The National Health Service (Primary Medical Services) (Miscellaneous Amendments) (Wales) Regulations 2006

Explanatory Note

(This note is not part of the Regulations)

These Regulations make amendments to certain regulations relating to general medical services contracts in Wales and to the NHS (Performers Lists) (Wales) Regulations 2004.

Part 2 amends the National Health Service (General Medical Services Contracts) (Wales) Regulations 2004 (the GMS Contracts (Wales) Regulations). In particular—

• it widens the definition of general medical practitioner in regulation 2 of the GMS Contracts (Wales) Regulations to cover all medical practitioners who are included in the General Practitioner Register or who, prior to coming into force of that Register, are suitably experienced within the meaning of section 31 of the National Health Service Act 1977 (“the 1977 Act”) or have an acquired right to practise (regulation 2(4));

• it provides that provisions that relate to a spouse will also relate to a civil partner to take into account the effect of the Civil Partnerships Act 2004 (regulations 2(7) and 11(34));

• it amends the definition of supplementary prescriber to include chiropodists, podiatrists, physiotherapists and radiographers and optometrists in the list of those who may be so recognised (regulation 2(10));

• it restricts the categories of general medical practitioner who, under regulation 4 of the GMS Contracts (Wales) Regulations, can act as the mandatory medical practitioner for the purposes of a general medical services contract (regulation 3). It excludes from that role practitioners who, prior to 1 April 2004 were restricted services principals or who were not considered to be suitably experienced for the purposes of operating as a principal in the provision of general medical services under section 29 of the 1977 Act;

• regulations 4 to 10 make provision for a number of minor corrections and amendments;

• it bans the use of telephone services for the purposes of general medical services contracts which make use of national rate numbers (starting with 087), premium rate numbers (starting with 090) or personal numbers (starting with 070) (regulation 11(2));

• it disapplies the provisions relating to clinical reports in the case of out of hours services (regulation 11(3));

• it inserts provisions to enable the supply of medicines to patients by providers of out of hours services where certain conditions are met (regulation 11(5));

• it amends paragraph 31 of Schedule 6 to the GMS Contracts (Wales) Regulations to enable a contractor’s list of patients which has been closed as a result of a determination by an assessment panel to re-open by agreement before the end of the closure period specified by that panel and, in certain circumstances, to re-close again during that period (regulation 11(7));

• it removes the restrictions preventing supplementary prescribers from prescribing controlled drugs or unlicensed medicines (regulations 11(10));

• it amends the circumstances in paragraph 52 of Schedule 6 in which a GP Registrar can perform medical services under a contract without being included in a medical performers list (regulation 11(13)). It brings them into line with those in regulation 22(3) of the National Health Service (Performers Lists) (Wales) Regulations 2004;

• it removes the requirement in paragraph 63 of Schedule 6 for the National Assembly for Wales to consent to the employment of a GP Registrar (regulation 11(14));

• it removes the provision relating to the Quality Information Preparation Scheme (regulation 11(18));

• it inserts in paragraph 76 of Schedule 6 a timescale for the provision of information by contractors to the Local Health Board (regulation 11(19));

• it clarifies the timescale for the submission of annual returns to Local Health Boards under paragraph 79 of Schedule 6 (regulation 11(20));

• regulation 11(21) requires contractors who are companies limited by shares to notify the Local Health Board of a change of director or secretary and enables the Local Health Board to terminate the contract if untrue information is given about the compliance of that director or secretary with the conditions in regulation 5 of the GMS Contracts (Wales) Regulations;

• regulation 11(23) disapplies the provision relating to the provision of information about complaints in the case of out of hours services which are covered by the quality requirements referred to in paragraph 11 of Schedule 6 ;

• it enables a Local Health Board to vary a contract to allow it to continue at least for an interim period after the death of a partner in a two-handed partnership even where the remaining individual is not a medical practitioner (regulation 11(27));

• it provides that a contract with an individual medical practitioner shall terminate seven days after that practitioner’s death unless before then arrangements have been made for it to continue for a further short period (regulation 11(28));

• it enables a Local Health Board to continue a contract for a limited period with a medical practitioner who no longer meets the conditions in regulation 4 if:

  (i)

  the reason for that failure is an immediate or interim suspension or health suspension under the Medical Act 1983,

  (ii)

  adequate arrangements are in place to provide clinical services during the period of suspension, and

  (iii)

  immediate termination is not necessary on grounds of patient safety or to protect public funds; (regulation 11(29));

• it clarifies that the grounds for termination of the contract in paragraph 111 of Schedule 6 to the GMS Contracts (Wales) Regulations only apply to partners, shareholders and directors who join the contracting body after the start of the contract in respect of circumstances which arise after they have so joined (regulation11(31));

• regulation 11(33) amends paragraph 120 of Schedule 6 to provide that, for the purpose of meeting its obligation of holding adequate insurance, a contractor can rely on insurance held by a person engaged by it as well as by an employee;

• regulation 12 corrects minor errors in Schedule 7 to the GMS Contracts (Wales) Regulations.

Part 3 of the Regulations makes transitional provision in relation to the removal by regulation 3 of the right of certain persons to be the mandatory general medical practitioner for the purposes of a general medical services contract. It provides that where such a person has been the mandatory medical practitioner for the purposes of a general medical services contract entered into before the date of coming into force of these Regulations, the contract will not be able to be terminated for breach of the amended requirements (regulation 14).

Part 4 of the Regulations makes a number of minor amendments to the NHS (Performers Lists) (Wales) Regulations 2004.