The National Health Service (General Medical Services) (Scotland) Regulations 1995

Services to patients

11.—(1) Subject to paragraphs 3, 13 and 31 a doctor shall render to his patients all necessary and appropriate personal medical services of the type usually provided by general medical practitioners.

(2) The services which a doctor is required by sub-paragraph (1) to render shall include the following:—

(a) the administration of anaesthetics or the rendering of any other assistance at an operation performed by, and of the kind usually performed by, a general medical practitioner;

(b) where appropriate giving advice personally to patients, either individually or in groups, relating to their general health, and in particular on the significance of diet, exercise, the use of tobacco, the consumption of alcohol and the misuse of drugs and solvents;

(c) offering to patients consultations and, where appropriate, physical examinations for the purpose of identifying, or reducing the risk of, disease or injury;

(d) offering to patients, where appropriate, vaccination or immunisation against Measles, Mumps, Rubella, Pertussis, Poliomyelitis, Diphtheria and Tetanus;

(e) arranging for the referral of patients, as appropriate, for the provision of any other services provided under the Act;

(f) giving advice, as appropriate, to enable patients to avail themselves of social work services provided by a local authority.

(3) A doctor shall not be required under sub-paragraph (1) or (2) to provide to any person—

(a) services which involve the application of such special skill or experience of a degree or kind which general medical practitioners as a class cannot reasonably be expected to possess;

(b) the administration of an anaesthetic at an operation performed by a doctor in the course of providing maternity medical services;

(c) contraceptive services, child health surveillance services, minor surgery services nor, except in an emergency, maternity medical services, unless he has previously undertaken to provide such services to that person; or

(d) where he is a restricted services principal, any category of general medical services which he has not undertaken to provide.

(4) In the case of maternity medical services the expression “all necessary and appropriate personal medical services” includes the provision of all necessary medical services (other than services which involve the application of special skill or experience of a degree or kind which general medical practitioners as a class cannot reasonably be expected to possess) during and following pregnancy and labour in respect of all conditions arising therefrom and in particular the following services:—

(a) antenatal services, i.e. full antenatal care, supervision and examination, including full medical and obstetric examination of the patient as soon as possible after the doctor’s engagement to provide maternity medical services and such further examination as the condition of the patient requires;

(b) services during the confinement and lying-in period including—

(i) attendance at some stage of labour either before or at delivery, or at such early time thereafter as is reasonably possible in the light of clinical circumstances;

(ii) attendance within twelve hours of completion of labour or as soon thereafter as practicable and as often as the condition of the patient or her child requires throughout a lying-in period of 14 days;

(iii) attendance at any time when summoned by the midwife attending the case;

(c) post-puerperal services, i.e., medical and pelvic examination of the patient at or about six weeks after confinement.

(5) The doctor providing the maternity medical services shall, if he is not the doctor on whose list the name of the person is included—

(a) comply with any request by the doctor on whose list the name of the woman is included to examine or give other assistance to the woman and her child if and so far as the practitioner providing the services considers it necessary and appropriate that he should do so;

(b) issue, in accordance with the provisions of paragraph 13(7) to the woman or her personal representative certificates of pregnancy, expected confinement and confinement, being certificates reasonably required by her.

(6) The doctor providing the services shall also, subject always to paragraph 4(5) administer an anaesthetic or render other assistance, as required, in connection with any service or operation performed by another doctor otherwise than as part of the general medical services, if the administration of the anaesthetic or the rendering of such other assistance does not involve the application of special skill or experience of a degree or kind which general medical practitioners as a class cannot reasonably be expected to possess.

(7) Nothing in the foregoing shall affect the responsibility of the doctor on whose list the name of the woman receiving maternity medical services is included for the provision of treatment necessary for her general health.

(8) In the case of emergency, the doctor is required to render whatever services are, having regard to the circumstances, in the best interest of the patient.

(9) In determining whether a particular service involves the application of such special skill and experience as aforesaid, regard is to be had to the question whether services of the kind are or are not usually undertaken by general medical practitioners practising in the area in which the question arose.