The General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004

Determination of a Primary Care Trust made on or after the relevant date (regulation 8 of the Service Committees Regulations)

98.—(1) Where, on or after the relevant date, an appropriate Primary Care Trust is determining what (if any) action to take pursuant to regulation 8 in accordance with provision made in this Part, it shall make such a determination in accordance with such limitations and modifications to that regulation as are specified in this article.

(2) The appropriate Primary Care Trust may—

(a) pursuant to regulation 8(1)(c)(i), determine that no further action should be taken;

(b) pursuant to regulation 8(3), determine after consultation with the Local Medical Committee that it would have considered it appropriate to impose a special limit on the number of persons for whom a doctor may undertake to provide treatment;

(c) pursuant to regulation 8(5)(a), determine that an amount shall be recovered from the doctor; or

(d) pursuant to regulation 8(6), determine that it would have warned the doctor to comply more closely with his terms of service in future, if those terms of service were still applicable,

and if it makes any one or more of the decisions specified in sub-paragraphs (b) to (d), it shall, after the period specified in regulation 8(11)(a) or (b) (as applicable) has expired, notify in writing the contracting PCT and the Performers List PCT (if any) of its decision and the reasons for it, if either one is a different Primary Care Trust to the appropriate Primary Care Trust.

(3) Where, pursuant to paragraph (2)(b), the appropriate Primary Care Trust determines that an amount should be recovered from the doctor, regulation 8(8) shall not apply and that amount shall be recoverable by the appropriate Primary Care Trust and it shall be treated as a debt owed by that doctor to that appropriate Primary Care Trust.

(4) Where the appropriate Primary Care Trust has notified the contracting PCT that it has made any of the determinations specified in paragraph (2)(b) to (d), or where the appropriate Primary Care Trust is the contracting PCT, paragraph (5) shall apply without prejudice to any other rights the contracting PCT may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(5) Where this paragraph applies, the contracting PCT—

(a) may, in relation to a relevant contractor, take into account the determination of the appropriate Primary Care Trust if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 115(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract; but

(b) shall not, pursuant to sub-paragraph (a), take into account any determination of an appropriate Primary Care Trust that was made more than 6 years prior to the date upon which the contracting PCT is considering terminating the general medical services contract or the default contract (as the case may be).

(6) Where—

(a) a Performers List PCT has received notification from an appropriate Primary Care Trust pursuant to paragraph (2); or

(b) where an appropriate Primary Care Trust that has taken a decision pursuant to paragraph (2) is also the Performers List PCT,

it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.