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The National Health Service (General Medical Services Contracts) Regulations 2015

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Variation of contracts: registered patients from outside practice area

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30.—(1) A contractor may accept onto its list of patients a person who resides outside of the contractor’s practice area.

(2) Subject to paragraphs (5) and (6), the terms of the contractor’s contract specified in paragraph (3) must be varied so as to require the contractor to provide to the person any services which the contractor is required to provide to its registered patients under the contract as if the person resided within the contractor’s practice area.

(3) The terms of the contract specified in this paragraph are—

(a)the terms under which the contractor is to provide essential services;

(b)the terms under which the contractor is required to provide for arrangements to access services throughout core hours;

(c)the terms under which the contractor is required to provide out of hours services; and

(d)the terms which give effect to the following provisions of Schedule 3 (other contractual terms)—

(i)paragraph 4(1) (attendance at practice premises),

(ii)paragraph 5(2)(a) (attendance outside practice premises), and

(iii)paragraph 21(2) (refusal of applications for inclusion in list of patients).

(4) Where, under paragraph (1), a contractor accepts onto its list of patients a person who resides outside of the contractor’s practice area and the contractor subsequently considers that it is not clinically appropriate or practical to continue to provide that patient with services in accordance with the terms specified in paragraph (3), or to comply with those terms, the contract must be varied so as to include a term which has the effect of modifying the application of paragraph 24 of Schedule 3 (which relates to the removal of a patient from the list at the contractor’s request) in relation to that patient so that—

(a)in sub-paragraph (1), the reference to the patient’s disability or medical condition is removed; and

(b)sub-paragraph (4) applies as if, after paragraph (a), there were inserted the following paragraph—

(aa)the reason for the removal is that the contractor considers that it is not clinically appropriate or practical to continue to provide services under the contract to the patient which do not include the provision of such services at the patient’s home address..

(5) Where the contractor is required to provide services to a patient in accordance with arrangements made under paragraph (1), the contract must also be varied so as to include terms which have the effect of releasing the contractor and the Board from all obligations, rights and liabilities relating to the terms specified in paragraph (3) (including any right to enforce those terms) where, in the opinion of the contractor, it is not clinically appropriate or practical under those arrangements to—

(a)provide the services in accordance with those terms; or

(b)comply with those terms.

(6) The contract must also include a term which has the effect of requiring the contractor to give notice in writing to a person, where the contractor is minded to accept that person on its list of registered patients in accordance with arrangements made under paragraph (1), that the contractor is under no obligation to provide—

(a)essential services if, at the time treatment is required, it is not clinically appropriate or practical to provide primary medical services given the particular circumstances of the patient;

(b)out of hours services if, at the time treatment is required, it is not clinically appropriate or practical to provide such services given the particular circumstances of the patient; or

(c)additional services to the patient if it is not clinically appropriate or practical to provide such services given the particular circumstances of the patient.

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