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
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  • (2) Sub-paragraph (1) does not apply to any medical practitioner who is an exempt medical practitioner within the meaning of sub-paragraph (3) but only in so far as any medical services that the medical practitioner performs constitute part of a post-registration programme.
  • (3) For the purposes of this paragraph, an “exempt medical practitioner” is—
  • (a) a medical practitioner employed by an NHS trust54, an NHS foundation trust55, a Health Board, or a Health and Social Care Trust who is providing services other than primary medical services at the practice premises,
  • (b) a person who is provisionally registered under section 15 (provisional registration), 15A (provisional registration for EEA nationals) or 21 (provisional registration) of the Medical Act 1983 and who is acting in the course of the person’s employment in a resident medical capacity,
  • (c) a GP Specialty Registrar who has applied to a Local Health Board to have their name included in its medical performers list until the first of the following events arises—
  • (i) the Local Health Board notifies the GP Specialty Registrar of its decision on that application, or
  • (ii) the end of a period of 12 weeks, starting with the date on which that GP Specialty Registrar begins a postgraduate medical education and training scheme necessary for the award of a Certificate of Completion of Training,
  • (d) a medical practitioner who is already included in a medical performers list or an equivalent performers list and who has submitted an application to a Local Health Board in accordance with regulation 5 of the National Health Service (Performers Lists) (Wales) Regulations 2026 until the first of the following events arises—
  • (i) the Local Health Board notifies the medical practitioner of its decision on that application, or
  • (ii) the end of a period of 12 weeks, starting with the date on which the application was submitted, or
  • (e) a medical practitioner, who—
  • (i) is not a GP Specialty Registrar,
  • (ii) is undertaking a post-registration programme of clinical practice supervised by the General Medical Council,
  • (iii) has notified the Local Health Board that they are to undertake part or all of a post-registration programme in its area at least 24 hours before commencing any part of that programme taking place in the Local Health Board’s area, and
  • (iv) has, with that notification, provided the Local Health Board with evidence sufficient for it to satisfy itself that they are undertaking a post-registration programme,

but only in so far as any medical services that the medical practitioner performs constitute part of a post-registration programme.

  • (4) In this paragraph “equivalent performers list” has the meaning given in regulation 2 of the National Health Service (Performers Lists) (Wales) Regulations 2026.

Qualifications of performers: health care professionals

62

A health care professional (other than one to whom paragraph 61 applies) may not perform clinical services under the contract unless—

  • (a) that person is registered with the professional body relevant to that person’s profession, and
  • (b) that registration is not subject to a period of suspension.

Conditional registration or inclusion in primary care list

63

Where the registration of a health care professional or, in the case of a medical practitioner, the medical practitioner’s inclusion in a primary care list is subject to conditions, the contractor must ensure compliance with those conditions insofar as they are relevant to the contract.

Clinical experience

64

No health care professional may perform any clinical services unless the health care professional has such clinical experience and training as are necessary to enable the health care professional properly to perform such services.

Conditions for employment and engagement: medical practitioner

65

  • (1) Subject to sub-paragraphs (2) to (4), a contractor must not employ or engage a medical practitioner (other than an exempt medical practitioner within the meaning of sub-paragraph 61(3)) unless—
  • (a) that practitioner has provided the contractor with the name and address of the Local Health Board on whose medical performers list the practitioner appears, and
  • (b) the contractor has checked that the practitioner meets the requirements in paragraph 61.
  • (2) Where—
  • (a) the employment or engagement of a medical practitioner is urgently needed, and
  • (b) it is not possible for the contractor to check that the medical practitioner meets the requirements referred to in paragraph 61 before employing or engaging the health care professional,

the contractor may employ or engage the medical practitioner on a temporary basis for a single period of up to 7 days while such checks are undertaken.

  • (3) Where the prospective employee is a GP Specialty Registrar, the requirements set out in sub-paragraph (1) apply with the modifications that—
  • (a) the name and address provided under sub-paragraph (1) may be the name and address of the Local Health Board on whose list the GP Specialty Registrar has applied for inclusion, and
  • (b) confirmation that the GP Specialty Registrar’s name appears on that list is not to be required until the end of the first 12 weeks of the GP Specialty Registrar’s training period.
  • (4) Where the prospective employee is a medical practitioner who is already included in a medical performers list or an equivalent performers list and who has submitted an application to the Local Health Board in accordance with regulation 5 of the National Health Service (Performers Lists) (Wales) Regulations 2026, the requirements set out in sub-paragraph (1) apply with the modifications that—
  • (a) the name and address provided under sub-paragraph (1) may be the name and address of the Local Health Board on whose list the medical practitioner has applied for inclusion, provided that the name and address of the primary care organisation on whose list the medical practitioner is already included is provided in addition; and
  • (b) confirmation that the medical practitioner’s name appears on that list means confirmation that the medical practitioner is provisionally included in the Local Health Board’s medical performers list in accordance with regulation 4A of the National Health Service (Performers Lists) (Wales) Regulations 2004.
  • (5) In this paragraph “equivalent performers list” and “primary care organisation” have the meanings given in regulation 2 of the National Health Service (Performers Lists) (Wales) Regulations 2026.

Conditions for employment or engagement: health care professionals

66

  • (1) Subject to sub-paragraph (2), a contractor may not employ or engage a health care professional to perform clinical services under the contract unless—
  • (a) the contractor has checked that the health care professional meets the requirements of paragraph 62, and
  • (b) the contractor has taken reasonable steps to satisfy itself that the health care professional meets the requirements of paragraph 64.
  • (2) Where—
  • (a) the employment or engagement of a health care professional is urgently needed, and
  • (b) it is not possible for the contractor to check that the health care professional meets the requirements referred to in paragraph 62 before employing or engaging the health care professional,

the contractor may employ or engage the health care professional on a temporary basis for a single period of up to 7 days while such checks are undertaken.

  • (3) When considering a health care professional’s experience and training for the purposes of sub-paragraph (1)(b), the contractor must, in particular, have regard to—
  • (a) any post-graduate or post-registration qualification held by the health care professional, and
  • (b) any relevant training undertaken, and any relevant clinical experience gained, by the health care professional.

Clinical references

67

  • (1) The contractor may not employ or engage a health care professional to perform clinical services under the contract (other than an exempt medical practitioner to whom paragraph 61(3)(e) applies) unless—
  • (a) that person has provided two clinical references, relating to two recent posts (which may include any current post) as a health care professional which lasted for at least 12 weeks without a significant break or, where this is not possible, a full explanation of why this is the case and details of alternative referees, and
  • (b) the contractor has checked and is satisfied with the references.
  • (2) Where—
  • (a) the employment or engagement of a health care professional is urgently needed, and
  • (b) it is not possible for the contractor to obtain and check the references in accordance with sub-paragraph (1)(b) before employing or engaging that health care professional,

the contractor may employ or engage the health care professional on a temporary basis for a single period of up to 14 days while the references are checked and considered, and for an additional period of a further 7 days if the contractor believes that the person supplying those references is ill, on holiday or otherwise temporarily unavailable.

  • (3) Where the contractor employs or engages the same person on more than one occasion within a period of 12 weeks, the contractor may rely on the references provided on the first occasion, provided that those references are not more than a year old.

Verification of qualifications and competence

68

  • (1) The contractor must, before employing or engaging any person—
  • (a) comply with the Pre-employment Checks Standards in relation to that person, and
  • (b) take reasonable steps to satisfy itself that the person in question is both suitably qualified and competent to discharge the duties for which that person is to be employed or engaged.
  • (2) The duty imposed by sub-paragraph (1) is in addition to the duties imposed by paragraphs 61 to 67.
  • (3) When considering the competence and suitability of any person for the purpose of sub-paragraph (1), the contractor must have regard, in particular, to—
  • (a) that person’s academic and vocational qualifications,
  • (b) that person’s education and training, and
  • (c) that person’s previous employment or work experience.

Training

69

  • (1) The contractor must ensure that for any health care professional who is—
  • (a) performing clinical services under the contract, or
  • (b) employed or engaged to assist in the performance of such services,

there are in place arrangements for the purpose of maintaining and updating the health care professional’s skills and knowledge in relation to the services which they are performing or assisting in performing.

  • (2) The contractor must afford to each employee reasonable opportunities to undertake appropriate training with a view to maintaining that employee’s competence.

Terms and conditions

70

The contractor may only offer employment to a general medical practitioner on terms which are no less favourable than those contained in the document the “Model terms and conditions of service for a salaried general practitioner employed by a GMS practice” published by the British Medical Association and the NHS Confederation as item 1.2 of the supplementary documents to the GMS contract 2003.

Arrangements for GP Specialty Registrars

71

  • (1) The contractor may only employ a GP Specialty Registrar subject to the conditions in sub-paragraph (2).
  • (2) The conditions referred to in sub-paragraph (1) are that the contractor must not, by reason only of having employed or engaged a GP Specialty Registrar, reduce the total number of hours that other medical practitioners perform primary medical services under the contract or that other staff spend assisting them in the performance of those services.
  • (3) A contractor employing a GP Registrar must—
  • (a) offer the GP Registrar terms of employment in accordance with the rates and subject to the conditions contained in any directions given by Welsh Ministers to Local Health Boards under section 12 of the Act (Functions of Local Health Board) concerning the grants, fees, travelling and other allowances payable to GP Registrars, and
  • (b) take into account the guidance contained in the document entitled “A Reference Guide For Postgraduate Foundation and Specialty Training in the UK”56.

Notice requirements in respect of relevant prescribers

72

  • (1) For the purposes of this paragraph, “a relevant prescriber” is—
  • (a) an independent nurse prescriber,
  • (b) a nurse independent prescriber,
  • (c) a paramedic independent prescriber,
  • (d) a pharmacist independent prescriber,
  • (e) a physiotherapist independent prescriber,
  • (f) a podiatrist or chiropodist independent prescriber,
  • (g) a supplementary prescriber, or
  • (h) a therapeutic radiographer independent prescriber.
  • (2) The contractor must give notice to the Local Health Board where—
  • (a) a relevant prescriber is employed or engaged by a contractor to perform functions which include prescribing,
  • (b) a relevant prescriber whose functions include prescribing is a party to the contract, or
  • (c) the functions of a relevant prescriber whom the contractor already employs or has already engaged are extended to include prescribing.
  • (3) The notice under sub-paragraph (2) must be given in writing to the Local Health Board before the expiry of the period of 7 days beginning with the date on which—
  • (a) the relevant prescriber was employed or engaged by the contractor or, as the case may be, became a party to the contract (unless, immediately before becoming such a party, sub-paragraph (2)(a) applied to that relevant prescriber), or
  • (b) the functions of the relevant prescriber were extended to include prescribing.
  • (4) The contractor must give notice to the Local Health Board where—
  • (a) the contractor ceases to employ or engage a relevant prescriber in the contractor’s practice whose functions include prescribing in the contractor’s practice,
  • (b) a relevant prescriber ceases to be a party to the contract,
  • (c) the functions of a relevant prescriber employed or engaged by the contractor in the contractor’s practice are changed so that they no longer include prescribing in the contractor’s practice, or
  • (d) the contractor becomes aware that a relevant prescriber whom it employs or engages has been removed or suspended from the relevant register.
  • (5) The notice under sub-paragraph (4) must be given in writing to the Local Health Board before the end of the second working day after the day on which an event described in sub-paragraphs (4)(a) to (d) occurred in relation to the relevant prescriber.
  • (6) The contractor must provide the following information when it gives notice to the Local Health Board in accordance with sub-paragraph (2)—
  • (a) the person’s full name,
  • (b) the person’s professional qualifications,
  • (c) the person’s identifying number which appears in the relevant register,
  • (d) the date on which the person’s entry in the relevant register was annotated to the effect that the person was qualified to order drugs, medicines and appliances for patients,
  • (e) the date on which—
  • (i) the person was employed or engaged (if applicable),
  • (ii) the person became a party to the contract (if applicable), or
  • (iii) the functions of the person were extended to include prescribing in the contractor’s practice.
  • (7) The contractor must provide the following information when it gives notice to the Local Health Board in accordance with sub-paragraph (4)—
  • (a) the person’s full name,
  • (b) the person’s professional qualifications,
  • (c) the person’s identifying number which appears in the relevant register,
  • (d) the date on which—
  • (i) the person ceased to be employed or engaged in the contractor’s practice,
  • (ii) the person ceased to be a party to the contract,
  • (iii) the functions of the person were changed so as to no longer include prescribing in the contractor’s practice, or
  • (iv) the person was removed or suspended from the relevant register.

Signing of documents

73

  • (1) The contractor must ensure—
  • (a) that the documents specified in sub-paragraph (2) include—
  • (i) the clinical profession of the health care professional who signed the document, and
  • (ii) the name of the contractor on whose behalf the document is signed, and
  • (b) that the documents specified in sub-paragraph (3) include the clinical profession of the health care professional who signed the document.
  • (2) The documents specified in this sub-paragraph are—
  • (a) certificates issued in accordance with regulation 19, unless regulations relating to particular certificates provide otherwise, and
  • (b) any other clinical documents apart from—
  • (i) home oxygen order forms, and
  • (ii) the documents specified in sub-paragraph (3).
  • (3) The documents specified in this paragraph are batch issues, prescription forms and repeatable prescriptions.
  • (4) This paragraph is in addition to any other requirements relating to the documents specified in sub-paragraphs (2) and (3) whether in these Regulations or elsewhere.

Level of skill and compliance with pathways

74

The contractor must, and the contractor must ensure that those it employs or engages must—

  • (a) carry out the contractor’s obligations under the contract with reasonable care and skill, and
  • (b) consider the application of national condition pathways relevant for each patient.

Appraisal and assessment

75

  • (1) The contractor must ensure that any medical practitioner performing services under the contract—
  • (a) participates in the appraisal system provided by the Local Health Board unless that medical practitioner participates in an appropriate appraisal system provided by another health service body or is an armed forces GP, and
  • (b) co-operates with the Local Health Board in relation to the Local Health Board’s patient safety functions.
  • (2) The Local Health Board must provide an appraisal system for the purposes of sub-paragraph (1)(a) after consultation with the Local Medical Committee (if any) for the area in which the practitioner provides services under the contract and such other persons as appear to it to be appropriate.
  • (3) In sub-paragraph (1), “armed forces GP” means a medical practitioner who is employed on a contract of service by the Ministry of Defence, whether or not as a member of the armed forces of the Crown.

PART 7 — Sub-contracting

Sub-contracting

76

  • (1) Subject to sub-paragraph (2), the contractor must not sub-contract any of its rights or duties under the contract in relation to clinical matters, or non-clinical matters directly affecting patients, unless—
  • (a) in all cases it has taken reasonable steps to satisfy itself that—
  • (i) it is reasonable in all the circumstances to do so, and
  • (ii) that person to whom any of those rights or duties is sub-contracted is qualified and competent to provide the service, and
  • (b) the contractor has given notice in writing to the Local Health Board of its intention to sub-contract as soon as reasonably practicable before the date on which the proposed sub-contract is intended to come into effect.
  • (2) Sub-paragraph (1)(b) does not apply to—
  • (a) a contract for services with a health care professional for the provision by that professional personally of clinical services, or
  • (b) a contract between the contractor and another practice in the contractor’s GP Collaborative under which that other practice is to provide, as part of that GP Collaborative’s activities, primary medical services to the contractor’s patients.
  • (3) A notice given under sub-paragraph (1)(b) must include—
  • (a) the name and address of the proposed sub-contractor,
  • (b) the duration of the proposed sub-contract,
  • (c) the services to be covered by the proposed sub-contract, and
  • (d) the address of any premises to be used for the provision of services under the proposed sub-contract.
  • (4) On receipt of a notice given under sub-paragraph (1)(b), the Local Health Board may request further information relating to the proposed sub-contract as appears to it to be reasonable, and the contractor must supply that information to the Local Health Board promptly.
  • (5) The contractor must not proceed with the sub-contract or, if the sub-contract has already taken effect, the contractor must take all reasonable steps to terminate it, where the Local Health Board gives notice in writing of its objection to the sub-contract on the grounds that—
  • (a) the sub-contract would—
  • (i) put the safety of the contractor’s patients at risk, or
  • (ii) put the Local Health Board at risk of material financial loss,
  • (b) the sub-contractor would be unable to meet the contractor’s obligations under the contract,

and such notice is given by the Local Health Board before the end of the period of 28 days beginning with the date on which the Local Health Board received a notice from the contractor under sub-paragraph (1)(b).

  • (6) A notice given by the Local Health Board under sub-paragraph (5)(a) must include a statement of the reasons for the Local Health Board’s objection.
  • (7) Sub-paragraphs (1) and (3) to (6) also apply in relation to any renewal or material variation of a sub-contract in relation to clinical matters and non-clinical matters directly related to a patient.
  • (8) Where the notification by the contractor pursuant to sub-paragraph (3) relates to clinical matters and the Local Health Board does not give notice of an objection under sub-paragraph (5), the parties to the contract are deemed to have agreed a variation of the contract which, subject to any notice served under sub-paragraph (5), has the effect of adding to the list of practice premises any premises the address of which was notified to the Local Health Board under sub-paragraph (3)(d) and, in these circumstances, paragraph 109(1) does not apply.
  • (9) Subject to sub-paragraph (10), a sub-contract entered into by a contractor must prohibit the sub-contractor from sub-contracting any of the clinical services that it has agreed with the contractor to provide under the sub-contract.
  • (10) A sub-contract entered into by the contractor falling within sub-paragraph (2)(b) may allow the sub-contractor to sub-contract clinical services provided the contractor obtains the written approval of the Local Health Board prior to the sub-contractor sub-contracting those services.
  • (11) The contractor must not sub-contract any of its rights or duties under the contract in relation to the provision of unified services to a company or firm—
  • (a) owned wholly or partly by the contractor, or by any former or current employee of, or partner or shareholder in, the contractor,
  • (b) formed by or on behalf of the contractor, or from which it derives or may derive a pecuniary benefit, or
  • (c) formed by or on behalf of a former or current employee of, or partner or shareholder in, the contractor, or from which such a person derives or may derive a pecuniary benefit,

where sub-paragraph (12) applies to that company or firm.

  • (12) This sub-paragraph applies to a company or firm which is or was formed wholly or partly for the purpose of avoiding the restrictions on the sale of goodwill of a medical practice in regulation 3 of the Primary Medical Services (Sale of Goodwill and Restrictions on Sub-contracting) (Wales) Regulations 200457.

Withdrawal and variation of approval and right to subsequently object to a sub-contract under paragraph 76

77

  • (1) Without prejudice to any other remedies which it may have under the contract, where a Local Health Board is deemed to have approved an application made under paragraph 76, it is entitled to serve notice on the contractor withdrawing or varying that approval with immediate effect if—
  • (a) it is no longer satisfied that the proposed arrangement enables the contractor to satisfactorily meet its obligations under the contract, or
  • (b) it is satisfied that immediate withdrawal of variation is necessary to protect—
  • (i) the safety of the contractor’s patients, or
  • (ii) the Local Health Board from material financial loss.
  • (2) A notice served under this paragraph takes effect on the date on which it is received by the contractor.

PART 8 — Records, information, notifications and rights of entry

Patient records

78

  • (1) The contractor must keep adequate records of its attendance on and treatment of its patients and must do so—
  • (a) on forms supplied to it for the purpose by the Local Health Board, or
  • (b) with the written consent of the Local Health Board, by way of computerised records,

or in a combination of those two ways.

  • (2) The contractor must include in the records referred to in sub-paragraph (1) clinical reports sent in accordance with paragraph 10 or from any other health care professional who has provided clinical services to a person on its list of patients.
  • (3) The consent of the Local Health Board required by sub-paragraph (1)(b) must not be withheld or withdrawn provided the Local Health Board is satisfied, and continues to be satisfied, that—
  • (a) the GP digital services upon which the contractor proposes to keep the records meet the requirements set out in the National Framework Agreement for GP Clinical Systems and Services in Wales,
  • (b) the security measures, audit and system management functions incorporated into the GP digital services are compliant with the National Framework Agreement for GP Clinical Systems and Services in Wales and have been enabled, and
  • (c) the contractor is compliant with the “Welsh Information Governance Toolkit” and is aware of and has signed an undertaking that it must have regard to the guidelines contained in “The Good Practice Guidelines for GP electronic patient records (GPGv5)”, published on 20th September 2023.
  • (4) Where the contractor’s patient records are computerised records, the contractor must, as soon as possible following a request from the Local Health Board, allow the Local Health Board to access the information recorded on the computer system on which those records are held by means of the audit function referred to in sub-paragraph (3)(b) to the extent necessary for the Local Health Board to confirm that the audit function is enabled and functioning correctly.
  • (5) Where a patient on the contractor’s list of patients dies, the contractor must—
  • (a) retain the complete medical records relating to that patient on their clinical computer system,
  • (b) upon receiving an appropriate Health Record request, the contractor must send the complete records relating to that patient to the Local Health Board or the requestor, as the case may be, and
  • (c) provide the complete medical records to the Local Health Board or requestor within seven days, where possible, beginning with the day the request was made, and in any event before the expiry of 40 days.
  • (6) Where a patient on a contractor’s list of patients has registered with another provider of primary medical services and the contractor receives a request from that provider for the complete records relating to that patient, the contractor must, as soon as possible and in any event before the end of the period of 28 days beginning with the day on which it receives the request from the provider, send to that provider the complete records (other than any part held only in paper form), via the GP2GP facility in accordance with paragraph 80 and send to the Local Health Board—
  • (a) the complete records, or any part of the records, sent via the GP2GP facility in accordance with paragraph 80 for which the contractor does not receive confirmation of safe and effective transfer via that facility, and
  • (b) any part of the records held by the contractor only in paper form.
  • (7) Where a patient on a contractor’s list of patients—
  • (a) is removed from that list at that patient’s request under paragraph 28, or by reason of the application of any of paragraphs 29 to 36, and
  • (b) the contractor has not received a request from another provider of medical services with which that patient has registered for the transfer of the complete records relating to that patient,

the contractor must send a copy of those records to the Local Health Board.

  • (8) Where a contractor’s responsibility for a patient terminates in accordance with paragraph 37, the contractor must send any records relating to that patient that it holds to—
  • (a) if known, the provider of primary medical services with which that patient is registered, or
  • (b) in all other cases, the Local Health Board.
  • (9) For the purposes of this regulation, “GP2GP facility” has the same meaning as in sub-paragraph (2) of paragraph 80.
  • (10) To the extent that a patient’s records are computerised records, the contractor complies with sub-paragraphs ... (7) or (8) if it sends to the Local Health Board a copy of those records—
  • (a) in written form, or
  • (b) with the written consent of the Local Health Board in any other form.
  • (11) The consent of the Local Health Board to the transmission of information other than in written form for the purposes of sub-paragraph (10)(b) must not be withheld or withdrawn provided it is satisfied, and continues to be satisfied, with the following matters—
  • (a) the contractor’s proposals as to how the record is to be transmitted,
  • (b) the contractor’s proposals as to the format of the transmitted record,
  • (c) how the contractor is to ensure that the record received by the Local Health Board is identical to that transmitted, and
  • (d) how a written copy of the record can be produced by the Local Health Board.
  • (12) A contractor whose patient records are computerised records must not disable, or attempt to disable, either the security measures or the audit and system management functions referred to in sub-paragraph (3)(b).
  • (13) In this paragraph, “computerised records” means records created by way of entries on a computer and “appropriate Health Record request” is a request made by the Local Health Board or one made under the Access to Health Records Act 1990.

Welsh GP record

79

  • (1) Subject to sub-paragraph (2), a contractor must, in any case where there is a change to the information included in a patient’s medical record, enable the automated retrieval of summary information from the Welsh GP Record ... and the NHS Wales App, when the change occurs, using approved systems provided to it by the Local Health Board.
  • (2) The enabling of automated retrieval of summary information from the Welsh GP Record must be for clinical use.
  • (3) In this paragraph—
  • “NHS Wales App” (“Ap GIG Cymru”) means the system managed by Digital Health and Care Wales for accessing and managing health appointments, prescriptions and personal details;
  • “Welsh GP Record” (“Cofnod Meddyg Teulu Cymru”) means the system approved by the Local Health Board for the automated retrieval, 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 taken from the patient’s electronic record;
  • “summary information” (“gwybodaeth gryno”) means items of patient data that comprise the Welsh GP Record.

Electronic transfer of patient records between GP practices

80

  • (1) A contractor must use the GP2GP facility 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 the practice of 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 paragraph, “GP2GP facility” means the facility provided by the Local Health Board to a contractor’s practice which enables the electronic health records of a registered patient which are held on the computerised clinical systems of a contractor’s practice to be electronically transferred securely and directly to another provider of primary medical services with which the patient has registered.
  • (3) The requirements of this paragraph do not apply in the case of a temporary resident.

Clinical correspondence: requirement for NHS number

81

  • (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 sub-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 paragraph—
  • “clinical correspondence” (“gohebiaeth glinigol”) means all correspondence in writing, whether in electronic form or otherwise, between the contractor and other health service providers concerning or arising out of patient attendance and treatment at practice premises including referrals made by letter or by any other means;
  • “NHS number” (“rhif GIG”), 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, accurately and efficiently sharing information relating to that patient across the whole of the health service in Wales.

Use of fax machines

82

  • (1) Where a contractor can transmit information securely and directly by electronic means other than facsimile transmission, the contractor must not—
  • (a) transmit information to a relevant person by facsimile transmission, or
  • (b) agree to receive any information from a relevant person by facsimile transmission.
  • (2) Sub-paragraph (1) does not apply to information which relates solely to a patient under a private arrangement for the provision of clinical services or treatment.
  • (3) In this paragraph “relevant person” means—
  • (a) an NHS body,
  • (b) another health service provider,
  • (c) a patient, or
  • (d) a person acting on behalf of a patient.

Confidentiality of personal data: nominated person

83

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

Provision of information to patients

84

  • (1) The contractor must—
  • (a) have an online resource,
  • (b) provide the information specified in Schedule4 digitally on the practice’s online resource and ensure that a written practice leaflet containing the information specified in Schedule 4 is also available,
  • (c) review the information provided in paragraphs (a) and (b) at least once every year, and
  • (d) make its patients and prospective patients aware of the information contained on their practice’s online resource or how they can access this information in a written practice leaflet.
  • (2) The contractor must make any amendments necessary to maintain the accuracy of the information on its online resource following—
  • (a) a review under sub-paragraph (1)(c),
  • (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 online resource), 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 (or access to information) at the request of the Local Health Board

85

  • (1) Subject to sub-paragraph (2), the contractor must, at the request of the Local Health Board, produce to the Local Health Board or to a person authorised in writing by the Local Health Board, or allow the Local Health Board or a person authorised in writing by it, to access—
  • (a) any information which is reasonably required by the Local Health Board for the purposes of or in connection with the contract, and
  • (b) any other information which is reasonably required in connection with the Local Health Board functions.
  • (2) The contractor is not required to comply with any request made in accordance with sub-paragraph (1) unless it has been made by the Local Health Board in accordance with directions relating to the provision of information by contractors given to it by the Welsh Ministers under section 12(3) of the Act.
  • (3) The contractor must produce the information requested, or, as the case may be, allow the Local Health Board access to that information—
  • (a) by a date agreed as reasonable between the contractor and the Local Health Board, or
  • (b) in the absence of such agreement, within 28 days beginning with the date the request is made.

Clinical audits and the National Data Resource

86

  • (1) A contractor must record and allow Digital Health and Care Wales to access any data required by the Local Health Board for the purposes of the National Clinical Audit and Outcome Review Programme for NHS Wales in accordance with sub-paragraph (2).
  • (2) The data referred to in sub-paragraph (1) must be appropriately coded by the contractor using standardised coding and uploaded onto the contractor’s computerised clinical systems in line with the requirements of guidance published by Digital Health and Care Wales for these purposes.
  • (3) The contractor must permit the extraction of patient level data by Digital Health and Care Wales for the purpose of undertaking clinical audits included in the National Clinical Audit and Outcome Review Programme (NCAORP) to support the management of the health and care system.
  • (4) Contractors must consider practice level data from national clinical audits and take relevant and proportionate action to reduce any significant and unwarranted variation that is identified.

Information relating to indicators no longer in the Quality Assurance and Improvement Framework

87

  • (1) A contractor must allow the extraction from the contractor’s computerised clinical systems by the Local Health Board of the information specified in the table below (Indicators relocated from the Quality Assurance and Improvement Framework) at such intervals during each financial year as are notified to the contractor by the Local Health Board.
  • (2) A contractor must—
  • (a) establish and maintain the registers specified in the clinical indicators listed in the column “Indicator Description” of the table below (Indicators relocated from the Quality Assurance and Improvement Framework),
  • (b) where an indicator specifies a particular statistic, contemporaneously record the related data as part of chronic disease management, and
  • (c) where the indicator specifies a particular requirement or activity, continually record details of the contractor’s compliance with any such requirements or activities.
Indicator ID Indicator Description
AF001 The contractor establishes and maintains a register of patients with atrial fibrillation
CHD001 The contractor establishes and maintains a register of patients with coronary heart disease
HF001 The contractor establishes and maintains a register of patients with heart failure
HYP001 The contractor establishes and maintains a register of patients with established hypertension
STIA001 The contractor establishes and maintains a register of patients with stroke or TIA
DM001 The contractor establishes and maintains a register of all patients aged 17 or over with diabetes mellitus, which specifies the type of diabetes where a diagnosis has been confirmed
AST001 The contractor establishes and maintains a register of patients with asthma, excluding patients with asthma who have been prescribed no asthma-related drugs in the preceding 12 months
COPD001 The contractor establishes and maintains a register of patients with COPD
DEM001 The contractor establishes and maintains a register of patients diagnosed with dementia
MH001 The contractor establishes and maintains a register of patients with schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy
CAN001 The contractor establishes and maintains a register of all cancer patients defined as a ‘register of patients with a diagnosis of cancer excluding non-melanotic skin cancers diagnosed on or after 1 April 2003’
EP001 The contractor establishes and maintains a register of patients aged 18 or over receiving drug treatment for epilepsy
LD001 The contractor establishes and maintains a register of patients with learning disabilities
OST001 The contractor establishes and maintains a register of patients—1. Aged 50 or over and who have not attained the age of 75 with a record of a fragility fracture on or after 1 April 2012 and a diagnosis of osteoporosis confirmed on DXA scan, and2. Aged 75 or over with a record of a fragility fracture on or after 1 April 2012
RA001 The contractor establishes and maintains a register of patients aged 16 or over with rheumatoid arthritis
PC001 The contractor establishes and maintains a register of all patients in need of palliative care/support irrespective of age
OB001 The contractor establishes and maintains a register of patients aged 16 or over with a BMI of 30 in the preceding 15 months.
AF006 The percentage of patient with atrial fibrillation in whom stroke risk has been assessed using CHA2DS2-VASx score risk stratification scoring system in the preceding 3 years (excluding those patients with a previous CHADS2 or CHA2DS2-VASc score of 2 or more) and a record of counselling regarding the risks and benefits of anticoagulation therapy has been made
AF007 In those patients with atrial fibrillation with a record of a CHA2DS2-VASc score of 2 or more, the percentage of patients who are currently treated with anticoagulation drug therapy
DEM002 The percentage of patients diagnosed with dementia whose care has been reviewed in person or, if clinically appropriate, via telephone or remote video consultation in a face-to-face review in the preceding 15 months.
DM002 The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 15 months) is 150/90 mmHg or less
DM003 The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 15 months) is 140/80 mmHg or less
DM007 The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 59 mmol/mol or less in the preceding 15 months
DM012 The percentage of patients with diabetes, on the register, with a record of a foot examination and risk classification; 1) low risk (normal sensation, palpable pulse), 2) increased risk (neuropathy or absent pulses), 3) high risk (neuropathy or absent pulses plus deformity or skin changes in previous ulcer) or 4) ulcerated foot within the preceding 15 months
DM014 The percentage of patients newly diagnosed with diabetes, on the register, in the preceding 1 April to 31 March who have a record of being referred to a structured education programme within 9 months after entry on to the diabetes register
COPD003 The percentage of patients with COPD who have had a review, undertaken by a healthcare professional, including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 15 months
MH011W The percentage of patients with Schizophrenia, Bipolar affective disorder and other psychoses who have a record of blood pressure, BMI, smoking status and alcohol consumption in the preceding 15 months and in addition to those aged 40 or over, a record of blood glucose or HbA1c in the preceding 15 months
PC002W The contractor has regular (at least 2 monthly) multi-disciplinary case review meetings where all patients on the palliative care register are discussed
FLU001W The percentage of the registered population aged 65 years or more who have had influenza immunisation in the preceding 1 August to 31 March
FLU002W The percentage of patients aged under 65 years included in (any of) the registers for CHD, COPD, Diabetes or Stroke who have had influenza immunisation in the preceding 1 August to 31 March

The Wales National Workforce Reporting System

88

  • (1) The contractor must update the workforce elements of the Primary Care Workforce Intelligence System to include—
  • (a) head count and whole-time equivalents, and
  • (b) a record of all new starters and leavers.
  • (2) The contractor must access, review and update, where necessary, their Primary Care Workforce Intelligence System dashboard view at least once per month.

General Practice Escalation Tool

89

The contractor must enter their escalation submission in the General Practice Escalation Tool by 3.30pm on the last working day of each month and also on each occasion that there is a significant change in practice circumstances.

Medicines and Healthcare Products Regulatory Agency Central Alerting System

90

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 that the contractor is unable to receive electronic mail.

Inquiries about prescriptions and referrals

91

  • (1) The contractor must, subject to sub-paragraphs (2) and (3), sufficiently answer any inquiries whether they are oral or in writing from the Local Health Board concerning—
  • (a) any prescription form or repeatable prescription issued by a prescriber,
  • (b) the considerations by reference to which prescribers issue such forms,
  • (c) the referral by or on behalf of the contractor of any patient to any other services provided under the Act, or
  • (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 sub-paragraph (1) may only be made for the purpose either of obtaining information to assist the Local Health Board to discharge its functions or of assisting the contractor in the discharge of its obligations under the contract.
  • (3) The contractor is not obliged to answer any inquiry referred to in sub-paragraph (1) unless it is made—
  • (a) in the case of sub-paragraph (1)(a) or (b), by an appropriately qualified health care professional, or
  • (b) in the case of sub-paragraph (1)(c) or (d), by an appropriately qualified medical practitioner.
  • (4) The appropriately qualified person referred to in sub-paragraph (3)(a) or (b) must—
  • (a) be appointed by the Local Health Board in either case to assist it in the exercise of its functions under this paragraph, and
  • (b) produce, on request, written evidence of that person’s authority from the Local Health Board to make such an inquiry on the Local Health Board’s behalf.

Provision of information to a medical officer etc.

92

  • (1) The contractor must, if satisfied that the patient consents—
  • (a) supply in writing to any person specified in sub-paragraph (3) (a “relevant person”), within such reasonable period as that person may specify, such clinical information as any of the persons mentioned in sub-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 sub-paragraph (1) and (2), a “relevant person” is—
  • (a) a medical officer,
  • (b) a nursing officer,
  • (c) an occupational therapist,
  • (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 paragraphs (a) to (d).
  • (4) In this paragraph—
  • “medical officer” (“swyddog meddygol”) 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” (“swyddog nyrsio”) 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” (“therapydd galwedigaethol”) 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 contract entered into with the Secretary of State for Work and Pensions;
  • “physiotherapist” (“ffisiotherapydd”) 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

93

  • (1) The contractor must submit an annual return relating to the contract to the Local Health Board which requires the same categories of information from all persons who hold contracts with that Local Health Board.
  • (2) The Local Health Board may request a return relating to the contract 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 to the Local Health Board—
  • (a) by a date agreed as reasonable between the contractor and the Local Health Board, 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 sub-paragraph (1), the Local Health Board must consider the performance of the contractor in relation to the contract and arrange with the contractor an annual review of its performance in relation to the contract.
  • (4A) On consideration of the return in sub-paragraph (4), the Local Health Board will determine whether a formal face-to-face review is necessary.
  • (5) The contractor or the Local Health Board may, if desired, invite the Local Medical Committee (if any) for the area in which the contractor is providing services under the contract to participate in the annual formal review.
  • (6) The Local Health Board must prepare a draft record of the review referred to in sub-paragraph (4) for comment by the contractor and, having regard to such comments, produce a final written record of the review.
  • (7) The Local Health Board must send a copy of the final record of the review referred to in sub-paragraph (6) to the contractor.
  • (8) The annual return must include the following information—
  • (a) the total number of patients on the LD register,
  • (b) the number of health checks offered, and
  • (c) the number of heath checks completed.
  • (9) In this paragraph “LD register” means the list of individuals with learning disabilities managed by GPs in Wales.

Notifications to the Local Health Board

94

  • (1) In addition to any requirements of notification elsewhere in these Regulations, the contractor must notify the Local Health Board in writing, as soon as reasonably practicable, of—
  • (a) any serious incident that, in the reasonable opinion of the contractor, affects or is likely to affect the contractor’s performance of its obligations under the contract;
  • (b) any circumstances which give rise to the Local Health Board’s right to terminate the contract under Part 11;
  • (c) any appointments system which it proposes to operate and the proposed discontinuance of any such system;
  • (d) any change of which the contractor is aware in the address of a registered patient;
  • (e) the death of any patient of which the contractor is aware.
  • (2) The contractor must, unless it is impracticable for it to do so, notify the Local Health Board in writing within 28 days of any occurrence requiring a change in the information about it published by the Local Health Board in accordance with regulations made under section 41 of the Act (primary medical services).
  • (3) The contractor must notify the Local Health Board in writing of any person other than a registered patient or a person whom it has accepted as a temporary resident to whom it has provided the unified services described in regulation 17(7) or (9) within the period of 28 days beginning on the day that the services were provided.

Co-operation with the Local Health Board

95

The Contractor must co-operate with the Local Health Board in the discharge of any of the Local Health Board’s obligations, or the obligations of the Local Health Board’s accountable officers, under the Controlled Drugs (Supervision of Management and Use) (Wales) Regulations 200858.

Notice provisions specific to a contract with a company limited by shares

96

  • (1) Where a contractor is a company limited by shares, the contractor must give notice in writing to the Local Health Board as soon as—
  • (a) the contractor is aware of any proposal for—
  • (i) any share in the company to be transmitted or transferred (whether legally or beneficially) to another person, or
  • (ii) a new director or secretary of the company to be appointed,
  • (b) circumstances arise which may entitle a creditor or a court to appoint a receiver, administrator or administrative receiver in respect of the company,
  • (c) circumstances arise which would enable the court to make a winding up order in respect of the company,
  • (d) a company resolution is passed, or a court of competent jurisdiction makes an order, that the company is to be wound up, or
  • (e) the company is unable to pay its debts within the meaning of section 123 of the Insolvency Act 198659 (definition of inability to pay debts).
  • (2) A notice under sub-paragraph (1)(a) must confirm that any proposed new shareholder or, as the case may be, the personal representative of a deceased shareholder—
  • (a) is either—
  • (i) a medical practitioner, or
  • (ii) a person who satisfies the conditions specified in section 44(2)(b)(i) to (iv) of the Act (persons eligible to enter into GMS contracts), and
  • (b) meets the further conditions imposed on shareholders by virtue of regulations 5 and 6.
  • (3) A notice under sub-paragraph (1)(a) must confirm that any proposed new director or, as the case may be, secretary meets the conditions imposed on directors and secretaries by virtue of regulation 6.

Notice provisions specific to a contract with a company limited by shares

97

  • (1) Where a contractor is a partnership, the contractor must give notice in writing to the Local Health Board as soon as—
  • (a) any partner in the partnership—
  • (i) leaves the partnership, or
  • (ii) informs the other partners in the partnership that they intend to leave the partnership, or
  • (b) a new partner joins the partnership.
  • (2) A notice under sub-paragraph (1)(a) must confirm the date on which the partner left or proposes to leave the partnership.
  • (3) A notice under sub-paragraph (1)(b) must—
  • (a) state the date on which the new partner joined the partnership,
  • (b) confirm that the new partner is—
  • (i) a medical practitioner, or
  • (ii) a person who satisfies the conditions specified in section 44(2)(b)(i) to (iv) of the Act (persons eligible to enter into GMS contracts),
  • (c) confirm that the new partner meets the conditions imposed by regulations 5 and 6, and
  • (d) state whether the new partner is a general or a limited partner in the partnership.

Notification of deaths

98

  • (1) The contractor must report in writing to the Local Health Board the death on its practice premises of any patient no later than the end of the first working day after the date on which the death occurred.
  • (2) The report must include—
  • (a) the patient’s full name,
  • (b) the patient’s National Health Service number where known,
  • (c) the date and place of the patient’s death,
  • (d) a brief description of the circumstances, as known, surrounding the patient’s death,
  • (e) the name of any medical practitioner or other person treating the patient while the patient was on the contractor’s practice premises, and
  • (f) the name, where known, of any other person who was present at the time of the patient’s death.
  • (3) The contractor must send a copy of the report referred to in sub-paragraph (1) to any other Local Health Board in whose area the deceased was resident at the time of the deceased’s death.

Notifications to patients following variation of the contract

99

  • (1) This paragraph applies where a contract is varied in accordance with Part 11 of this Schedule and, as a result of that variation—
  • (a) there is to be a change in the range of services provided to the contractor’s registered patients, or
  • (b) patients who are on the contractor’s list of patients are to be removed from that list.
  • (2) Where this paragraph applies, the Local Health Board must—
  • (a) give notice in writing to those patients of the variation and of its effect, and
  • (b) inform those patients of the steps that they may take to—
  • (i) obtain the services in question elsewhere, or
  • (ii) register elsewhere for the provision to them of unified services (or their equivalent).

Entry and Inspection by the Local Health Board

100

  • (1) Subject to the conditions in sub-paragraph (2), the contractor must allow any persons authorised in writing by the Local Health Board to enter and inspect the contractor’s practice premises at any reasonable time.
  • (2) The conditions referred to in sub-paragraph (1) are that—
  • (a) reasonable notice of the intended entry has been given,
  • (b) written evidence of the authority of the person seeking entry is produced to the contractor on request, and
  • (c) entry is not made to any premises or part of the premises used as residential accommodation without the consent of the resident.
  • (3) The contractor or the Local Health Board or a person authorised in writing by the Local Health Board may invite the Local Medical Committee (if any) for the area in which the contractor provides services under the contract to be present at any inspection of the contractor’s practice premises which takes place under this paragraph.

PART 9 — Concerns, complaints and investigations

Concerns and complaints

101

The contractor must establish and operate arrangements which meet the requirements of the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 201160 to deal with any concerns or complaints about any matter reasonably connected with the provision of services under the contract.

Co-operation with investigations

102

  • (1) The contractor must co-operate with—
  • (a) any investigation of a complaint or a concern notified in accordance with the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011 in relation to any matter reasonably connected with the provision of services under the contract undertaken by—
  • (i) the Local Health Board,
  • (ii) the Welsh Ministers,
  • (iii) the Public Services Ombudsman for Wales, and
  • (b) any investigation of a complaint or a concern notified in accordance with the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011 by an NHS body or local authority which relates to a patient or former patient of the contractor.
  • (2) The co-operation required by sub-paragraph (1) includes—
  • (a) answering questions reasonably put to the contractor by the Local Health Board,
  • (b) providing any information relating to the complaint or a concern notified in accordance with the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011 reasonably required by the Local Health Board, and
  • (c) attending any meeting to consider the complaint or a concern notified in accordance with the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011 (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given) if the contractor’s presence at the meeting is reasonably required by the Local Health Board.
  • (3) In this paragraph—
  • “NHS body” (“corff GIG”) means a Local Health Board, (in England and Wales and Scotland) an NHS trust, an NHS foundation trust, an Integrated Care Board, NHS England, a Health Board, a Health and Social Services Board or a Health and Social Care Trust;
  • “local authority” (“awdurdod lleol”) means—any of the bodies listed in section 1 of the Local Authority Social Services Act 197061 (local authorities) (constitution of councils),the Council of the Isles of Scilly,a council constituted under section 2 of the Local Government etc (Scotland) Act 1994 (constitution of councils), ora council of a county or county borough in Wales.

Provision of information about complaints

103

The contractor must inform the Local Health Board, at such intervals as required, of the number of complaints it has received under the procedure established in accordance with this Part.

PART 10 — Dispute resolution

Local resolution of contract disputes

104

  • (1) The contractor and the Local Health Board 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 contract before referring the dispute for determination in accordance with the NHS dispute resolution procedure (or, where applicable, before commencing court proceedings).
  • (2) Sub-paragraph (1) does not apply to a dispute relating to the assignment of patients to a closed list which falls to be determined under the NHS dispute resolution procedure by virtue of paragraph 46(1) where it is not practicable for the parties to attempt local resolution before the expiry of the period of 7 days specified in paragraph 46(4).
  • (3) The contractor or the Local Health Board may invite the Local Medical Committee (if any) for the area in which the contractor is providing services under the contract to participate in discussions which take place by virtue of sub-paragraph (1).

Dispute resolution: non-NHS contracts

105

  • (1) In the case of a contract that is not an NHS contract, any dispute arising out of or in connection with the contract, except matters dealt with under the procedures for notifying concerns or complaints pursuant to Part 9 of this Schedule, may be referred for consideration and determination to the Welsh Ministers—
  • (a) if it relates to a period when the contractor was treated as a health service body, by the contractor or by the Local Health Board, or
  • (b) in any other case, by the contractor or, if the contractor agrees in writing, by the Local Health Board.
  • (2) In the case of a dispute referred to the Welsh Ministers under sub-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

106

  • (1) Subject to sub-paragraph (2), the procedure specified in the following sub-paragraphs and paragraph 107 applies in the case of any dispute arising out of or in connection with the contract which is referred to the Welsh Ministers—
  • (a) in accordance with section 7(6) of the Act (where the contract is an NHS contract), or
  • (b) in accordance with paragraph 105(1) (where the contract is not an NHS contract).
  • (2) The procedure specified in this paragraph does not apply where a contractor refers a matter for determination in accordance with paragraph 46, and in such a case the procedure specified in that paragraph applies instead.
  • (3) Any party wishing to refer a dispute as mentioned in sub-paragraph (1) must send to the Welsh Ministers 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, and
  • (c) a brief statement describing the nature of, and circumstances giving rise to, the dispute.
  • (4) Any party wishing to refer a dispute as mentioned in sub-paragraph (1) must send the request under sub-paragraph (3) within a period of 3 years beginning with the date on which the matter giving rise to the dispute happened or should reasonably have come to the attention of the party wishing to refer the dispute.
  • (5) Where the dispute relates to a contract which is not an NHS contract, the Welsh Ministers may determine the matter themselves or, if the Welsh Ministers consider it appropriate, appoint a person or persons to consider and determine it.
  • (6) Before reaching a decision as to who should determine the dispute, either under sub-paragraph (5) or under section 7(8) of the Act, the Welsh Ministers must, within the period of 7 days beginning with the date on which a matter under dispute was referred to it, send a written request to the parties to make in writing, within a specified period, any representations which they may wish to make about the matter under dispute.
  • (7) The Welsh Ministers must give, with the notice given under sub-paragraph (6), to the party other than the one which referred the matter to dispute resolution a copy of any document by which the matter was referred to dispute resolution.
  • (8) The Welsh Ministers must give a copy of any representation received from a party to the other party and must 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 it wishes to make on those representations.
  • (9) Following receipt of any representations from the parties or, if earlier , at the end of the period for making such representations specified in the request sent under sub-paragraph (6) or (8), the Welsh Ministers must, if they decide to appoint a person or persons to hear the dispute—
  • (a) inform the parties in writing of the name of the person or persons whom it has appointed, and
  • (b) pass to the person or persons so appointed any documents received from the parties under or pursuant to sub-paragraph (3), (6) or (8).
  • (10) For the purpose of assisting the adjudicator in the consideration of the matter, the adjudicator may—
  • (a) invite representatives of the parties to appear before the adjudicator to make oral representations 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 adjudicator wishes them to give special consideration, or
  • (b) consult other persons whose expertise the adjudicator considers can assist in the consideration of the matter.
  • (11) Where the adjudicator consults another person under sub-paragraph (10)(b), the adjudicator must notify the parties accordingly in writing and, where the adjudicator considers that the interests of any party might be substantially affected by the result of the consultation, the adjudicator must give to the parties such opportunity as the adjudicator considers reasonable in the circumstances to make observations on those results.
  • (12) In considering the matter, the adjudicator must consider—
  • (a) any written representations made in response to a request under sub-paragraph (6), but only if they are made within the specified period,
  • (b) any written observations made in response to a request under sub-paragraph (8), but only if they are made within the specified period,
  • (c) any oral representations made in response to an invitation under sub-paragraph (10)(a),
  • (d) the results of any consultation under sub-paragraph (10)(b), and
  • (e) any observations made in accordance with an opportunity given under sub-paragraph (11).

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