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

Newly registered patients

14.—(1) Subject to sub-paragraphs (4) to (9), where a patient has been accepted on the list of a doctor under paragraph 6 or assigned to such a list under regulation 20, the doctor shall, in addition and without prejudice to his other obligations in respect of that patient under these terms of service, within 30 days of the date of such acceptance or assignment, invite the patient to participate in a consultation either at his practice premises or, if the condition of the patient so warrants, at such other place as the doctor is obliged, under paragraph 13(4)(b), to render personal medical services to that patient.

(2) Where a patient (or, in the case of a patient who is a child, the appropriate person in relation to that child) agrees that he, or in the case of a child, that the child will participate in such a consultation as is mentioned in sub-paragraph (1), the doctor shall, in the course of that consultation—

(a) seek details as to the medical history of the patient and, so far as may be relevant to the patient’s medical history, as to that of his consanguineous family, in respect of—

(i) illnesses, immunisations, allergies, hereditary conditions, medication and tests carried out for breast or cervical cancer,

(ii) social factors (including employment or unemployment, housing and family circumstances) which may affect his health,

(iii) factors of his lifestyle (including diet, exercise, use of tobacco, consumption of alcohol, and misuse of drugs or solvents) which may affect his health, and

(iv) the current state of his health;

(b) offer to undertake a physical examination of the patient, comprising—

(i) the measurement of his blood pressure,

(ii) the taking of a urine sample and its analysis to identify the presence of albumin and glucose, and

(iii) the measurements necessary to detect any changes in his body mass index;

(c) record, in the records maintained in relation to the patient pursuant to paragraph 32, his findings arising out of the details supplied by or in relation to, and any examination of, the patient under this sub-paragraph;

(d) assess whether and, if so, in what manner and to what extent he should render personal medical services to the patient; and

(e) in so far as it would not, in the opinion of the doctor, be likely to cause serious damage to the physical or mental health of the patient to do so, discuss with the patient (or, where the patient is a child, the appropriate person) the conclusions the doctor has drawn as a result of the consultation as to the state of the patient’s health.

(3) In sub-paragraphs (2) and (4) and in paragraph 15(3)(e) “the appropriate person”, in relation to a child, is a person who has the right under regulation 39 to choose on behalf of the child the person by whom general medical services are to be provided for the child.

(4) On each occasion where a doctor invites a patient or, where the patient is a child, the appropriate person, to participate in a consultation pursuant to sub-paragraph (1), he shall—

(a) make the invitation in writing or, if the invitation is initially made orally, confirm it in writing, by a letter either handed to the patient or his representative or sent to the patient or, where the patient is a child, to the appropriate person, at the address recorded in the medical records kept for the patient as being his last home address or that of the appropriate person, as the case may be;

(b) record in the patient’s medical records the date of each such invitation and whether or not it was accepted;

(c) where, as a result of making the invitation, the doctor becomes aware that the patient is no longer residing at the address shown in his medical records, advise the Board accordingly.

(5) A doctor shall not be obliged to offer a consultation pursuant to sub-paragraph (1)—

(a) if he is a restricted services principal;

(b) in respect of a child under the age of 5 years;

(c) to any patient who, immediately before joining the list of a doctor, was a patient of a partner of the doctor and who, during the year immediately preceding the date of his acceptance or assignment to his current doctor’s list, had participated in a consultation pursuant to sub-paragraph (1); or

(d) to the extent allowed by the Board, to any patient within a class of patients in respect of which the Board or, on appeal, the Secretary of State, has pursuant to sub-paragraphs (6) to (9), deferred the doctor’s obligation under sub-paragraph (1).

(6) Where a doctor assumes responsibility for a list of patients on his succession to a vacant medical practice or otherwise becomes responsible for a significant number of new patients within a short period, he may apply, in accordance with sub-paragraph (7), to the Board for the deferment of his obligation under sub-paragraph (1) for a period not exceeding 2 years from the date of the application.

(7) An application pursuant to sub-paragraph (6) shall be made in writing and shall be accompanied by a statement of the doctor’s proposals by reference to particular classes of patients, with a view to securing that all eligible patients are invited to participate in a consultation pursuant to sub-paragraph (1) by the end of the period of the deferment.

(8) Within 60 days of receiving an application the Board shall decide it—

(a) by approving the application;

(b) by approving the application subject to conditions; or

(c) by refusing the application,

and shall give written notice of its decision and, where it refuses the application or grants it subject to conditions, of its reasons for refusal or for such conditions, and of the doctor’s right of appeal under sub-paragraph (9).

(9) A doctor may appeal in writing to the Secretary of State against any refusal of an application, or against any condition subject to which an application is approved by a Board pursuant to sub-paragraph (8)(b), and on determining such an appeal the Secretary of State shall—

(a) either confirm the Board’s decision or substitute his own determination for the decision of the Board, and

(b) give to the doctor written notice of his decision and of his reasons therefor.

(10) In this paragraph and paragraph 15 “body mass index” means the figure produced by dividing the number of kilograms in the patient’s weight by the square of the number of metres in his height.