Health and Personal Social Services (Northern Ireland) Order 1972

[F1 Prior authorisation for the purposes of Article 14D(5)(c) and (7) N.I.

14E.— (1) A person may apply to the Department under this Article for prior authorisation for the purposes of Article 14D(or (7) in relation to the provision of a service (“the requested service”) to an eligible person.

(2) The requested service must be—

(a) a service as respects which Condition A, mentioned in paragraph (5) of Article 14D, is satisfied and which falls within paragraph (6) of that Article; or

(b) a service that is neither the same as nor equivalent to a service that the Department would make available to the eligible person under this Order or the 2009 Act in the circumstances of the person’s case.

(3) The Department may determine—

(a) the form in which an application under this Article must be made; and

(b) the information to be provided in support of this application.

(4) The Department—

(a) must authorise the provision of the requested service if it is a service mentioned in paragraph (2)(a) (but see paragraph (5)); and

(b) may authorise the provision of the requested service in any case where—

(i) the requested service is necessary to treat or diagnose a medical condition of the eligible person; and

(ii) the duty in paragraph (a) does not apply.

(5) The duty in paragraph (4)(a) does not apply if at least one of the following conditions is met—

(a) the eligible person will, according to a clinical evaluation, be exposed with reasonable certainty to a patient-safety risk that cannot be regarded as acceptable, taking into account the potential benefit for the person of the requested service;

(b) the general public will be exposed with reasonable certainty to a substantial safety hazard as a result of the requested service;

(c) the requested service is to be provided by a health care provider that raises serious and specific concerns relating to the respect of standards and guidelines on quality of care and patient safety, including provisions on supervision, whether these standards and guidelines are laid down by laws or regulations or through accreditation systems established by the member State in which the service will be provided;

(d) the Department can provide to the eligible person a service that is the same as or equivalent to the requested service within a period of time that is medically justifiable, taking into account the patient’s state of health at the time the decision under paragraph (4)(a) is made and the probable course of the medical condition to which the service relates.

(6) The matters to which the Department is to have regard in determining for the purpose of paragraph (5)(d) whether the length of any delay is medically justifiable include—

(a) the eligible person’s medical history;

(b) the extent of any pain, disability, discomfort or other suffering that is attributable to the medical condition to which the service is to relate;

(c) whether any such pain, disability, discomfort or suffering makes it impossible or extremely difficult for the eligible person to carry out ordinary daily tasks; and

(d) the extent to which the provision of the service would be likely to alleviate, or to enable the alleviation of the pain, disability, discomfort or suffering.

(7) Any authorisation under paragraph (4) must be in writing.]

F1 Arts. 14D, 14E inserted (27.12.2013) by The Health Services (Cross-Border Health Care) Regulations (Northern Ireland) 2013 (S.R. 2013/299), regs. 1(1), 8(2)