispute resolution procedure, the end of the period of 12 weeks beginning with the date on which a final determination to reject the application was made in accordance with that procedure (or any court proceedings).

(3) A contractor may make a further application to close its list of patients where there has been a change in the circumstances of the contractor which affects the contractor’s ability to deliver services under the contract.

Re-opening of list of patients

41

The contractor may re-open its list of patients before the expiry of the closure period if the Local Health Board and the contractor agree that the contractor should do so.

PART 4 — Assignment of patients to lists

42

(1) This Part applies in respect of the assignment by the Local Health Board of—

(a) a person as a new patient to a contractor’s list of patients where that person—

(i) has been refused inclusion in a contractor’s list of patients or has not been accepted as a temporary resident by a contractor, and

(ii) would like to be included in the list of patients of a contractor within the area of the Local Health Board in which that person resides, or

(b) any person who is part of a list dispersal resulting from the closure of a practice where that person—

(i) has not registered with another contractor, and

(ii) would like to be included in the list of patients of a contractor within the area of the Local Health Board in which that person resides; or

(c) any person who is part of a list dispersal resulting from the closure of a practice where that person has not registered with another contractor and the Local Health Board has been unable to contact that person.

(2) In this paragraph, “list dispersal” means the allocation of patients from a contractor’s list of patients by the Local Health Board following termination of the contract or during the period set out in the notice of termination or agreement to terminate.

Assignment of patients to list of patients: open and closed lists

43

(1) Subject to paragraph 44, the Local Health Board may—

(a) assign a new patient to a contractor whose list of patients is open, and

(b) only assign a new patient to a contractor whose list of patients is closed in the circumstances specified in sub-paragraph (2).

(2) The circumstances specified in this sub-paragraph are where—

(a) the assessment panel has determined under paragraph 45(7) that new patients may be assigned to the contractor in question, and that determination has not been overturned either by a determination of the Welsh Ministers under paragraph 46(13) or (where applicable) by a court, and

(b) the Local Health Board has entered into discussions with the contractor in question regarding the assignment of new patients if such discussions are required under paragraph 47.

Factors relevant to assignments

44

When assigning a person as a new patient to a contractor’s list of patients under paragraph 43(1)(a) or (b), the Local Health Board must have regard to—

(a) the preferences and circumstances of the person,

(b) the distance between the person’s place of residence and the contractor’s practice premises,

(c) any request made by a contractor to remove the person from its list of patients within the preceding period of 6 months beginning with the date on which the application for assignment is received by the Local Health Board,

(d) whether, during the preceding period of 6 months beginning with the date on which the application for assignment is received by the Local Health Board, the person has been removed from a list of patients on the grounds referred to in—

(i) paragraph 29 (relating to the circumstances in which a person may be removed from a contractor’s list of patients at the request of the contractor),

(ii) paragraph 30 (relating to the removal from the contractor’s list of patients of persons who are violent), or

(iii) the equivalent provisions to those paragraphs in relation to arrangements made under section 41(2) of the Act (which relate to arrangements for the provision of primary medical services),

(e) in a case to which sub-paragraph (d)(ii) applies (or equivalent provisions as mentioned in sub-paragraph (d)(iii) apply), whether the contractor has appropriate facilities to deal with such patients, and

(f) such other matters as the Local Health Board considers relevant.

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

45

(1) Where the Local Health Board wants to assign a new patient to a contractor which has closed its lists of patients, the Local Health Board must prepare a proposal to be considered by the assessment panel.

(2) The Local Health Board must give notice in writing that it has referred the matter to the assessment panel to—

(a) contractors, including those contractors who provide primary medical services under arrangements made under section 41(2) of the Act (which relate to arrangements for the provision of primary medical services) which—

(i) have closed their lists of patients, and

(ii) may, in the opinion of the Local Health Board, be affected by the determination of the assessment panel, and

(b) the Local Medical Committee (if any) for the area in which the contractors referred to in paragraph (a) provide unified services (or their equivalent).

(3) The Local Health Board must ensure that the assessment panel is appointed to consider and determine the proposal made under sub-paragraph (1), and the composition of the assessment panel must be as described in sub-paragraph (4).

(4) The members of the assessment panel must be—

(a) the Chief Executive of the Local Health Board of which the assessment panel is a committee or sub-committee,

(b) a person representative of patients in an area other than that of the Local Health Board which is a party to the contract, and

(c) a person representative of a Local Medical Committee which does not represent practitioners in the area of the Local Health Board which is a party to the contract.

(5) In reaching its determination, the assessment panel must have regard to all relevant factors including—

(a) whether the Local Health Board has attempted to secure the provision of unified services (or their equivalent) for new patients other than by means of assignment to a contractor with a closed list; and

(b) the workload of those contractors likely to be affected by any decision to assign such patients to their list of patients.

(6) The assessment panel must reach a determination before the end of the period of 28 days beginning with the date on which the panel was appointed.

(7) The assessment panel must—

(a) determine whether the Local Health Board may assign new patients to a contractor which has a closed list of patients, and

(b) if it determines that the Local Health Board may make such an assignment, determine, where there is more than one contractor, the contractors to which patients may be assigned.

(8) The assessment panel may determine that the Local Health Board may assign new patients to contractors other than any of the contractors specified in its proposals under sub-paragraph (1), as long as the contractors were given notice in writing under sub-paragraph (2)(a).

(9) The assessment panel’s determination must include its comments on the matters referred to in sub-paragraph (5), and notice in writing of that determination must be given to those contractors referred to in sub-paragraph (2)(a).

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

46

(1) Where an assessment panel makes a determination under paragraph 45(7) that the Local Health Board may assign new patients to contractors who have closed their lists of patients, any contractor specified in the determination may refer the matter to the Welsh Ministers to review that determination.

(2) Where a matter is referred to the Welsh Ministers under sub-paragraph (1), it must be reviewed in accordance with the procedure specified in the following sub-paragraphs.

(3) Where more than one contractor specified in the determination would like to refer the matter for dispute resolution, those contractors may, if they all agree, refer the matter jointly and, in that case, the Welsh Ministers must review the matter in relation to those contractors together.

(4) The contractor (or contractors) must send to the Welsh Ministers, before the end of the period of 7 days beginning with the date of the determination of the assessment panel in accordance with paragraph 45(7), 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 contract (or contracts), and

(5) The Welsh Ministers must, before the end of the period of 7 days beginning with the date on which the matter was referred to the Welsh Ministers—

(a) give notice in writing to the parties that the Welsh Ministers are dealing with the matter, and

(b) include with the notice a written request to the parties to make, in writing before the end of a specified period, any representations which those parties would like to make about the dispute.

(6) The Welsh Ministers must give, with the notice under sub-paragraph (5), to the party other than the one which referred the matter to dispute resolution, a copy of any document by which the dispute was referred to dispute resolution.

(7) The Welsh Ministers must, upon receiving any representations from a party—

(a) give a copy of those representations to each other party, and

(b) request, in writing, that each party to which a copy of those representations is given makes, before the end of a specified period, any written observations which the party would like to make about those representations.

(8) The Welsh Ministers may—

(a) invite representatives of the parties to appear before, and make oral representations to, the Welsh Ministers either together or, with the agreement of the parties, separately, and may, in advance, provide the parties with a list of matters or questions to which the Welsh Ministers would like them to give special consideration, or

(b) consult other persons whose expertise the Welsh Ministers considers is likely to assist the Welsh Ministers consideration of the dispute.

(9) Where the Welsh Ministers consult another person under sub-paragraph (8)(b), the Welsh Ministers must—

(a) give notice in writing to that effect to the parties, and

(b) where the Welsh Ministers consider that the interests of any party might be substantially affected by the results of the consultation, give to the parties such opportunity as the Welsh Ministers consider reasonable in the circumstances to make observations about those results.

(10) In considering the dispute, the Welsh Ministers must take into account—

(a) any written representations made in response to a request under sub-paragraph (5)(b), but only if those representations are made before the end of the specified period,

(b) any written observations made in response to a request under sub-paragraph (7), but only if those written observations are made before the end of the specified period,

(d) the results of any consultation under sub-paragraph (8)(b), and

(e) any observations made in accordance with an opportunity given under sub-paragraph (9).

(11) Subject to the other provisions of this paragraph and to any agreement between the parties, the Welsh Ministers may determine the procedure which is to apply to the dispute resolution in such manner as the Welsh Ministers consider appropriate in order to ensure the just, expeditious, economical and final determination of the dispute.

(12) In this paragraph, “specified period” means—

(a) such period as the Welsh Ministers specify in the request being a period of not less than 7 days and not more than 14 days beginning with the date on which the notice referred to is given, or

(b) such longer period as the Welsh Ministers may allow for the determination of the dispute where the period for determination of the dispute has been extended in accordance with sub-paragraph (16), and where the Welsh Ministers do so allow, a reference in this paragraph to the specified period is to the period as so extended.

(13) Subject to sub-paragraph (16), the Welsh Ministers must—

(a) determine the dispute before the end of the period of 21 days beginning with the date on which the matter was referred to the Welsh Ministers,

(b) determine whether the Local Health Board may assign new patients to contractors which have closed their lists of patients, and

(c) if the Welsh Ministers determine that the Local Health Board may assign new patients to those contractors, determine the contractors to which the new patients may be assigned.

(14) The Welsh Ministers must not determine that patients may be assigned to a contractor which was not specified in the determination of the assessment panel under paragraph 45(7)(b).

(15) In the case of a matter referred jointly by contractors in accordance with sub-paragraph (3), the Welsh Ministers may determine that patients may be assigned to one, some or all of the contractors which referred the matter.

(16) The period of 21 days referred to in sub-paragraph (13) may be extended (even after it has expired) by a further specified number of days if an agreement to that effect is reached by—

(a) the Welsh Ministers,

(b) the Local Health Board, and

(17) The Welsh Ministers must—

(a) record the determination, and the reasons for it, in writing, and

(b) give notice in writing of the determination (including the record of the reasons) to the parties.

Assignments to closed lists: assignments of patients by the Local Health Board

47

(1) Before the Local Health Board assigns a new patient to a contractor, the Local Health Board must, subject to sub-paragraph (3)—

(a) enter into discussions with the contractor regarding the additional support that the Local Health Board can offer the contractor, and

(b) use its best endeavours to provide such appropriate support.

(2) In the discussions referred to in sub-paragraph (1)(a), both parties must use reasonable endeavours to reach agreement.

(3) The requirement in sub-paragraph (1)(a) to enter into discussions applies—

(a) to the first assignment of a patient to a particular contractor, and

(b) to any subsequent assignment to that contractor to the extent that it is reasonable and appropriate having regard to—

(i) the numbers of patients who have been or may be assigned to it, and

(ii) the period of time since the last discussions under sub-paragraph (1)(a) took place.

PART 5 — Prescribing and dispensing

Prescribing: general

48

(1) The contractor must ensure that—

(a) any prescription form or repeatable prescription for drugs, medicines or appliances issued by a prescriber, and

(b) any home oxygen order form issued by a health care professional,

complies, as appropriate, with the requirements in this Part.

(2) In this Part, a reference to “drugs” includes contraceptive substances and a reference to “appliances” includes contraceptive appliances.

Orders for drugs, medicines and appliances

49

(1) Subject to sub-paragraphs (2) and (4) and to the restrictions on prescribing in paragraphs 55 and 56, a prescriber must order any drugs, medicines or appliances which are needed for the treatment of any patient who is receiving treatment under the contract by—

(a) issuing to the patient a non-electronic prescription form or a non-electronic repeatable prescription completed in accordance with sub-paragraph (6), or

(b) creating and transmitting an electronic prescription in circumstances to which paragraph 50(1) applies,

and a non-electronic prescription form, non-electronic repeatable prescription or electronic prescription that is for health service use must not be used in any other circumstances.

(2) If, on a particular occasion when a drug, medicine or appliance is needed as mentioned in sub-paragraph (1)—

(a) the prescriber is able, without delay, to order the drug, medicine or appliance by means of an electronic prescription,

(b) the Electronic Prescription Service software that the prescriber would use for that purpose provides for the creation and transmission of electronic prescriptions without the need for a nominated dispenser, and

(c) none of the reasons for issuing a non-electronic prescription form or a non-electronic repeatable prescription given in sub-paragraph (3) apply,

the prescriber must create and transmit an electronic prescription for that drug, medicine or appliance.

(3) The reasons given in this sub-paragraph are—

(a) although the prescriber is able to use the Electronic Prescription Service, the prescriber is not satisfied that—

(i) the access that the prescriber has to the Electronic Prescription Service is reliable, or

(ii) the Electronic Prescription Service is functioning reliably,

(b) the patient, or where appropriate the patient’s authorised person, informs the prescriber that the patient wants the option of having the prescription dispensed elsewhere than in Wales, or

(c) the patient, or where appropriate the patient’s authorised person, insists on the patient being issued with a non-electronic prescription form or, a non-electronic repeatable prescription for a particular prescription and in the professional judgement of the prescriber the welfare of the patient is likely to be in jeopardy unless a non-electronic prescription form or a non-electronic repeatable prescription is issued.

(4) A health care professional must order any home oxygen services which are needed for the treatment of any patient who is receiving treatment under the contract by issuing a home oxygen order form.

(5) A prescriber may order drugs, medicines or appliances on a repeatable prescription only where the drugs, medicines or appliances are to be provided more than once.

(6) In issuing a non-electronic prescription form or a non-electronic repeatable prescription, the prescriber must—

(a) sign the prescription form or repeatable prescription in ink in the prescriber’s own handwriting, and not by means of a stamp, with the prescriber’s initials, or forenames, and surname, and

(b) only sign the prescription form or repeatable prescription after particulars of the order have been inserted in the prescription form or repeatable prescription.

(7) A prescription form or repeatable prescription must not refer to any previous prescription form or repeatable prescription.

(8) A separate prescription form or repeatable prescription must be used for each patient, except where a bulk prescription is issued for a school or institution under paragraph 57.

(9) A home oxygen order form must be signed by a health care professional.

(10) Where a prescriber orders the drug buprenorphine or diazepam or a drug specified in Part 1 of Schedule 2 to the Misuse of Drugs Regulations 2001 (controlled drugs to which regulations 14 to 16, 16A, 18 to 21, 23, 26 and 27 of those Regulations apply) for supply by instalments for treating addiction to any drug specified in that Schedule, the prescriber must—

(a) use only the prescription form provided specially for the purposes of supply by instalments,

(b) specify the number of instalments to be dispensed and the interval between each instalment, and

(11) The prescription form provided specially for the purpose of supply by instalments must not be used for any purpose other than ordering drugs in accordance with sub-paragraph (10).

(12) In an urgent case, a prescriber may request an NHS pharmacist to dispense a drug or medicine before a prescription form or repeatable prescription is issued or created, only if—

(a) that drug or medicine is not a Scheduled drug,

(b) the drug is not a controlled drug within the meaning of section 2 of the Misuse of Drugs Act 1971 (which relates to controlled drugs and their classification for the purposes of that Act), other than a drug which is for the time being specified in Part 1 of 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, and

(i) provide the NHS pharmacist, within 72 hours beginning with the time of the request, with a non-electronic prescription form or a non-electronic repeatable prescription completed in accordance with sub-paragraph (6), or

(ii) transmit an electronic prescription by the Electronic Prescription Service within 72 hours, beginning with the time of the request.

(13) In an urgent case, a prescriber may request an NHS pharmacist to dispense an appliance before a prescription form or repeatable prescription is issued or created, only if—

(a) the appliance does not contain a Scheduled drug, or a controlled drug within the meaning of section 2 of the Misuse of Drugs Act 1971 (which relates to controlled drugs and their classification for the purposes of that Act), other than a drug which is for the time being specified in Schedule 5 to the Misuse of Drugs Regulations 2001 (controlled drugs excepted from the prohibition on importation, exportation and possession and subject to the requirements of regulations 24 and 26),

(b) where the appliance is a restricted availability appliance, the patient is a person, or the appliance is for a purpose, specified in the Drug Tariff, and

(i) provide the NHS pharmacist, within 72 hours beginning with the time of the request, with a non-electronic prescription form or non-electronic repeatable prescription completed in accordance with sub-paragraph (6), or

(ii) transmit an electronic prescription by the Electronic Prescription Service within 72 hours, beginning with the time of the request.

Electronic prescriptions

50

(1) A prescriber may only order drugs, medicines or appliances by means of an electronic prescription if the prescription is not—

(a) for a controlled drug within the meaning of section 2 of the Misuse of Drugs Act 1971 (which relates to controlled drugs and their classification for the purposes of that Act), other than a drug which is for the time being specified in Schedules 2 to 5 to the Misuse of Drugs Regulations 2001, or

(b) a bulk prescription issued for a school or institution under paragraph 57.

(2) If a prescriber orders a drug, medicine or appliance by means of an electronic prescription, the prescriber must issue the patient with—

(a) subject to sub-paragraph (4), an EPS token, and

(b) if the patient, or where appropriate the patient’s authorised person, so requests, a written record of the prescription that has been created.

(3) On and after the contractor’s EPS go live date, if the order is eligible for Electronic Prescription Service use, the prescriber must ascertain if the patient, or where appropriate the patient’s authorised person, wants to have the electronic prescription dispensed by a nominated dispenser.

(4) The prescriber must not issue the patient with an EPS token if the patient, or where appropriate the patient’s authorised person, wants to have the electronic prescription dispensed by a nominated dispenser.

(5) A health care professional may not order home oxygen services by means of an electronic prescription.

Nomination of dispensers for the purposes of electronic prescriptions

51

(1) A contractor authorised to use the Electronic Prescription Service for its patients must, if a patient, or where appropriate the patient’s authorised person, so requests, enter into the particulars relating to the patient which are held in the Welsh Demographic Service managed by Digital Health and Care Wales or the Personal Demographic Service managed by NHS England—

(a) where the patient does not have a nominated dispenser, the dispenser chosen by the patient, or where appropriate the patient’s authorised person, and

(b) where the patient does have a nominated dispenser—

(i) a replacement dispenser, or

(ii) a further dispenser,

chosen by the patient, or where appropriate the patient’s authorised person.

(2) Sub-paragraph (1)(b)(ii) does not apply if the number of the nominated dispensers would thereby exceed the maximum number permitted by the Electronic Prescription Service.

(3) A contractor must—

(a) not seek to persuade a patient or a patient’s authorised person to nominate a dispenser recommended by the prescriber or the contractor, and

(b) if asked by a patient or a patient’s authorised person to recommend an NHS pharmacist whom the patient or the patient’s authorised person might nominate as the patient’s dispenser, provide the patient or, as the case may be, the patient’s authorised person with the list given to the contractor by the Local Health Board containing all NHS pharmacists in the area who provide an Electronic Prescription Service.

Repeatable prescribing services

52

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

(a) satisfies the conditions in sub-paragraph (2), and

(b) has notified the relevant Local Health Board of its intention to provide repeatable prescribing services in accordance with sub-paragraphs (3) and (4).

(1A) The contractor must enable the repeat prescribing functionality within the NHS Wales App, to allow patients to order repeatable prescriptions.

(2) The conditions referred to in sub-paragraph (1)(a) are—

(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 an area of the Local Health Board in which there is also located the premises of at least one NHS pharmacist who has undertaken to provide, or has entered into an arrangement to provide, repeat dispensing services.

(3) The notification referred to in sub-paragraph (1)(b) is a notification, in writing, by the contractor to the relevant Local Health Board that it—

(a) wishes to provide repeatable prescribing services,

(b) intends to begin to provide those services from a date specified in the notification, and

(4) The date specified by the contractor under sub-paragraph (3)(b) must be at least 10 days after the date on which the notification specified in sub-paragraph (1) is given.

(5) Nothing in this paragraph 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) that 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 person on its list of patients to whom any person specified in sub-paragraph (8) is authorised or required by the Local Health Board to provide pharmaceutical services in accordance with arrangements under section 80 (arrangements for pharmaceutical services) and section 86 (persons authorised to provide pharmaceutical services) of the Act.

(8) The persons referred to in sub-paragraph (7) are—

(a) in the case of a contract with an individual medical practitioner, that medical practitioner,

(b) in the case of a contract with two or more individuals practising in partnership, any medical practitioner who is a partner,

(c) in the case of a contract with a company limited by shares, any medical practitioner who is both a legal and beneficial shareholder in that company, or

(d) any medical practitioner employed 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 NHS pharmacist providing repeat dispensing services to that person,

that the original repeatable prescription is no longer to 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 repeatable prescription in respect of 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—

(i) receive the drugs, medicines or appliances ordered on the person’s electronic repeatable prescription, or

(ii) 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 on whose behalf the prescription was issued has been removed from the list of patients of the contractor.

(4) Where a prescriber has cancelled an electronic repeatable prescription in respect of a person in accordance with sub-paragraph (3), the prescriber must give notice of the cancellation to the person as soon as possible.

(5) A prescriber who has issued a non-electronic repeatable prescription in respect of a person must, as soon as possible, make reasonable efforts to give notice to the NHS pharmacist that that repeatable prescription must 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—

(i) receive the drugs, medicines or appliances ordered on the person’s repeatable prescription, or

(ii) 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 sub-paragraph (2)(a) (for example, because the person wants to obtain the drugs, medicines or appliances from a different NHS pharmacist), or

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

(6) Where the circumstances in sub-paragraph (5)(a) to (c) apply in respect of a person, the prescriber must, as soon as possible, give notice to that person that their repeatable prescription must no longer be used to obtain repeat dispensing services.

Prescribing for electronic repeat dispensing

54

(1) Subject to paragraphs 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 paragraph, “electronic repeat dispensing” means dispensing as part of pharmaceutical services or local pharmaceutical services which involves the provision of drugs, medicines or appliances in accordance with an electronic repeatable prescription.

Restrictions on prescribing by medical practitioners

55

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

(2) The medical practitioner must not order on a listed medicines voucher, prescription form or a repeatable prescription, drugs, medicines or other substances specified in any directions given by the Welsh Ministers in regulations made under section 46 of the Act (GMS contracts: prescription of drugs etc) as being drugs, medicines or other substances which may not be ordered for patients in the provision of medical services under the contract.

(3) The medical practitioner must not order on a listed medicines voucher, a prescription form or repeatable prescription drugs, medicines or other substances specified in any directions given by the Welsh Ministers under section 46 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 for 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

(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 the restricted availability appliance 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 (which relates to 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 21(2)(b) and to sub-paragraph (7), nothing in the preceding sub-paragraphs prevents a medical practitioner, in the course of treating a patient to whom this sub-paragraph 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 (which relates to controlled drugs and their classification for the purposes of that Act), for the treatment of that patient under a private arrangement.

(7) Where, under sub-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 an NHS pharmacist 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, 16A, 18, 19, 20, 21, 23, 26 and 27) or 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, 16A, 18, 19, 20, 21, 23, 26 and 27) or 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

56

(1) The contractor must have arrangements in place to secure that an individual who is a supplementary prescriber may—

(a) issue or create a prescription for a prescription only medicine,

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

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

(2) The conditions referred to in sub-paragraph (1) are that—

(a) the individual satisfies the applicable conditions set out in regulation 215 of the Human Medicines Regulations 2012⁵³ (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 drug, medicine or other substance is not specified in any directions given by the Welsh Ministers under section 46 of the Act as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under the contract;

(c) the drug, medicine or other substance is not specified in any directions given by the Welsh Ministers under section 46 of the Act 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 the specified description,

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

(iii) if the supplementary prescriber is giving a prescription, he or she endorses the face of the form with the reference “SLS”.

(3) Where the functions of a supplementary prescriber include prescribing, the contractor must have arrangements in place to secure that that person may only give 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 sub-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 the supplementary 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 notification 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,

(bb) incidents occurring with the appliance which might lead, might have led or has led to the death or serious deterioration of 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 drug, medicine or other substance, that drug, medicine or other substance is not specified in any directions given by the Welsh Ministers under section 46 of the Act as being a drug, medicine or other substance which may not be ordered for patients in the provision of medical services under the contract,

(d) if it is a prescription for a drug, medicine or other substance, that drug, medicine or other substance is not specified in any directions given by the Welsh Ministers under section 46 of the Act 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 the specified description,

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

(iii) when giving the prescription, the supplementary prescriber endorses the face of the form with the reference “SLS”,

(e) if it is a prescription for an appliance, the appliance is listed in Part 9 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 9 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 giving the prescription, the supplementary prescriber endorses the face of the form with the reference “SLS”.

(5) In sub-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

Bulk prescribing

57

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

(a) a contractor is responsible under the contract for the treatment of 10 or more persons in a school or other institution in which at least 20 persons normally reside, and

(b) the prescriber orders, for any 2 or more of those persons for whose treatment the contractor is responsible, drugs, medicines or appliances to which this paragraph applies.

(2) Where a prescriber uses a single non-electronic prescription form for the purpose mentioned in sub-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 paragraph applies to any drug, medicine or appliance which can be supplied as part of pharmaceutical services or local pharmaceutical services and which in the case of—

(a) a drug or medicine, is not a prescription only medicine, or

(b) an appliance, does not contain such a product.

Excessive prescribing

58

(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 sub-paragraph (1), the Local Health Board must seek the views of the Local Medical Committee (if any) for the area in which the contractor provides services under the contract.

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

59

(1) Subject to sub-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 under sub-paragraph (1)(a) or (b) if it is for a person or a purpose specified in the Drug Tariff.

(3) Nothing in sub-paragraph (1) or (2) authorises a person to supply a prescription only medicine to a patient otherwise than in accordance with Part 12 of the Human Medicines Regulations 2012 (which relates to dealings with medicinal products).

Provision of dispensing services

60

(1) The contractor may only provide, and must ensure that those employed or engaged by it only provide, pharmaceutical services or dispensing services in the circumstances provided for in the Pharmaceutical Regulations.

(2) Where the contractor, or a person employed or engaged by the contractor, is included in the Local Health Board’s dispensing doctor list, the contractor must ensure that in the provision of any pharmaceutical services or dispensing services the contractor, and the dispensing doctor (and any person authorised to dispense on their behalf under the Pharmaceutical Regulations)—

(a) complies with the terms of service applicable to the person providing those pharmaceutical services or dispensing services by virtue of regulation 12(2) of the Pharmaceutical Regulations, and

(b) ensures that the patient to whom they are seeking to provide those services is aware that the relevant drugs or appliances are not only available from them (or by a person with whom the contractor is associated) and that the patient has the option to obtain those drugs or appliances from any NHS pharmacist.

PART 6 — Persons who perform services

Qualifications of performers: medical practitioners

61

(1) Subject to sub-paragraph (2), no medical practitioner may perform medical services under the contract unless the medical practitioner is—

(a) included in a medical performers’ list for a Local Health Board in Wales,

(b) not suspended from that list or from the Medical Register, and

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