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PART 3E+WServices to be commissioned by [F1NHS England]

Textual Amendments

Interpretation of Part 3E+W

5.  In this Part—

“Armed Forces Compensation Scheme” means the Armed Forces and Reserve Forces Compensation Scheme 2011 set out in the Armed Forces and Reserve Forces (Compensation Scheme) Order 2011 M1;

“community dental services” means dental services provided as part of the health service other than—

(a)

emergency services,

(b)

dental services provided pursuant to arrangements made by [F1NHS England] under Part 5 of the 2006 Act, or

(c)

the dental services specified in Schedule 2;

“community services” means services provided as part of the health service other than—

(a)

emergency services,

(b)

primary care services,

(c)

secondary care services, or

(d)

the services specified in Schedule 4;

“Defence Medical Services” means medical services provided by—

(a)

the Ministry of Defence including the Surgeon General's organisation,

(b)

other elements of the Joint Forces Command, and

(c)

the three single Service medical organisations M2;

“emergency services” means ambulance services and accident and emergency services provided as part of the health service, whether provided at a hospital accident or emergency department, a minor injuries unit, a walk-in centre or elsewhere;

[F2“mandatory dental services” means dental services which are equivalent in nature to services which must be provided under a general dental services contract by virtue of provision in regulation 14 of the National Health Services (General Dental Services Contracts) Regulations 2005 (mandatory services);]

“secondary care services” means services provided as part of the health service in a hospital setting, or by those working in or based in a hospital setting, other than emergency services, primary care services or the services specified in Schedule 4;

[F3“sedation services” means a course of treatment provided to a patient in connection with the provision to that patient of mandatory dental services during which the provider of that treatment administers one or more drugs to the patient which produce a state of depression of the central nervous system to enable treatment to be carried out, and during and in respect of that period of sedation—

(a)

the drugs and techniques used to provide the sedation are deployed by the provider of the treatment in a manner that ensures loss of consciousness is rendered unlikely; and

(b)

verbal contact with the patient is maintained in so far as is reasonably possible;]

“veteran” means any person who has served for at least one day in one of the armed forces or Merchant Navy seafarers and fishermen who have served in a vessel at a time when it was operated to facilitate military operations by the armed forces.

Textual Amendments

Marginal Citations

M2The three single Service organisations referred to are Royal Navy Medical Services, Army Medical Services and RAF Medical Services.

Dental servicesE+W

6.  [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of—

(a)community dental services; and

(b)the dental services specified in Schedule 2.

Services for serving members of the armed forces and their familiesE+W

7.—(1) This regulation applies to—

(a)a person who is a serving member of the armed forces; and

(b)that person's family.

(2) [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service to persons to whom this regulation applies of—

(a)community services;

(b)secondary care services; and

(c)the services specified in Schedule 4.

(3) The arrangements to be made by [F1NHS England] under paragraph (2)(b) in respect of a person referred to in paragraph (1)(a) must include the provision of any infertility treatment to that person and to that person's partner.

(4) The infertility treatment referred to in paragraph (3) must—

(a)where a person referred to in paragraph (1)(a) has been injured in service and is in receipt of compensation for infertility under the Armed Forces Compensation Scheme, include funding the cost of sperm storage facilities from the date on which the injury was sustained (where clinically necessary and where provision for such storage has previously been made); and

(b)where, and to the extent that, [F1NHS England] is satisfied that this is clinically appropriate in the circumstances of any case, include the provision of up to three cycles of in vitro fertilisation treatments or other means of assisted conception.

(5) In paragraph (1)(b), “family”, in relation to a person to whom this regulation applies, means that person's immediate family registered for primary care services with Defence Medical Services.

(6) [F1NHS England] must regard a person (“A”) as the partner of a person referred to in paragraph (1)(a) (“B”) if—

(a)A is the spouse or civil partner of B; or

(b)A and B are cohabiting as partners in a substantial and exclusive relationship in circumstances where either—

(i)A is financially dependent on B, or

(ii)A and B are financially interdependent.

(7) In deciding whether A is in a substantial relationship with B, [F1NHS England]must—

(a)have regard to any evidence which A considers demonstrates that the relationship is substantial; and

(b)in particular, have regard to the examples of evidence specified in paragraph (8) which could, either alone or together, indicate that the relationship is substantial.

(8) The evidence referred to in paragraph (7)(b) is—

(a)evidence of regular financial support of A by B;

(b)evidence of a will or life insurance policy, valid at the time at which the infertility treatment is sought in which—

(i)B nominates A as principal beneficiary or co-beneficiary, or

(ii)A nominates B as the principal beneficiary;

(c)evidence indicating that A and B have purchased or are purchasing accommodation together as joint owners or evidence of joint ownership of other valuable property, such as a car or land;

(d)evidence of a joint savings plan or joint investments of a substantial nature;

(e)evidence that A and B operate a joint account for which they are co-signatories;

(f)evidence of joint financial arrangements such as joint repayment of a loan or payment of each other's debts;

(g)evidence that either A or B has given the other the power of attorney;

(h)evidence that the names of both A and B appear on a lease or, if they live in rental accommodation, rental agreement; and

(i)evidence of the length of the relationship.

(9) For the purposes of paragraph (6)(b), a relationship is not an exclusive relationship if one or both of the parties is a party to another relationship which is, or could be considered to be, a substantial and exclusive relationship having regard to the provisions of this regulation.

Infertility treatment: seriously injured serving members and veteransE+W

8.—(1) This regulation applies to a person who is a serving member of the armed forces or a veteran of the armed forces where that person—

(a)has been severely injured in service; and

(b)as a result of the injury sustained—

(i)suffers from infertility, and

(ii)is in receipt of compensation for infertility under the Armed Forces Compensation Scheme; and

(c)after specialist sperm retrieval, wishes to receive infertility treatment and is eligible for, and has been accepted for, such treatment.

(2) [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of infertility treatment to a person to whom this regulation applies and to that person's partner.

(3) The infertility treatment referred to in paragraph (2) must—

(a)in any case, include funding the cost of sperm storage facilities;

(b)where, and to the extent that, [F1NHS England] is satisfied that it is clinically appropriate in the circumstances of any particular case, include up to three cycles of in vitro fertilisation treatments or other means of assisted conception;

(c)be provided at the same facility at which the specialist sperm retrieval took place and the extracted sperm of that person is stored.

(4) For the purposes of this regulation and regulation 9, “partner” is to be construed in accordance with regulation 7(6) to (9).

Infertility treatment: further provisionE+W

9.—(1) Where a person referred to in regulation 7(1)(a) or 8(1)—

(a)has died or has become mentally incapacitated; and

(b)has, before the time of that person's death or mental incapacity—

(i)made provision for sperm storage, and

(ii)given written consent to the stored sperm being used by a named partner,

[F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of infertility treatment to that person's named partner.

(2) The infertility treatment referred to in paragraph (1) must—

(a)in any case, include funding the cost of sperm storage facilities from the date on which the person died or, as the case may be, became mentally incapacitated; and

(b)where, and to the extent that, [F1NHS England] is satisfied that it is clinically appropriate in the circumstances of any particular case, include up to three cycles of in vitro fertilisation treatments and other means of assisted conception.

(3) Where infertility treatment is provided by [F1NHS England] under paragraph (1) to the named partner of a person referred to in regulation 8(1), that treatment must be provided at the same facility at which specialist sperm retrieval took place in relation to that person and at which that person's extracted sperm has been stored.

Services for prisoners and other detaineesE+W

10.—(1) Where a person is detained in a prison or in other accommodation described in paragraph (2), [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision to that person as part of the health service of—

[F4(a)community services (including mandatory dental services and sedation services);]

(b)secondary care services; and

(c)the services specified in Schedule 4.

(2) The other accommodation referred to in paragraph (1) is—

(a)a court;

(b)a secure children's home F5...;

(c)a secure training centre specified in the first column of Table 1 in Schedule 3 from the date specified in the corresponding entry in the second column of that Table;

(d)an immigration removal centre specified in the first column of Table 2 in Schedule 3 from the date specified in the corresponding entry in the second column of that Table; and

(e)a young offender institution F6....

(3) In this regulation, “court” means any court in which criminal proceedings against a person are heard.

Textual Amendments

Specified services for rare and very rare conditionsE+W

11.  [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of the services specified in Schedule 4.

[F7Saving and transitional provision in relation to certain services for rare and very rare conditionsE+W

11A.—(1) A relevant contract in relation to transferring services is not terminated or modified by virtue of the omission of those transferring services from Schedule 4 with effect from the transfer date and continues in force as it did immediately before the transfer date.

(2) [F1NHS England] retains the duty under regulations 7(2)(c), 10(1)(c) and 11 which it held in relation to those transferring services immediately before the transfer date for so long as a relevant contract for the provision of those services continues to have effect in relation to those transferring services but only to the extent of the provision which is made in that relevant contract for such services.

(3) In this regulation—

(a)a “relevant contract” is a contract having effect as between [F1NHS England] and another person for the provision as part of the health service of transferring services where that contract has effect immediately before the transfer date;

[F8(b)“the transfer date” means—

(i)in relation to transferring services referred to in paragraph (c)(i) (wheelchair services), 1st April 2015; and

(ii)in relation to transferring services referred to in paragraph (c)(ii) (specialist morbid obesity services), 1st April 2016;

(c)“transferring services” are—

(i)wheelchair services as included within the service specified in paragraph 135 of Schedule 4 immediately prior to the transfer date;

(ii)specialist morbid obesity services as specified in paragraph 118 of that Schedule immediately prior to the transfer date.]]

Textual Amendments

Assessment, diagnostic, elective and minor elective care services provided by Independent Sector Treatment CentresE+W

12.—(1) This regulation applies to services provided by an Independent Sector Treatment Centre pursuant to the arrangements specified in paragraph (2).

(2) The arrangements referred to in paragraph (1) are—

(a)the agreement made on 20thJuly 2005 and ending on 27th July 2013 between the Secretary of State for Health, Nations Healthcare (Nottingham) Limited, Nottinghamshire County Teaching Primary Care Trust, Nottingham City Primary Care Trust, Derby City Primary Care Trust, Derbyshire County Primary Care Trust, Lincolnshire Teaching Primary Care Trust, Leicestershire County and Rutland Primary Care Trust, Bassetlaw Primary Care Trust and Nottinghamshire University Hospitals NHS Trust for the provision of elective services and diagnostic services by Nations Healthcare (Nottingham) Limited;

(b)the agreement made on 15th December 2006 and ending on 31st March 2014 between the Secretary of State for Health, InHealth Group Limited and InHealth London Limited for the provision of diagnostic services by InHealth London Limited;

(c)the agreement made on 30th May 2008 and ending on 2nd February 2016 between the Secretary of State for Health, Care UK Clinical Services Limited and Care UK Limited for the provision of assessment and minor elective care services and diagnostic services by Care UK Clinical Services Limited;

(d)the agreement made on 30th May 2008 and ending on 27th October 2015 between the Secretary of State for Health, PHG (Hampshire) Limited and Care UK plc for the provision of elective services and diagnostic services by PHG (Hampshire) Limited;

(e)the agreement made on 31st July 2008 and ending on 31st October 2015 between the Secretary of State for Health, UKSH South West Limited and UK Specialist Hospitals Limited for the provision of elective services and diagnostic services by UKSH South West Limited; and

(f)the agreement made on 26th September 2011 and ending on 16th October 2016 between the Secretary of State for Health, Clinicenta (Hertfordshire) Limited and Carillion plc for the provision of elective services and assessment and minor elective care services by Clinicenta (Hertfordshire) Limited.

(3) [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of the services to which each of the agreements specified in paragraph (2)(a) to (f) relates for the period beginning on 1st April 2013 and, in the case of each respective agreement, ending on the date on which that agreement comes to an end.

(4) In this regulation—

“assessment and minor elective care services” means services related to the assessment, screening and planned care or treatment of minor medical conditions;

“diagnostic services” includes imaging services (such as MRI, CT, Ultrasound, Xray, Dexa Scan), physiological measurement, audiology, endoscopies, including direct access diagnostic services from primary care and other ancillary services needed to support the delivery of these services; and

“elective services” means clinical care services including Final Finished Consultant Episodes relating to, for example, trauma and orthopaedic surgery, general surgery, ear nose and throat, oral surgery, urology, gynaecology, plastic surgery, ophthalmology, hepatobiliary and pancreatic surgery, colorectal surgery, vascular surgery, gastroenterology, respiratory medicine, endocrinology, rheumatology, pain management and dermatology.

Fixated threat assessment servicesE+W

13.—(1) [F1NHS England] must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of specialised clinical risk assessment and management services for people with mental health problems who may present a risk to prominent people or locations.

(2) The arrangements to be made by [F1NHS England] under paragraph (1) must include—

(a)the provision of funding for mental health staff to provide the services referred to in paragraph (1); and

(b)such provision for partnership working with other persons or health services as is considered necessary to facilitate the effective delivery of those services.