The National Health Service (General Medical Services Contracts) (Wales) (Amendment) Regulations 2026

Made: 29 January 2026

Coming into force: 2 March 2026

The Welsh Ministers make the following Regulations in exercise of the powers conferred on them by sections 7(8), 41(5) and (6), 43, 44, 47 and 203(9) and (10) of the National Health Service (Wales) Act 2006[^f00003].

Title and coming into force

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• (1) The title of these Regulations is the National Health Service (General Medical Services Contracts) (Wales) (Amendment) Regulations 2026.

• (2) These Regulations come into force on 2 March 2026.

Application

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These Regulations apply in relation to Wales.

Interpretation

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In these Regulations the “2023 Regulations” means the National Health Service (General Medical Services Contracts) (Wales) Regulations 2023[^f00004].

Amendment to the 2023 Regulations

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• (1) The 2023 Regulations are amended as follows.

• (2) In the following places, for “general medical services contract” substitute “GMS Contract”—

• (a) in regulation 3(1) (interpretation), in the definition of “contract”, and

• (b) in regulation 3(1), in the definition of “scheduled drug”.

• (3) In regulation 3(1), in the definition of “general medical practitioner”, for “under section 2 of the Medical Act 1983 (registration of medical practitioners)” substitute “under section 34C of the Medical Act 1983[^f00005] (the General Practitioner Register)”.

• (4) In regulation 3(1), in the definition of “the Health and Care Professions Council Register”, for “(registration)” substitute “(establishment and maintenance of register);”.

• (5) In regulation 3(1), omit the definition of “registered paramedic”.

• (6) In regulation 3(1), in the definition of “supplementary prescriber”, after sub-paragraph (d) insert—

and who is employed or engaged by the contractor, or the contractor has retained their services for the purposes of prescribing;

• (7) In regulation 3(1), in the definition of “unified services”, for “means the services required to be provided in accordance with regulation 17” substitute “means the services required to be provided in accordance with regulations 17 and 18(2)”.

• (8) In regulation 3(1), in the Welsh language text, in the definition of “person awdurdodedig”, for “62(a) i (c)” substitute “62(a) i (d)”.

• (9) In regulation 3(1), in the appropriate place, in alphabetical order, insert—

• “learning disability” (“anabledd dysgu”) means a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with a reduced ability to cope independently (impaired social functioning), which started before adulthood;

• “learning disability services” (“gwasanaethau anableddau dysgu”) means the service described in paragraph 7A of Schedule 2;

• “paramedic” (“parafeddyg”) means a person registered in Part 8 of the Health and Care Professions Council register;

• “significant cognitive impairment” (“amhariad gwybyddol sylweddol”) means a person is subject to a significant cognitive impairment if they have a severe and permanent mental condition or neurological change that impacts on the brain’s ability to function and has a significant impact on that individual’s daily life;

• (10) In regulation 17(1) (unified services), for “period” substitute “periods”.

• (11) In regulation 17(2)—

• (a) for “period” substitute “periods”, and

• (b) in the English language text, after the word “paragraph”, for “is” substitute “are”.

• (12) In regulation 17(6)—

• (a) in sub-paragraph (e), for “maternity medical services” substitute “learning disability services”,

• (b) in sub-paragraph (f), for “minor surgery services, and” substitute “maternity medical services,”,

• (c) in sub paragraph (g), for “vaccine and immunisation services.” substitute “minor surgery services, and”, and

• (d) at the end insert—

(h) vaccination and immunisation services.

• (13) In regulation 22(e) (circumstances in which fees and charges may be made), after “under regulation 21(6)” insert “)”.

• (14) After regulation 22(i) insert—

(j) for prescribing or providing drugs or medicines for malaria chemoprophylaxis.

• (15) In Schedule 1, in the table, in the first column, for “severely mentally impaired person” substitute “person with a significant cognitive impairment”.

• (16) In Schedule 1 (list of prescribed medical certificates), in the table, in the second column—

• (a) for “Reserve Forces (Safeguard of Employment) Act 1985 (c. 22)” substitute “Reserve Forces (Safeguard of Employment) Act 1985 (c. 17)”;

• (b) for “Local Government Finance Act 1992 (c. 28)” substitute “Local Government Finance Act 1992 (c. 14)”.

• (17) In Schedule 2 (further details about specific Unified Services)—

• (a) for the heading “Cervical screening” substitute “Cervical screening services”;

• (b) for the heading “Child health surveillance” substitute “Child health surveillance services”, and

• (c) for the heading “Childhood vaccinations and immunisations” substitute “Childhood vaccinations and immunisations services”.

• (18) In Schedule 2, after paragraph 7, insert the following—

(7A) A contractor must— (a) develop and maintain a register of those individuals aged 18 and over, with learning disabilities, (b) demonstrate a systematic recall system for all patients on the register, (c) provide an offer of an annual health check to include the minimum requirements set out in the Contract Implementation Guidance for Providers of General Medical Services at Annex B[^f00006], which is updated from time to time, (d) integrate the health check as part of the patient’s personal health record, (e) engage with carers and support workers, and with the consent of the patient where possible, a carer or support worker should be fully informed of the patient’s health care needs and supported as necessary, (f) liaise with relevant local support services such as with community and learning disability health professionals, social services and educational support services, and (g) where appropriate, inform patients and their carers of local and national voluntary support groups for vital information and support.

• (19) In Schedule 3 (other contractual terms), paragraph 2, in the English language text—

• (a) omit “staffed”, and

• (b) in sub-paragraph (a), before “for the duration of core hours” insert “staffed”.

• (20) In Schedule 3, paragraph 18(a), omit “Integrated Medium Term”.

• (21) In Schedule 3, paragraph 19(e), for “GP Collaborative Integrated Medium-Term” substitute “Cluster”.

• (22) In Schedule 3, paragraph 27(1), for “(or, in the case of a child or an adult who lacks capacity, the person who made the application on the applicant’s behalf)” substitute “or a person making an application on behalf of that person”.

• (23) In Schedule 3, after paragraph 52(1) insert—

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

• (24) In Schedule 3, for paragraph 70 substitute “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.”

• (25) In Schedule 3, paragraph 76(7), after “clinical matters” insert “and non-clinical matters directly related to a patient.”

• (26) In Schedule 3, paragraph 76(8), for “subject to any notice served under sub-paragraph (1)(b)” substitute “subject to any notice served under sub-paragraph (5)”.

• (27) In Schedule 3, paragraph 78(3)(b), in the English language text, before “have been enabled” insert “and”.

• (28) In Schedule 3, paragraph 78(3)(c), for “the contractor 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 (Version 4)” published on 21 March 2011” substitute “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.”

• (29) In Schedule 3, paragraph 78, for sub-paragraph (5) substitute—

(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.

• (30) In Schedule 3, paragraph 78(10), omit “(5),”.

• (31) In Schedule 3, paragraph 78(13), after “computer” insert “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[^f00007]”.

• (32) In Schedule 3, paragraph 87, in the table, under AF007 insert “DEM002”, and in the corresponding column insert “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.”

• (33) In Schedule 3, for paragraph 88 including the heading substitute—

(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.

• (34) In Schedule 3, in the heading of paragraph 93, after “and” insert “formal”.

• (35) In Schedule 3, paragraph 93(4), after “must” insert “consider the performance of the contractor in relation to the contract and”

• (36) In Schedule 3, paragraph 93, after sub-paragraph (4) insert—

(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.

• (37) In Schedule 3, paragraph 93(5), before “review” insert “formal”.

• (38) In Schedule 3, after paragraph 93(7) insert—

(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.

• (39) In Schedule 3, after paragraph 93 insert—

(93A) (1) The Local Health Board must undertake a face-to-face review with each contractor at least every three years to discuss the performance of the contractor in relation to the contract. (2) 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 formal review. (3) The Local Health Board must prepare a draft record of the review referred to in sub-paragraph (1) for comment by the contractor and, having regard to such comments, produce a final written record of the review. (4) The Local Health Board must send a copy of the final record of the review referred to in sub-paragraph (1) to the contractor. (5) The review in sub-paragraph (1) is in addition to any formal review under paragraph 93.

• (40) In Schedule 3, paragraph 117(6)(b), for “Fitness to Practise Panel” substitute “Medical Practitioners Tribunal”.

• (41) In Schedule 3, for paragraph 119(3)(v) substitute—

(v) the contractor has refused to comply with a request by the Local Health Board for the contractor to be medically examined because the Local Health Board is concerned that the contractor is incapable of adequately providing services under the contract; and, where the contract is with— (i) a partnership, and any partner has refused to comply with such a request, or (ii) a company limited by shares, and any person legally or beneficially owning a share in the company or any director or secretary of the company has refused to comply with such a request, and the Local Health Board is not satisfied that the contractor is taking adequate steps to deal with the matter.

• (42) In Schedule 3, after paragraph 130(2) insert—

(2A) For the purposes of sub-paragraph (3), any reference to “the contractor” is to be read as including— (a) in the case of a contract with a partnership, any partner in the partnership, and (b) in the case of a contract with a company limited by shares, any person legally or beneficially owning a share in the company and any director or secretary of the company.

• (43) In Schedule 3, paragraph 130(3), for “may be” substitute “is”.

• (44) In Schedule 3, paragraph 132(2)(c), in the English language text, for “company limited with shares” substitute “company limited by shares”.

• (45) In Schedule 3, after paragraph 136 insert—

(137) The contractor must, if a patient has tested positive for Covid-19, clinically assess the patient inclusive of Covid-19 antiviral treatment. If clinically appropriate the contractor must prescribe and, if relevant, dispense Paxlovid to the patient. (138) (1) The contractor must undertake a frailty assessment as part of chronic disease annual review, on appropriate patients, utilising the Rockwood assessment tool. (2) The contractor may also assess patient frailty during other interactions during the year. (3) The contractor must update the patient’s medical record with appropriate coding once a diagnosis has been confirmed. (139) The contractor must record the ethnicity of all patients, including new patients, in the patient’s medical record, using the ethnic group categories in the national minimum dataset questionnaire. (140) The contractor must support patients requiring assistance with the Welsh Identity Verification Service process to enable patients to access the NHS Wales App.

Signed

Jeremy Miles — Cabinet Secretary for Health and Social Care, one of the Welsh Ministers — 29 January 2026

Explanatory note

(This note is not part of the Regulations)

EXPLANATORY NOTE

These Regulations amend the National Health Service (General Medical Services Contracts) (Wales) Regulations 2023[^f00001] (“the 2023 Regulations”). Those regulations set out, for Wales, the framework for general medical services contracts under section 42 of the National Health Service (Wales) Act 2006[^f00002].

These Regulations make amendments to the 2023 Regulations to correct errors of a technical nature and insert new definitions.

The Welsh Ministers’ Code of Practice on the carrying out of Regulatory Impact Assessments was considered in relation to these Regulations. As a result, a regulatory impact assessment has been prepared as to the likely costs and benefits of complying with these Regulations. A copy can be obtained by contacting the Health and Social Services Group, Welsh Government, Cathays Park, Cardiff CF10 3NQ.

Footnotes

[^f00001]: S.I. 2023/953 (W. 155).

[^f00002]: 2006 c. 42.

[^f00003]: 2006 c. 42.

[^f00004]: S.I. 2023/953 as amended by S.I. 2023/1421.

[^f00005]: Section 2 was amended by S.I. 2002/3135, S.I. 2006/1914, S.I. 2007/3101, S.I. 2008/1774 and S.I. 2014/1101.

[^f00006]: Which can be found at https://www.gov.wales/contract-implementation-guidance-providers-general-medical-services-gms-0

[^f00007]: Section 3(f) and (g) of the Access to Health Records Act 1990 sets out the right to access health records where a patient has died.