2004 No. 291 NATIONAL HEALTH SERVICE, ENGLAND

1 STATUTORY INSTRUMENTS2004 No. 291 national health service , ENGLANDThe NATIONAL HEALTH Service (General Medical ServicesContracts) Regulations 2004 Made - - - - -8th February 2004 Laid before Parliament9th February 2004 Coming into force - -1st March 2004 ARRANGEMENT OF REGULATIONSPART 1 General1. Citation, commencement and application2. InterpretationPART 2 Contractors3. Conditions: general4. Conditions relating solely to medical practitioners5. General condition relating to all contracts6. Reasons7. Appeal8. Prescribed period under section 28D(1)(bc) of the ActPART 3 Pre-contract Dispute Resolution9. Pre-contract disputesPART 4 HEALTH Service Body Status10. HEALTH service body status1 PART 5 Contracts: Required Terms11. Parties to the contract12.

2 HEALTH service contract13. Contracts with individuals practising in partnership14. Duration15. Essential services16. Additional services17. Opt outs of additional and out of hours services18-20. services generally21. Certificates22-23. Finance24. Fees and charges25. Arrangements on termination26. Other contractual termsPART 6 Functions of Local Medical Committees27. Functions of Local Medical CommitteesPART 7 Transitional Provisions28. Commencement29. Additional services30-32. Out of hours servicesSCHEDULESS chedule 1 Repeat Dispensing FormsPart 1 Repeatable prescriptionPart 2 Batch issueSchedule 2 Additional services1. Additional services generally2. Cervical screening3. Contraceptive services4. Vaccinations and immunisations5. Childhood vaccinations and immunisations6.

3 Child HEALTH surveillance7. Maternity medical services8. Minor surgerySchedule 3 Opt outs of additional and out of hours services1. Opt outs of additional services : general2. Temporary opt outs and permanent opt outs following temporary optouts3. Permanent opt outs4. Out of hours opt outs where the opt out notice is served after30th September 200425. Out of hours opt outs where the opt out notice is served before1st October 20046. Informing patients of opt outsSchedule 4 List of prescribed medical certificatesSchedule 5 Fees and chargesSchedule 6 Other contractual termsPart 1 Provision of services1. Premises2. Attendance at practice premises3. Attendance outside practice premises4. Newly registered patients5. Patients not seen within three years6. Patients aged 75 years and over7.

4 Clinical reports8. Storage of vaccines9. Infection control10. Criteria for out of hours services11. Standards for out of hours services12-13. Duty of co-operation in relation to additional, enhanced and out ofhours servicesPart 2 Patients14. List of patients15. Application for inclusion in a list of patients16. Temporary residents17. Refusal of applications for inclusion in the list of patients or foracceptance as a temporary resident18. Patient preference of practitioner19. Removal from the list at the request of the patient20. Removal from the list at the request of the contractor21. Removals from the list of patients who are violent22. Removals from the list of patients registered elsewhere23-24. Removals from the list of patients who have moved25. Removals from the list of patients absent from the United Kingdom Removals from the list of patients accepted elsewhere as temporaryresidents27.

5 Removals from the list of pupils etc. of a school28. Termination of responsibility for patients not registered with thecontractor29. Closure of lists of patients30. Approval of closure notice by the Primary Care Trust31. Rejection of closure notice by the Primary Care Trust32. Assignment of patients to lists: open lists33. Assignment of patients to lists: closed lists34. Factors relevant to assignments35. Assignments to closed lists: determinations of the assessment panel36. Assignments to closed lists: NHS dispute resolution procedurerelating to determinations of the assessment panel37. Assignments to closed lists: assignments of patients by aPrimary Care Trust3 Part 3 Prescribing and dispensing38-39. Prescribing40. Repeatable prescribing services41. Repeatable prescriptions42.

6 Restrictions on prescribing by medical practitioners43. Restrictions on prescribing by supplementary prescribers44. Bulk prescribing45. Interpretation of paragraphs 38, 39 and 41-4446. Excessive prescribing47. Provision of dispensing services48. Consent to dispense49. Contractors who previously provided dispensing services underpilot schemes or section 28C arrangements50. Terms relating to the provision of dispensing services51. Dispensing contractor list52. Provision of drugs, medicines and appliances for immediatetreatment or personal administrationPart 4 Persons who perform services53-56. Qualifications of performers57-60. Conditions for employment and engagement61-62. Training63. Terms and conditions64. Arrangements for GP Registrars65. Independent nurse prescribers and supplementary prescribers66.

7 Signing of documents67. Level of skill68. Appraisal and assessment69. Sub-contracting of clinical matters70. Sub-contracting of out of hours services71-72. Withdrawal and variation of approval under paragraph 70 Part 5 Records, information, notifications and rights of entry73. Patient records74. Access to records for the purpose of the Quality Information PreparationScheme75. Confidentiality of personal data76. Practice leaflet77. Provision of information78. Requests for information from Patients Forums79. Inquiries about prescriptions and referrals80. Reports to a medical oYcer81. Annual return and review82-84. Notifications to the Primary Care Trust85. Notice provisions specific to a contract with a company limited by shares86. Notice provisions specific to a contract with two or more individualspractising in partnership487.

8 Notification of deaths88. Notifications to patients following variation of the contract89. Entry and inspection by the Primary Care Trust90. Entry and inspection by members of Patients Forums91. Entry and inspection by the Commission for Healthcare Audit andInspectionPart 6 Complaints92. Complaints procedure93-94. Making of complaints95. Period for making complaints96. Further requirements for complaints procedures97. Co-operation with investigations98. Provision of information about complaintsPart 7 Dispute resolution99. Local resolution of contract disputes100. Dispute resolution: non-NHS contracts101. NHS dispute resolution procedure102. Determination of dispute103. Interpretation of Part 7 Part 8 Variation and termination of contracts104. Variation of a contract: general105.

9 Variation provisions specific to a contract with an individualmedical practitioner106. Variation provisions specific to a contract with two or moreindividuals practising in partnership107. Termination by agreement108. Termination by the contractor109. Late payment notices110. Termination by the Primary Care Trust: general111. Termination by the Primary Care Trust for breach of conditions inregulation 4112. Termination by the Primary Care Trust for the provision of untrue Other grounds for termination by the Primary Care Trust115. Termination by the Primary Care Trust: remedial notices and breachnotices116. Termination by the Primary Care Trust: additional provisionsspecific to contracts with two or more individuals practising inpartnership and companies limited by shares117.

10 Contract sanctions118. Contract sanctions and the NHS dispute resolution procedure119. Termination and the NHS dispute resolution procedure120. Consultation with the Local Medical CommitteePart 9 Miscellaneous121. Clinical governance122-123. Insurance124. Gifts125. Compliance with legislation and guidance126. Third party rights5 Schedule 7 Out of hours services1. Temporary arrangements for transfer of obligations and liabilities inrelation to certain out of hours services2. Application for approval of an out of hours arrangement3. EVect of approval of an arrangement with a transferee doctor4. Review of approval5. Suspension of approval6. Immediate withdrawal of approval other than following review7. Suspension or termination of an out of hours arrangementSchedule 8 Closure noticeSchedule 9 Primary Care Trusts specified for the purposes ofrepeatable prescribingSchedule 10 Information to be included in practice leaflets6 The Secretary of State for HEALTH , in exercise of the powers conferred upon him by sections28D(1)(bc), 28R, 28S, 28V, 28W, 45A(9) and 126(4) of the NATIONAL HEALTH Service Act 1977(a),section 4(5) of the NATIONAL HEALTH Service and Community Care Act 1990(b) and of all otherpowers enabling him in that behalf, hereby makes the following Regulations:PART 1 GENERALC itation, commencement and application1.