The National Health Service (Pharmaceutical Services) (Wales) Regulations 2013

PART 4 Applications for outline consent and premises approval

Details of the application

32.  Name of the Local Health Board to which the application is made.

33.  Type of application (outline consent, premises approval or both).

Details of the applicant

34.  Name and address of the applicant.

35.  The General Medical Council reference number under which the applicant is included in the List of Registered Medical Practitioners maintained by the General Medical Council.

Application for outline consent

36.  Description and map of the area within which the applicant wishes to provide pharmaceutical services.

37.  Address of any pharmacy within the area described and delineated under paragraph 36.

Application for premises approval

38.  The address of the practice premises from which the applicant applies to provide pharmaceutical services and whether those practice premises are listed premises in relation to a different area.

39.  Distance between those premises and the nearest pharmacy (and the address of that pharmacy).

40.  Whether the application is for premises approval, for additional premises or to relocate to new premises (and if the latter the distance from the new premises to the premises in respect of which the applicant currently has premises approval).

41.  Whether the application arises because a practice amalgamation has taken place or will be taking place and, if so, the names of the doctors or contractors participating in the amalgamation.

42.  If outline consent has already been granted a description and map of the area in respect of which consent has been granted.

43.  Details of any other medical practice premises which have been granted premises approval or in respect of which an application has already been made but not yet determined by the Local Health Board.

Pharmaceutical services to be provided

44.  The pharmaceutical services to be provided and the opening hours and days on which those services will be provided.

Prejudice test

45.  The reasons why the applicant considers that granting the application will not prejudice the proper provision of primary medical services, dispensing services or pharmaceutical services in the controlled locality in which the premises specified in the application are situated.

Necessary or expedient

46.  The reasons why the applicant considers it is necessary or expedient to grant the application in order to secure in the area in respect of which the applicant has applied for outline consent the adequate provision, by persons included in a list, of the services or some of the services specified in the application.

Applicant’s undertaking

47.  The applicant must given an undertaking that if the application is granted and outline consent and premises approval is in effect the applicant will provide the services from the practice premises in respect of which the application is granted in accordance with the terms of service.