The National Health Service (Personal Medical Services Agreements) Regulations 2015

PART 3 List of patients: closure etc.

Application for closure of list of patients

32.—(1) Where a contractor wants to close its list of patients, the contractor must send a written application to that effect (“the application”) to the Board.

(2) The application must include the following information—

(a) the options which the contractor has considered, rejected or implemented in an attempt to alleviate the difficulties which the contractor has encountered in respect of its open list and, if any of the options were implemented, the level of success in reducing or extinguishing such difficulties;

(b) details of any discussions between the contractor and its patients and a summary of those discussions including whether or not, in the opinion of those patients, the list of patients should be closed;

(c) details of any discussions between the contractor and the other contractors in the contractor’s practice area and a summary of the opinion of the other contractors as to whether or not the list of patients should be closed;

(d) the period of time, being a period of not less than three months and not more than 12 months, during which the contractor wants its list of patients to be closed;

(e) details of any reasonable support from the Board which the contractor considers would enable its list of patients to remain open or would enable the period of proposed closure to be minimised;

(f) any plans which the contractor may have to alleviate the difficulties mentioned in the application during the period of the proposed closure in order for that list to re-open at the end of that period without the existence of those difficulties; and

(g) any other information which the contractor considers ought to be drawn to the attention of the Board.

(3) The Board must acknowledge receipt of the application before the end of the period of seven days beginning with the date on which the application was received by the Board.

(4) The Board must consider the application and may request such other information from the contractor as the Board requires in order to enable it to decide the application.

(5) The Board must enter into discussions with the contractor concerning—

(a) the support which the Board may give to the contractor; or

(b) any changes which the Board or the contractor may make,

which would enable the contractor to keep its list of patients open.

(6) The Board and the contractor must, throughout the period of the discussions referred to in sub-paragraph (5), use reasonable endeavours to achieve the aim of keeping the contractor’s list of patients open.

(7) The Board or the contractor may, at any stage during the discussions, invite the Local Medical Committee (if any) for the area in which the contractor provides services under the agreement to attend any meetings arranged between the Board and the contractor to discuss the application.

(8) The Board may consult such persons as it appears to the Board may be affected by the closure of the contractor’s list of patients and, if it does so, the Board must provide to the contractor a summary of the views expressed by those persons consulted in respect of the application.

(9) The Board must enable the contractor to consider and comment on all the information before the Board makes a decision in respect of the application.

(10) A contractor may withdraw the application at any time before the Board makes a decision in respect of that application.

(11) The Board must, before the end of the period of 21 days beginning with the date on which the application was received by the Board (or within such longer period as the parties may agree), make a decision to—

(a) approve the application and determine the date from which the closure of the contractor’s list is to take effect and the date on which the list of patients is to reopen; or

(b) reject the application.

(12) The Board must give notice in writing to the contractor of its decision to—

(a) approve the application in accordance with paragraph 33; or

(b) reject the application in accordance with paragraph 34.

(13) A contractor may not submit more than one application to close its list of patients in any period of 12 months beginning with the date on which the Board makes its decision on the application unless—

(a) paragraph 35 applies; or

(b) there has been a change in the circumstances of the contractor which affects its ability to deliver services under the agreement.

Approval of an application to close a list of patients

33.—(1) Where the Board approves an application to close a contractor’s list of patients, the Board must—

(a) give notice in writing to the contractor of its decision as soon as possible and the notice (“the closure notice”) must include the details specified in sub-paragraph (2); and

(b) at the same time as the Board gives notice to the contractor, send a copy of the closure notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the agreement, and

(ii) any person who the Board consulted in accordance with paragraph 32(8).

(2) The closure notice must include—

(a) the period of time for which the contractor’s list of patients is to be closed which must be—

(i) the period specified in the application, or

(ii) where the Board and the contractor have agreed in writing to a different period, that different period,

and, in either case, the period must not be less than three months and not more than 12 months;

(b) the date on which the closure of the contractor’s list of patients is to take effect (“the closure date”); and

(c) the date on which the list of patients is to re-open.

(3) Subject to paragraph 36, a contractor must close its list of patients with effect from the closure date and the list of patients must remain closed for the duration of the closure period as specified in the closure notice.

Rejection of an application to close a list of patients

34.—(1) Where the Board rejects an application to close a contractor’s list of patients, the Board must—

(a) give notice in writing to the contractor of its decision as soon as possible and the notice must include the Board’s reasons for rejecting the application; and

(b) at the same time as the Board gives notice to the contractor, send a copy of the notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the agreement, and

(ii) any person who the Board consulted in accordance with paragraph 32(8).

(2) Subject to sub-paragraph (3), if the Board decides to reject an application from a contractor to close its list of patients, the contractor may not make a further application to close its list of patients until whichever is the later of—

(a) the end of the period of three months beginning with the date on which the Board’s decision to reject the application was made; or

(b) in a case where a dispute arising from the Board’s decision to reject the application has been referred to the NHS dispute resolution procedure, the end of the period of three months beginning with the date on which a final determination to reject the application was made in accordance with that procedure (or any court proceedings).

(3) A contractor may make a further application to close its list of patients where there has been a change in the circumstances of the contractor which affects the contractor’s ability to deliver services under the agreement.

Application for an extension of the closure period

35.—(1) A contractor may apply to extend the closure period by sending a written application (“the application”) to that effect to the Board no later than eight weeks before the date on which the closure period is due to expire.

(2) The application must include the following information—

(a) details of the options which the contractor has considered, rejected or implemented in an attempt to alleviate the difficulties which have been encountered during the closure period or which may be encountered when the closure period expires;

(b) the period of time during which the contractor wants its list of patients to remain closed (which may not be longer than 12 months);

(c) details of any reasonable support from the Board which the contractor considers would enable the contractor’s list of patients to re-open or would enable the proposed extension to the closure period to be minimised;

(d) details of any plans which the contractor may have to alleviate the difficulties mentioned in the application to extend the closure period in order for the list of patients to re-open at the end of the proposed extension of the closure period without the existence of those difficulties; and

(e) any other information which the contractor considers ought to be drawn to the attention of the Board.

(3) The Board must acknowledge receipt of the application before the end of the period of seven days beginning with the date on which the application was received by the Board.

(4) The Board must consider the application and may request such other information from the contractor as it requires in order to enable it to decide the application.

(5) The Board may enter into discussions with the contractor concerning—

(a) the support which the Board may give to the contractor; or

(b) any changes which the Board or the contractor may make,

which would enable the contractor to re-open its list of patients.

(6) The Board must determine the application before the end of the period of 14 days beginning with the date on which the Board received that application (or before the end of such longer period as the parties may agree).

(7) The Board must give notice in writing to the contractor of its decision to approve or reject the application as soon as possible after making that decision.

(8) Where the Board approves the application, the Board must—

(a) give notice in writing to the contractor of its decision (“the extended closure notice”) which must include the details specified in sub-paragraph (9); and

(b) at the same time as it gives notice in writing to the contractor, send a copy of the extended closure notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the agreement, and

(ii) any person who the Board consulted in accordance with paragraph 32(8).

(9) The extended closure notice must include—

(a) the period of time for which the contractor’s list of patients is to remain closed which must be—

(i) the period specified in the application, or

(ii) where the Board and contractor have agreed in writing a different period to the period specified in that application, that agreed period,

and, in either case, the period (“the extended closure period”) must not be less than three months and not more than 12 months beginning with the date on which the extended closure period is to take effect ;

(b) the date on which the extended closure period is to take effect; and

(c) the date on which the contractor’s list of patients is to re-open.

(10) Where the Board rejects an application, the Board must—

(a) give notice in writing to the contractor of its decision which must include its reasons for rejecting the application; and

(b) at the same time as it gives notice to the contractor, send a copy of the notice to the Local Medical Committee (if any) for the area in which the contractor provides services under the agreement.

(11) Where an application is made in accordance with sub-paragraphs (1) and (2), the contractor’s list of patients is to remain closed pending whichever is the later of—

(a) the determination by the Board of that application; or

(b) in a case where a dispute arising from the Board’s decision to reject the application has been referred to the NHS dispute resolution procedure, the contractor ceasing to pursue that dispute through that procedure (or any court proceedings).

Re-opening of list of patients

36.  The contractor may re-open its list of patients before the expiry of the closure period if the Board and the contractor agree that the contractor should do so.