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F1PART IIN.I.PILOT SCHEMES FOR PRIMARY CARE

Preparation and making of pilot schemesN.I.

Pilot schemesN.I.

3.—(1) In this Order “pilot scheme” means one or more agreements made by a board with respect to its area and in accordance with this Part under which—

(a)personal medical services are provided (otherwise than by the board); or

(b)personal dental services are provided (otherwise than by the board).

(2) A pilot scheme may not combine arrangements for the provision of personal medical services with arrangements for the provision of personal dental services.

(3) A pilot scheme may include arrangements for the provision of [F2health care]

(a)which are not personal medical services or personal dental services; but

(b)which may be provided under Part II of the 1972 Order.

(4) In this Order “piloted services” means services provided in accordance with a pilot scheme (including any services to which the scheme applies by virtue of paragraph (3)).

(5) Except to such extent as may be prescribed—

(a)a patient for whom personal medical services are provided under a pilot scheme is not to count as a person for whom arrangements must be made by the board concerned under Article 56 of the 1972 Order;

(b)a patient for whom personal dental services am provided under a pilot scheme is not to count as a person for whom arrangements must be made by the board concerned under Article 61 of the 1972 Order.

(6) The functions of an [F3HSC trust] include power to provide piloted services, and to do so as a member of a qualifying body (within the meaning of Article 4 or 5).

(7) For the purposes of this Part—

“personal medical services” means medical services of a kind that may be provided by a general medical practitioner in accordance with arrangements made under Part VI of the 1972 Order; and

“personal dental services” means dental services of a kind that may be provided by a general dental practitioner in accordance with arrangements made under Part VI of the 1972 Order.

Provision of personal medical services under a pilot schemeN.I.

4.—(1) This Article applies to any pilot scheme under which personal medical services are provided.

(2) An agreement which constitutes, or is one of the agreements which together constitute, a pilot scheme may be made by a board only with one or more of the following—

(a)an [F4HSC trust];

(b)a suitably experienced medical practitioner;

(c)an [F5HSC employee] or a pilot scheme employee;

(d)a qualifying body;

(e)an individual who is providing personal medical services under that or another pilot scheme.

(3) In this Article—

[F5HSC employee]” means an individual who, in connection with the provision of [F6health care], is employed by—

(a)an [F4HSC trust];

(b)a medical practitioner whose name is included in a medical list; or

(c)a medical practitioner who is providing personal medical services in accordance with a pilot scheme;

“pilot scheme employee” means an individual who, in connection with the provision of personal medical services in accordance with a pilot scheme, is employed by an individual providing those services;

“qualifying body” means a company which is limited by shares all of which are legally and beneficially owned by persons falling within sub-paragraph (a), (b), (c) or (e) of paragraph (2).

(4) For the purposes of this Article, a medical practitioner is suitably experienced if he is suitably experienced for the purposes of Article 12 of this Order or Article 8 of the [1978 NI 26.] Health and Personal Social Services (Northern Ireland) Order 1978.

Provision of personal dental services under a pilot schemeN.I.

5.—(1) This Article applies to any pilot scheme under which personal dental services are provided.

(2) An agreement which constitutes, or is one of the agreements which together constitute, a pilot scheme may be made by a board only with one or more of the following—

(a)an [F7HSC trust];

(b)a dental practitioner whose name is included in a dental list;

(c)an [F8HSC employee] or a pilot scheme employee;

(d)a qualifying body;

(e)an individual who is providing personal dental services under that or another pilot scheme.

(3) In this Article—

“dental list” means a list prepared in accordance with regulations under Article 61(2)(a) of the 1972 Order;

[F8HSC employee]” means an individual who, in connection with the provision of [F9health care], is employed by—

(a)an [F7HSC trust];

(b)a dental practitioner whose name is included in a dental list; or

(c)a dental practitioner who is providing personal dental services in accordance with a pilot scheme;

“pilot scheme employee” means an individual who, in connection with the provision of personal dental services in accordance with a pilot scheme, is employed by an individual providing those services;

“qualifying body” means—

(a)a body corporate which, in accordance with the provisions of Part IV of the [1984 c. 24.] Dentists Act 1984, is entitled to carry on the business of dentistry; or

(b)a company which is limited by shares all of which are legally and beneficially owned by persons falling within sub-paragraph (a), (b), (c) or (e) of paragraph (2).

Proposals for pilot schemesN.I.

6.—(1) Before any pilot scheme may be made, the board concerned must prepare proposals for the scheme and submit them to the Department.

(2) A board must prepare and submit such proposals if it is asked to do so by a person—

(a)who wishes to provide piloted services; and

(b)with whom an agreement which constitutes, or is part of, a pilot scheme may be made;

but otherwise a board may not do so.

(3) A request to a board under paragraph (2) must—

(a)be made in writing; and

(b)comply with such requirements (if any) as may be prescribed.

(4) In preparing proposals for a pilot scheme, a board must comply with any directions given to it by the Department as to the matters to be dealt with, and information to be included, in the proposals.

(5) Before submitting proposals for a pilot scheme, a board must (in addition to complying with any requirements about consultation imposed by or under any other statutory provision) comply with any directions given to it by the Department about the extent to which, and manner in which, it is to consult on the proposals.

(6) The Department may give directions as to—

(a)the matters to which a board must have regard in making any recommendation to the Department when submitting proposals for a pilot scheme; and

(b)the form in which any such recommendation is to be made.

Approval of pilot schemesN.I.

7.—(1) If proposals for a pilot scheme are submitted to the Department under Article 6, it must—

(a)approve them as submitted;

(b)make such modifications as it considers appropriate and approve them as modified; or

(c)reject them.

(2) The Department may not approve proposals for a pilot scheme unless it is satisfied that they include satisfactory provision for any participant other than the board to withdraw from the scheme if he wishes to do so.

(3) Where—

(a)the Department intends to approve proposals for a pilot scheme; and

(b)it appears to the Department that the effect of implementing the proposals would be to increase or reduce the number of general medical practitioners in the area of the board concerned,

the Department must have regard to the effect that the proposals, as the Department intends to approve them, are likely to have on the distribution of general practitioners in Northern Ireland.

(4) The Department must notify the board concerned, in writing, of any decision made under this Article.

(5) In this Article “general practitioner” means any, medical practitioner who is providing general medical services or performing personal medical services.

Making of pilot schemesN.I.

8.—(1) If the Department approves proposals for a pilot scheme and notifies the board concerned in accordance with Article 7, the board must implement the proposals in accordance with directions given by the Department.

(2) A proposed participant in a pilot scheme (other than the board concerned) may withdraw at any time before the proposals relating to him are implemented.

(3) A pilot scheme, as implemented, may differ from the proposals for the scheme approved by the Department only if the Department agrees to the variation or—

(a)directions given by the Department (either under paragraph (1) or generally) authorise variations that satisfy specified requirements; and

(b)the variation satisfies those requirements.

(4) As soon as, is reasonably practicable after implementing proposals for a pilot scheme, the board concerned must (in accordance with any directions given to it by the Department) publish details of the scheme.