13.—(1) For regulation 20 of the principal Regulations (arrangements for provision of pharmaceutical services by doctors) substitute the following regulation—
20.—(1) Where a patient—
(a)satisfies a Local Health Board that he or she would have serious difficulty in obtaining any necessary drugs or appliances from a pharmacy by reason of distance or inadequacy of means of communication; or
(b)is resident in a controlled locality, at a distance of more than 1.6 kilometres from any pharmacy, and one of the conditions specified in paragraph (3) is satisfied in the patient’s case;
(c)is resident in a controlled locality and any pharmacy within a distance of 1.6 kilometres from where the patient lives has been determined to be in a reserved location, and that determination has not been altered on appeal or by way of a further determination, and one of the conditions specified in paragraph (3) is satisfied in the patient’s case; or
(d)is one to whom sub-paragraph (a) or (b) applies and at the time of the request the patient is living as a member of the household, other than as a temporary resident, of another person in respect of whom a doctor has residual premises approval, and for this purpose “residual premises approval” has the same meaning as in regulation 21E(9) and a person is a “temporary resident” if he or she intends to stay in the household for more than 24 hours but not longer than three months,
that patient may at any time request in writing a doctor who falls within paragraph (2) to provide him or her with pharmaceutical services.
(2) A doctor falls within this paragraph if he or she is—
(a)the GMS contractor or the APMS contractor;
(b)engaged or employed by the GMS contractor or the APMS contractor; or
(c)engaged by a Local Health Board for the purposes of providing primary medical services within an LHBMS practice,
on whose list the patient making the request is included.
(3) The conditions referred to in paragraph (1)(b) and (c) are—
(a)that—
(i)there is in effect an outline consent granted to—
(aa)that doctor;
(bb)another doctor who is a party to the GMS contract or the APMS contract concerned;
(cc)another doctor who is engaged or employed by the GMS contractor or the APMS contractor concerned; or
(dd)another doctor who is providing medical services within the same LHBMS practice,
(ii)there is in effect premises approval in relation to the premise from which the doctor will dispense to that patient, and
(iii)any conditions imposed under regulation 10(10)(b), 11ZA(6)(b), 12(17) or 13(15)(b) in connection with that grant are such as to permit arrangements to be made under this regulation for the provision of pharmaceutical services by that doctor to the patient; or
(b)that—
(i)immediately before the coming into force of these Regulations, arrangements or requirements were in effect for —
(aa)that doctor;
(bb)another doctor who is party to the GMS contract concerned;
(cc)another doctor who was a party to the GMS contract, or who was engaged or employed by the GMS contractor concerned; or
(dd)any previous doctor who was a party to the GMS contract concerned, or who was engaged or employed by the GMS contractor concerned,
to provide drugs or appliances to patients,
(ii)the patient—
(aa)has not previously been included in a
patient list;
(bb)has changed his or her address from that last notified to the Local Health Board, or
(cc)has not changed his or her address but, immediately before his or her acceptance as a patient by that doctor, was being provided with pharmaceutical services by a doctor pursuant to an arrangement or requirement under these Regulations, and
(iii)there is in effect premises approval in relation to the premises from which the doctor will dispense to that patient.
(4) If a doctor so requested by a patient under paragraph (1)—
(a)applies to provide pharmaceutical services to the patient, and sends with his or her application the patient’s request in writing, the Local Health Board will make arrangements with the doctor for the provision at listed premises in the case of a patient falling within paragraph (1)(b) or (c) or practice premises in the case of a patient falling within paragraph (1)(a) of such services by him or her; or
(b)does not so apply within 30 days, the Local Health Board may, subject to paragraph (6), require the doctor to undertake such provision at listed premises in the case of a patient falling within paragraph (1)(b) or
(c)or practice premises in the case of a patient falling within paragraph (1)(a) and must give the doctor notice to that effect.
(5) Subject to regulation 21E, an arrangement made by a Local Health Board under paragraph (4)(a) will—
(a)have effect from the date of the patient’s request in writing; and
(b)enable—
(i)that doctor,
(ii)any other doctor who is party to the same GMS contract or APMS contract as that doctor,
(iii)any other doctor who is employed or engaged by the same GMS or APMS contractor, or
(iv)any doctor who provides primary medical services within the same LHBMS practice, to provide pharmaceutical services at listed premises for the patient so long as the arrangement remains in effect.
(6) A Local Health Board will not under paragraph (4)(b) require a doctor to provide pharmaceutical services at listed premises or practice premises to a person on the relevant patient list for that doctor if that doctor satisfies the Local Health Board, or on appeal, the Welsh Ministers that—
(a)he or she does not normally provide pharmaceutical services under this regulation; or
(b)in the case of a person to whom paragraph (1)(b), (c) or (d) applies, the person would not have serious difficulty, by reason of distance or inadequacy of means of communication, in obtaining drugs and appliances from a pharmacy.
(7) A Local Health Board must give a doctor reasonable notice—
(a)that it requires him or her to provide pharmaceutical services to any person; or
(b)subject to paragraph (8), that where a person no longer satisfies the provisions of paragraph (1), the doctor must discontinue the provision of pharmaceutical services to that person.
(8) A notice under paragraph (7)(b)—
(a)is subject to any postponement or termination of arrangements for the provision of pharmaceutical services to that person by that doctor made under regulation (10)(10)(b), 11ZA(6)(b), 12(17) or 13(15); and
(b)must not be given—
(i)pending any appeal against a decision by the Local Health Board to postpone the making or termination of such arrangements, or
(ii)where regulation 9(10) so requires.
(9) Notwithstanding paragraph (4), where a drug or appliance is one for which a doctor is entitled to an additional payment if he or she provides it, the doctor may, with the consent of the patient, instead of providing it himself or herself, order it by issuing a prescription to the patient in accordance with paragraph 39 of Schedule 6 to the GMS Regulations (or equivalent provision applying in relation to an APMS contractor or an LHBMS practice).
(10) Where an arrangement or requirement for a doctor to provide drugs or appliances to a patient was in effect immediately before 1 April 1992, that arrangement will have effect as though made under this regulation notwithstanding that neither of the conditions specified in paragraph (3) is satisfied.
(11) A doctor who provides pharmaceutical services to some or all of the patients on the relevant patients list in accordance with this regulation may provide any necessary pharmaceutical services to a person whom the relevant GMS or APMS contractor or LHBMS practice has accepted as a temporary resident under paragraph 16 of Schedule 6 to the GMS Regulations or any equivalent provision applying to APMS contractor or LHBMS practices.
(12) An appeal under paragraph (6) must be made in writing within 30 days beginning on the date on which notice of the decision was sent to the doctor and must contain a concise statement of the grounds of appeal.
(13) The Welsh Ministers will, on receipt of any notice of appeal under this regulation, send a copy of that notice to the Local Health Board and the relevant GMS contractor or APMS contractor, and the Local Health Board and relevant GMS contractor or APMS contractor may, within 30 days from the date on which the Welsh Ministers sent a copy of the notice of appeal, make representations in writing to the Welsh Ministers.
(14) The Welsh Ministers may determine an appeal pursuant to paragraph (6) in such manner as they think fit.
(15) The Welsh Ministers will, upon determination by them of any appeal under this regulation, give notice of their decision in writing, together with the reasons for it, to the appellant, to the Local Health Board, and to the relevant GMS contractor or APMS contractor.”.