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2004 No. 2694

NATIONAL HEALTH SERVICE, ENGLAND

The National Health Service (Primary Medical Services) (Miscellaneous Amendments) Regulations 2004

  Made 18th October 2004 
  Laid before Parliament 25th October 2004 
  Coming into force 15th November 2004 

The Secretary of State for Health, in exercise of the powers conferred on him by sections 28D, 28E, 28S, 28V, 28W, 28X and 126(4) of the National Health Service Act 1977[1] and section 4(5) of the National Health Service and Community Care Act 1990[2] and all other powers enabling him in that behalf, hereby makes the following Regulations:



PART 1

GENERAL

Citation, commencement, interpretation and application
     1.  - (1) These Regulations may be cited as the National Health Service (Primary Medical Services) (Miscellaneous Amendments) Regulations 2004 and shall come into force on 15th November 2004.

    (2) These Regulations apply in relation to England only.

    (3) In these Regulations - 



PART 2

AMENDMENT OF THE GMS CONTRACTS REGULATIONS

Amendment of regulation 2 of the GMS Contracts Regulations
     2.  - (1) Regulation 2(1) (interpretation) of the GMS Contracts Regulations shall be amended as provided in the following paragraphs.

    (2) In the definition of "general medical practitioner" - 

    (3) For the definition of "GP Registrar", substitute - 

    (4) Omit the definition of "GP Trainer".

    (5) In the definition of "out of hours services", in paragraph (a), after "if provided" insert "by a contractor to its registered patients".

Amendment of regulation 4 of the GMS Contracts Regulations
     3. In regulation 4 (conditions relating solely to medical practitioners) of the GMS Contracts Regulations, add - 

Amendment of paragraph 4 of Schedule 2 to the GMS Contracts Regulations
     4. In paragraph 4 (vaccinations and immunisations) of Schedule 2 to the GMS Contracts Regulations, in paragraph (2)(a), for "influenza vaccination" substitute "influenza and pneumococcal vaccinations".

Amendment of Schedule 6 to the GMS Contracts Regulations
    
5.  - (1) Schedule 6 (other contractual terms) to the GMS Contracts Regulations shall be amended as provided in the following paragraphs.

    (2) In paragraph 7 (clinical reports), at end insert - 

    (3) In paragraph 11 (standards for out of hours services) - 

    (4) In paragraph 31 (rejection of closure notice by the Primary Care Trust), after sub-paragraph (8) insert - 

    (5) In paragraph 43 (restrictions on prescribing by supplementary prescribers), in sub-paragraph (6), after "Secretary of" insert "State".

    (6) In paragraph 48 (consent to dispense), in sub-paragraph (6)(a), for "paragraph (2)" substitute "paragraph (1)(c)".

    (7) In paragraph 50 (terms relating to the provision of dispensing services), in sub-paragraph (8) - 

    (8) In paragraph 53 (qualifications of performers), in sub-paragraph (2) - 

    (9) In paragraph 64 (arrangements for GP Registrars), in sub-paragraph (1), omit "for the purpose of being trained by a GP Trainer with the agreement of the Secretary of State and".

    (10) In paragraph 68 (appraisal and assessment), in sub-paragraph (1)(a), before "appraisal system", in the second place where it occurs, insert "appropriate"[15].

    (11) In paragraph 72 (withdrawal and variation of approval under paragraph 70), for sub-paragraph (2) substitute - 

    (12) In paragraph 77 (provision of information), at end insert - 

    (13) In paragraph 81 (annual return and review) - 

    (14) In paragraph 98 (provision of information about complaints) - 

    (15) In paragraph 101 (NHS dispute resolution procedure), in sub-paragraph (6), after "the matter" insert "under dispute".

    (16) In paragraph 122 (insurance), in sub-paragraph (3)(b) for "an employee of its in connection with clinical services which that employee" substitute "a person employed or engaged by it in connection with clinical services which that person".



PART 3

AMENDMENT OF THE PMS AGREEMENTS REGULATIONS

Amendment of regulation 2 of the PMS Agreements Regulations
     6.  - (1) Regulation 2 (interpretation) of the PMS Agreements Regulations shall be amended as provided in the following paragraphs.

    (2) For the definition of "GP Registrar", substitute - 

    (3) Omit the definition of "GP Trainer".

    (4) In the definition of "out of hours services", after "if provided" insert "by a contractor to its registered patients".

Amendment of regulation 3 of the PMS Agreements Regulations
     7. In regulation 3 (conditions: introductory) of the PMS Agreements Regulations, for "regulations 4 and" substitute "regulation".

Revocation of regulation 4 of the PMS Agreements Regulations
    
8. Regulation 4 of the PMS Agreements Regulations is revoked.

Amendment of regulation 5 of the PMS Agreements Regulations
    
9. In regulation 5 (general condition relating to all agreements) of the PMS Agreements Regulations, in paragraph (3) - 

Amendment of regulation 6 of the PMS Agreements Regulations
    
10. In regulation 6 (reasons) of the PMS Agreements Regulations, in paragraph (1), omit "4 or".

Amendment of regulation 7 of the PMS Agreements Regulations
    
11. In regulation 7 (appeal) of the PMS Agreements Regulations, omit "4 or".

Amendment of regulation 9 of the PMS Agreements Regulations
    
12. In regulation 9 (health service body status) of the PMS Agreements Regulations, in paragraph (5), for "(7)" substitute "(8)".

Amendment of regulation 15 of the PMS Agreements Regulations
    
13. In regulation 15 (fees and charges) of the PMS Agreements Regulations, in paragraph (2)(b), after "drug" insert ", medicine".

Amendment of paragraph 2 of Schedule 4 to the PMS Agreements Regulations
    
14. In paragraph 2 of Schedule 4 to the PMS Agreements Regulations (opt outs of out of hours services where the opt out notice is served before 1st October 2004), in sub-paragraph (17), before "1st October 2004" insert "before".

Amendment of Schedule 5 to the PMS Agreements Regulations
    
15.  - (1) Schedule 5 (other contractual terms) to the PMS Agreements Regulations shall be amended as provided in the following paragraphs.

    (2) In paragraph 5 (clinical reports), in sub-paragraph (4), after "standards" insert "or requirements".

    (3) In paragraph 9 (standards for out of hours services) - 

    (4) in sub-paragraph (2) - 

    (5) In paragraph 30 (rejection of closure notice) after sub-paragraph (8) insert - 

    (6) In paragraph 38 (prescribing), in sub-paragraph (1), for "39 and 40" substitute "41 and 42".

    (7) In paragraph 47 (consent to dispense), in sub-paragraph (6)(a), for "paragraph (2)" substitute "paragraph (1)(c)".

    (8) In paragraph 50 (terms relating to the provision of dispensing services), in sub-paragraph (8) - 

    (9) In paragraph 53 (qualifications of performers), in sub-paragraph (2) - 

    (10) In paragraph 63 (arrangements for GP Registrars), in sub-paragraph (1), omit "for the purpose of being trained by a GP Trainer".

    (11) In paragraph 73 (provision of information), at end insert - 

    (12) In paragraph 77 (annual return and review) - 

    (13) In paragraph 80 (notice provisions specific to an agreement with a qualifying body), in sub-paragraph (2)(b), for "regulations 4 and" substitute "regulation".

    (14) In paragraph 86 (complaints procedure), in sub-paragraph (2)(a)(i), after "paragraphs 87 to 90" insert "and 92".

    (15) In paragraph 92 (provision of information about complaints) - 

    (16) In paragraph 95 (NHS dispute resolution procedure), in sub-paragraph (6), after "the matter" insert "under dispute".

    (17) In paragraph 98 (variation of an agreement: general), in sub-paragraph (1), for "70(3)" substitute "69(3)".

    (18) Omit paragraph 103 (termination by the relevant body for breach of conditions in regulation 4).

    (19) In paragraph 104 (termination by the relevant body for the provision of untrue etc information), for "regulations 4 and" substitute "regulation".

    (20) In paragraph 113 (insurance), in sub-paragraph (3)(b) for "an employee of its in connection with clinical services which that employee" substitute "a person employed or engaged by it in connection with clinical services which that person".



PART 4

AMENDMENT OF THE PERFORMERS LISTS REGULATIONS

Amendment of regulation 10 of the Performers Lists Regulations
     16. In regulation 10 of the Performers Lists Regulations (removal from performers list), in paragraph (14), for "paragraph (6)" substitute "paragraph (3) or (6)".

Amendment of regulation 21 of the Performers Lists Regulations
    
17. In regulation 21 of the Performers Lists Regulations (interpretation), for the definition of "GP Registrar", substitute - 



PART 5

AMENDMENT OF THE GENERAL MEDICAL SERVICES AND PERSONAL MEDICAL SERVICES TRANSITIONAL AND CONSEQUENTIAL PROVISIONS ORDER 2004

Revocation of article 34 of the General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004
    
18. Article 34 of the General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004[20] (arrangements for GP Registrars) is revoked.



PART 6

TRANSITIONAL PROVISION

Transitional provision relating to regulation 4 of the GMS Contracts Regulations
     19.  - (1) This regulation applies where, in relation to a general medical services contract entered into before 15th November 2004, the only person who counted as the general medical practitioner for the purposes of regulation 4(1), (2)(a) or (3)(a) of the GMS Contracts Regulations falls within regulation 4(4) of those Regulations as inserted by regulation 3 of these Regulations.

    (2) A Primary Care Trust shall not terminate a general medical services contract under paragraph 111 of Schedule 6 to the GMS Contracts Regulations on the grounds that the person referred to in paragraph (1) no longer falls within the definition of general medical practitioner for the purposes of regulation 4(1), (2)(a) or (3)(a) of the GMS Contracts Regulations as amended by these Regulations.



Signed on behalf of the Secretary of State


John Hutton
Minister of State, Department of Health

18th October 2004



EXPLANATORY NOTE

(This note is not part of the Regulations)


These Regulations make amendments to certain regulations relating to primary medical services.

Part 2 amends the National Health Service (General Medical Services Contracts) Regulations 2004 (the GMS Contracts Regulations). In particular - 

Part 3 of the Regulations makes amendments to the National Health Service (Personal Medical Services Agreements) Regulations 2004 which mainly mirror those made to the GMS Contracts Regulations or make other minor drafting amendments. In addition, regulation 8 revokes regulation 4 of the PMS Agreements Regulations to remove conditions which had been imposed solely in relation to medical practitioners. The effect of the revocation is to leave such practitioners subject to the same conditions as apply under regulation 5 of those Regulations to all persons eligible to enter into PMS Agreements.

Part 4 of the Regulations makes two amendments to the National Health Service (Performers Lists) Regulations 2004. Regulation 16 amends regulation 10 of those Regulations so that when a performer is removed from a performers list on any of the discretionary grounds, the removal does not take immediate effect. Regulation 17 amends the definition of GP Registrar in those Regulations to bring it into line with that included in the GMS Contracts and PMS Agreements Regulations (as amended by these Regulations).

Part 5 of the Regulations revokes a provision in the General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004 which is no longer required in the light of the amendment to paragraph 64 of Schedule 6 to the GMS Contracts Regulations made by regulation 5(9).

Part 6 of the Regulations makes transitional provision in relation to the removal by regulation 3 of the right of certain persons to be the mandatory general medical practitioner for the purposes of a general medical services contract. It provides that where such a person has been the mandatory medical practitioner for the purposes of a general medical services contract entered into before the date of coming into force of these Regulations, the contract will not be able to be terminated for breach of the amended requirements.


Notes:

[1] 1977 c. 49; section 28D was inserted by section 21(1) of the National Health Service (Primary Care) Act 1997 (c. 46) ("the 1997 Act") and was amended by the Health Act 1999 (c. 8) ("the 1999 Act"), section 65(1), Schedule 4, paragraphs 4 and 16a and by the National Health Service Reform and Health Care Professions Act 2002 (c. 17) ("the 2002 Act"), section 4(3), Schedule 3, paragraph 7(3) and the Health and Social Care (Community Health and Standards) Act 2003 ("the 2003 Act"), section 177(1) to (6) and section 184 and Schedule 11, paragraph 15; section 28E was inserted by section 22(1) of the 1997 Act and was amended by the 1999 Act, section 65(2) and Schedule 5; the Health and Social Care Act 2001 (c. 15) ("the 2001 Act") section 27(5)(a); the 2002 Act, section 4(3), Schedule 3, paragraph 8 and the 2003 Act, section 177(7) to (11); sections 28S, 28V and 28W were inserted by section 175(1) of the 2003 Act; section 28X was inserted by section 179(1) of the 2003 Act; section 126(4) was amended by the National Health Service and Community Care Act 1990 (c. 19), section 65(2), the 1999 Act , Schedule 4, paragraph 37(6) and the 2001 Act, Schedule 5, paragraph 5(13)(b).back

[2] 1990 c. 19.back

[3] S.I. 2004/291, as amended by S.I. 2004/906.back

[4] S.I. 2004/627, as amended by S.I. 2004/906.back

[5] S.I. 2004/585.back

[6] S.I. 1994/3130; regulation 5 was amended by S.I. 1997/2817 and modified by article 117 of S.I. 2004/865. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Schedule 10, Part 2.back

[7] S.I. 1997/2817 as amended by S.I. 1998/669 and modified by article 118 of S.I. 2004/865.back

[8] S.I. 1994/3130 as amended by S.I. 1997/2817 and 2003/3148. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back

[9] S.I. 1997/2817 as amended by S.I. 1998/669 and 2003/3148 and modified by S.I. 2004/865, article 118. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back

[10] S.I. 1998/5 as amended by S.I. 1998/669 and S.S.I. 2000/23 and modified by S.S.1. 2004/163, article 101. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back

[11] S.R. 1998/13 as modified by S.R. 2004/156, Article 93. The whole Regulations are prospectively revoked by S.I. 2003/1250, article 31(5) and Part 2 of Schedule 10.back

[12] The definition of "restricted services principal was substituted, for England, by S.I. 2004/865 and, for Scotland, by S.I. 2004/2261.back

[13] The document "National Quality Requirements in the Delivery of Out of Hours Services" published on 14th October 2004 is published electronically at www.out-of-hours.info or a copy may be obtained by writing to Primary Care, Room 4N34E, Department of Health, Quarry House, Quarry Hill, Leeds LS2 7UE.back

[14] S.I. 2004/585.back

[15] By correction slip issued by Her Majesty's Stationery Office in April 2004 (ISBN 0-11-048656-0) the words "in an" were inserted after "he participates" in paragraph 68(1)(a).back

[16] S.I. 2004/865.back

[17] S.I. 1997/2817 as amended by S.I. 1998/669 and modified by article 118 of S.I. 2004/865.back

[18] This document is published by the Department of Health on its website at www.dh.gov.uk/PublicationsAndStatistics//Publications/PublicationsPolicyAndGuidance or a copy may be obtained by writing to Primary Care, Room 4N34E, Department of Health, Quarry House, Quarry Hill, Leeds LS2 7UE.back

[19] The document "National Quality Requirements in the Delivery of Out of Hours Services" published on 14th October 2004 is published electronically at www.out-of-hours.info or a copy may be obtained by writing to Primary Care, Room 4N34E, Department of Health, Quarry House, Quarry Hill, Leeds LS2 7UE.back

[20] S.I. 2004/865.back



ISBN 0 11 049968 9


  © Crown copyright 2004

Prepared 25 October 2004


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