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2003 No. 2644

NATIONAL HEALTH SERVICE, ENGLAND

The National Health Service (Personal Medical Services) (Services List) and the (General Medical Services Supplementary List) and (General Medical Services) Amendment Regulations 2003

  Made 10th October 2003 
  Laid before Parliament 13th October 2003 
  Coming into force 3rd November 2003 

The Secretary of State for Health, in exercise of the powers conferred upon him by sections 29, 29A, 29B, 43ZA, 43D, 49N, 49O, 49P, 49Q, 49R and 126(4) of the National Health Service Act 1977[1], sections 8ZA, 9 and 39 of the National Health Service (Primary Care) Act 1997[2] and section 65 of the Health and Social Care Act 2001[3], and all other powers enabling him in that behalf, hereby makes the following Regulations:

Citation, commencement and application
     1.  - (1) These Regulations may be cited as the National Health Service (Personal Medical Services) (Services List) and the (General Medical Services Supplementary List) and (General Medical Services) Amendment Regulations 2003 and shall come into force on 3rd November 2003.

    (2) These Regulations apply to England only.



PART I

SERVICES LIST

Interpretation
    
2.  - (1) In this Part - 

who is being trained in general practice by a GP trainer;

and shall be treated as including a case where a person is treated as suspended by a Primary Care Trust or, prior to 1st October 2002, a Health Authority by virtue of regulation 6(2) of the Abolition of the Tribunal Regulations, or in Wales, by a Local Health Board or, prior to 1st April 2003, by a Health Authority by virtue of regulation 6(2) of the Abolition of the Tribunal (Wales) Regulations, and "suspends" and "suspension" shall be construed accordingly;

    (2) All references in this Part to sections are to sections of the National Health Service Act 1977, except where specified otherwise.

Services list
     3.  - (1) A Primary Care Trust shall prepare and publish a services list of all doctors who may perform personal medical services in connection with the provision of such services under a pilot scheme.

    (2) Subject to paragraph (3) and regulation 21, a doctor may not perform personal medical services, unless - 

    (3) A doctor who is provisionally registered under section 15 or 21 of the Medical Act[18], may perform personal medical services when his name is not included in a services list, medical list or a supplementary list, but only whilst acting in the course of his employment in a resident medical capacity in an approved medical practice (within the meaning of section 11(4) of that Act[19]).

    (4) In respect of any doctor whose name is included in a services list, the list shall include - 

    (5) The services list shall be available for public inspection.

Application for inclusion in the services list
     4.  - (1) Subject to paragraphs (8) and (9), an application by a doctor for the inclusion of his name in the services list shall be made by sending the Primary Care Trust an application in writing, which shall include the information mentioned in paragraph (2), the undertakings and consents required by paragraphs (3) and (7) and any declaration required under paragraph (2), (5) or (6).

    (2) The doctor shall provide the following information - 

    (3) The doctor shall provide the following undertakings and consent - 

    (4) The events to which this paragraph applies are - 

    (5) The doctor shall send with the application a declaration as to whether he - 

and, if so, he shall give details, including approximate dates, of where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome.

    (6) If the doctor is, has in the preceding six months been, or was at the time of the originating events a director of a body corporate, he shall in addition make a declaration to the Primary Care Trust as to whether the body corporate - 

and, if so, he shall give the name and registered office of the body corporate and details, including approximate dates, of where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome.

    (7) The doctor shall consent to a request being made by the Primary Care Trust to any employer or former employer, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, into the doctor or a body corporate referred to in paragraphs (3), (5) and (6).

    (8) If, in the case of any application, the Primary Care Trust finds that the information, references or documentation supplied by the doctor are not sufficient for it to decide his application, it shall seek from that doctor such further information, references or documentation as it may reasonably require in order to make a decision and that doctor shall supply the material so sought to the Trust.

    (9) In the case of an application to a Primary Care Trust by a doctor, who is included in the medical list or the supplementary list of that Trust, seeking to withdraw from that list and to include his name in its services list, that doctor shall only be required to provide the information required by paragraph (2) insofar as - 

Readmission
     5.  - (1) Where a doctor has been removed from any list by a Primary Care Trust on the grounds that he had been convicted of a criminal offence, and that conviction is overturned on appeal, that Primary Care Trust may agree to include the doctor in its services list without a full application if it - 

    (2) In a case to which paragraph (1) applies, if the conviction is reinstated on a further appeal, the previous determination of the Primary Care Trust to remove that doctor from its services list shall once again have effect.

Grounds for refusal
    
6.  - (1) The grounds on which a Primary Care Trust may refuse to include a doctor in its services list are that - 

    (2) The grounds on which a Primary Care Trust must refuse to include a doctor in its services list are that - 

    (3) Before making a decision on the application, the Primary Care Trust shall - 

    (4) Where the Primary Care Trust is considering a refusal under paragraph (1) or (2) it shall consider all facts which appear to it to be relevant, and shall in particular take into consideration, in relation to paragraph (1)(a), (d) or (e) above - 

    (5) When the Primary Care Trust takes into consideration any of the matters set out in paragraph (4), it shall consider the overall effect of all the matters being considered.

    (6) When refusing to include a doctor in its services list, the Primary Care Trust shall notify the doctor of its decision and the reasons for it (including any facts relied upon) and of any right of appeal under regulation 15 against the Primary Care Trust's decision.

Deferment of decision on application
     7.  - (1) A Primary Care Trust may defer a decision on an application to be included in the services list, where - 

    (2) A Primary Care Trust may only defer a decision under paragraph (1) above until the outcome of the relevant event mentioned in any of sub-paragraphs (a) to (i) is known.

    (3) The Primary Care Trust must notify the doctor that it has deferred a decision on the application and the reasons for it.

    (4) Once the outcome of the relevant event mentioned in paragraph (1) is known, the Primary Care Trust shall notify the doctor in writing that he must within 28 days of the date of the notification (or such longer period as the Primary Care Trust may agree) - 

    (5) Provided any additional information has been received within the 28 days or the time agreed, the Primary Care Trust shall notify the doctor as soon as possible - 

Conditional inclusion
    
8.  - (1) A Primary Care Trust may determine that, if a person is to be included in the services list, he is to be subject, while he remains included in that list, to the imposition of conditions, having regard to the requirements of section 8ZA(5) of the Primary Care Act (purpose of conditions).

    (2) If a doctor fails to comply with a condition, which has been imposed by the Primary Care Trust, it may remove him from its services list.

    (3) Where the Primary Care Trust is considering the removal of a doctor from its services list for breach of a condition, it shall give him - 

    (4) If there are no representations within the period specified in paragraph (3)(c), the Primary Care Trust shall inform the doctor of - 

within 7 days of making that decision.

    (5) If there are representations, the Primary Care Trust must take them into account before reaching its decision, and shall then notify the doctor of - 

within 7 days of making that decision.

    (6) If the doctor requests an oral hearing, this must take place before the Primary Care Trust reaches its decision and the Primary Care Trust must then notify the doctor of - 

within 7 days of making that decision.

    (7) When the Primary Care Trust notifies the doctor of any decision, it shall inform him that, if he wishes to exercise a right of appeal, he must do so within the period of 28 days beginning with the date on which the Primary Care Trust gave him the notice informing him of its decision and shall tell him how to proceed with any appeal.

    (8) The Primary Care Trust shall also notify the doctor of his right to have the decision reviewed in accordance with regulation 14.

    (9) Where the Primary Care Trust determines that a doctor - 

the name of the doctor may be included (or continue to be included) in its services list during the period for bringing the appeal to the FHSAA pursuant to regulation 15, or if an appeal is brought, until such time as that appeal has been decided, provided the doctor agrees to be bound by the conditions imposed until the time for appeal has expired or the appeal is decided.

Requirements with which a doctor in the services list must comply
    
9.  - (1) A doctor, who is included in the services list of a Primary Care Trust, shall make a declaration to that Trust in writing within 7 days of its occurrence if he - 

and, if so, he shall give details, including approximate dates, and where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome.

    (2) A doctor, who is included in the services list of a Primary Care Trust, and is, was in the preceding six months, or was at the time of the originating events, a director of a body corporate, shall make a declaration to that Trust in writing within 7 days of its occurrence if that body corporate - 

and, if so, he shall give the name and registered address of the body corporate and details, including approximate dates, of where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome.

    (3) A doctor, who is included in the services list of a Primary Care Trust, shall consent to a request being made by that Trust to any employer or former employer, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, by that employer or body into the doctor or a body corporate referred to in paragraph (1) and (2).

    (4) A doctor, who is included in the services list of a Primary Care Trust, shall supply that Trust with an enhanced criminal record certificate under section 115 of the Police Act 1997[32] in relation to himself, if the Primary Care Trust at any time, for reasonable cause, requests him to provide such a certificate.

Removal from services list
     10.  - (1) The Primary Care Trust must remove the doctor from its services list where it becomes aware that he - 

    (2) Where a Primary Care Trust is notified by the FHSAA that it has considered an appeal by a doctor against - 

the Primary Care Trust shall remove the doctor from its services list and shall notify the doctor immediately that it has done so.

    (3) The Primary Care Trust may remove a doctor from its services list where any of the conditions set out in paragraph (4) is satisfied.

    (4) The conditions mentioned in paragraph (3) are that the - 

    (5) For the purposes of this regulation, in addition to the services covered by the definition of "health scheme" in section 49F(8), the following shall also be health schemes - 

    (6) Where the doctor cannot demonstrate that he has performed personal medical services within the area of the Primary Care Trust during the preceding twelve months, the Primary Care Trust may remove him from its services list.

    (7) In calculating the period of twelve months referred to in paragraph (6), the Primary Care Trust shall disregard any period during which - 

    (8) Where a Primary Care Trust is considering removing a doctor from its services list under paragraphs (3) to (6) or regulations 8(2), 12(3)(c) or 15(6)(b) or contingently removing a doctor under regulation 12(1), it shall give him - 

    (9) If there are no representations within the period specified in paragraph (8)(c), the Primary Care Trust shall inform the doctor of - 

within 7 days of making that decision.

    (10) If there are representations, the Primary Care Trust must take them into account before reaching its decision, and shall then notify the doctor of - 

within 7 days of making that decision.

    (11) If the doctor requests an oral hearing, this must take place before the Primary Care Trust reaches its decision, and the Primary Care Trust shall then notify the doctor of - 

within 7 days of making that decision.

    (12) When the Primary Care Trust notifies the doctor of any decision, it shall inform him that, if he wishes to exercise a right of appeal, he must do so within the period of 28 days beginning with the date on which the Primary Care Trust informed him of its decision and shall tell him how to proceed with any appeal.

    (13) The Primary Care Trust shall also notify the doctor of his right to have the decision reviewed in accordance with regulation 14.

    (14) Where the Primary Care Trust decides to remove a doctor under paragraph (6), the doctor shall not be removed from its services list for a period of three months, starting on the date - 

whichever is the later.

Criteria for a decision on removal
     11.  - (1) Where a Primary Care Trust is considering whether to remove a doctor from its services list under regulation 10(2) and (4)(c) (an unsuitability case), it shall - 

    (2) The matters referred to in paragraph (1) are - 

    (3) Where a Primary Care Trust is considering removal of a doctor from its services list under regulation 10(3) and (4)(b) it shall consider - 

    (4) The matters referred to in paragraph (3)(c) are - 

    (5) Where a Primary Care Trust is considering removal of a doctor from its services list under regulation 10(3) and (4)(a) ("an efficiency case"), it shall - 

    (6) The matters referred to in paragraph (5)(c) are - 

    (7) In making any decision under regulation 10, the Primary Care Trust shall take into account the overall effect of any relevant incidents and offences relating to the doctor of which it is aware, whichever condition it relies on.

    (8) When making a decision on any condition in regulation 10(6), the Primary Care Trust shall state in its decision on which condition it relies.

Contingent removal
     12.  - (1) In an efficiency case or a fraud case the Primary Care Trust may, instead of deciding to remove a doctor from its services list, decide to remove him contingently.

    (2) If it so decides, it must impose such conditions as it may decide on his inclusion in its services list with a view to - 

    (3) If the Primary Care Trust determine that the doctor has failed to comply with a condition, it may decide to - 

Suspension
    
13.  - (1) If a Primary Care Trust is satisfied that it is necessary to do so for the protection of members of the public or is otherwise in the public interest, it may suspend a doctor from its services list - 

    (2) In a case falling within paragraph (1)(a), the Primary Care Trust must specify a period, not exceeding six months, as the period of suspension.

    (3) In a case falling within paragraph (1)(b), the Primary Care Trust may specify that the doctor remains suspended after the decision referred to in that paragraph has been made for an additional period, not exceeding six months.

    (4) The period of suspension may extend beyond six months if - 

    (5) If the FHSAA does so order, it shall specify - 

    (6) The FHSAA may, on the application of the Primary Care Trust, make a further order (complying with paragraph (5)) at any time while the period of suspension pursuant to the earlier order is still continuing.

    (7) If the Primary Care Trust suspends a doctor in a case falling within paragraph (1)(c) or (d), the suspension has effect from - 

    (8) The Primary Care Trust may extend the period of suspension under paragraph (2) or impose a further period of suspension under paragraph (3), so long as the aggregate does not exceed six months.

    (9) The effect of a suspension is that while a doctor is suspended under these Regulations he is to be treated as not being included in the Primary Care Trust's services list, even though his name appears in it.

    (10) The Primary Care Trust may at any time revoke the suspension and inform the doctor of its decision.

    (11) Where a Primary Care Trust is considering suspending a doctor or varying the period of suspension under this regulation, it shall give the doctor - 

    (12) If the doctor does not wish to have an oral hearing or does not attend the oral hearing, the Primary Care Trust shall inform him of its decision and the reasons for it (including any facts relied upon).

    (13) If an oral hearing does take place, the Primary Care Trust shall take into account any representations made before it reaches its decision.

    (14) The Primary Care Trust may suspend the doctor with immediate effect following the hearing.

    (15) The Primary Care Trust shall notify the doctor of its decision and the reasons for it (including any facts relied upon) within 7 days of making that decision.

    (16) The Primary Care Trust shall inform the doctor of any right of review under regulation 14.

    (17) During a period of suspension payments may be made to or in respect of the doctor in accordance with a determination by the Secretary of State.

Reviews
    
14.  - (1) A Primary Care Trust may, and if requested in writing to do so by the doctor shall, review its decision to - 

    (2) A doctor may not request a review of a Primary Care Trust's decision until the expiry of a three month period beginning with the date of the Primary Care Trust's decision or, in the case of a conditional inclusion under regulation 8, beginning with the date the Primary Care Trust includes the doctor's name in the services list.

    (3) After a review has taken place, the doctor cannot request a further review before the expiry of six months from the date of the decision on the last review.

    (4) If a Primary Care Trust decides to review its decision under this regulation to conditionally include, contingently remove or suspend a doctor, it shall give the doctor - 

    (5) If there are no representations within the period specified in paragraph (4)(c), the Primary Care Trust shall inform the doctor of its decision, the reasons for it (including any facts relied upon) and of any right of appeal under regulation 15.

    (6) If there are representations, the Primary Care Trust must take them into account before reaching its decision.

    (7) The Primary Care Trust shall notify the doctor of - 

within 7 days of making that decision.

    (8) If a Primary Care Trust decides to review its decision to impose conditions under regulation 9, the Primary Care Trust may vary the conditions, impose different conditions, remove the conditions or remove the doctor from its services list.

    (9) If a Primary Care Trust decides to review its decision to impose a contingent removal under regulation 12, the Primary Care Trust may vary the conditions, impose different conditions, or remove the doctor from its services list.

    (10) If a Primary Care Trust decides to review its decision to suspend a doctor under regulation 13(1)(a) or (b), the Primary Care Trust may decide to impose conditions or remove the doctor from its services list.

    (11) A Primary Care Trust may not review its decision to suspend a doctor under regulation 13(1)(c) or (d).

Appeals
    
15.  - (1) A doctor may appeal (by way of redetermination) to the FHSAA against a decision of a Primary Care Trust mentioned in paragraph (2) by giving notice in writing to the FHSAA.

    (2) The Primary Care Trust decisions in question are - 

    (3) On appeal the FHSAA may make any decision which the Primary Care Trust could have made.

    (4) Where the decision of the FHSAA on appeal is that the appellant's inclusion in the services list is to be subject to conditions, whether or not those conditions are identical with the conditions imposed by the Primary Care Trust, the Primary Care Trust shall ask him to notify it within 28 days of the decision (or such longer period as the Primary Care Trust may agree) whether he wishes to be included on the services list subject to those conditions.

    (5) If the doctor notifies the Primary Care Trust that he does wish to be included in the services list subject to the condition or conditions, the Primary Care Trust shall so include him.

    (6) Where the FHSAA on appeal decides to impose a contingent removal - 

Notification
    
16.  - (1) Where a Primary Care Trust - 

it shall notify the persons or bodies specified in paragraph (2), and shall additionally notify those specified in paragraph (3), if requested to do so by those persons or bodies in writing (including electronically), of the matters set out in paragraph (4).

    (2) Where paragraph (1) applies, a Primary Care Trust shall notify - 

    (3) The persons or bodies to be additionally notified in accordance with paragraph (1) are persons or bodies that can establish that they are or were employing or that they are considering employing the doctor in a professional capacity.

    (4) The matters referred to in paragraph (1) are - 

    (5) The Primary Care Trust shall send to the doctor concerned a copy of any information about him provided to the persons or bodies listed in paragraph (2) or (3), and any correspondence with that person or body relating to that information.

    (6) Where the Primary Care Trust has notified any of the persons or bodies specified in paragraph (2) or (3) of the matters set out in paragraph (4), it may, in addition, if requested by that person or body, notify that person or body of any evidence that was considered, including any representations from the doctor.

    (7) Where a Primary Care Trust is notified by the FHSAA that it has imposed a national disqualification on a doctor who was, or had applied to be included, in its services list, it shall notify the persons or bodies listed in paragraph (2)(b), (g) and (h) and paragraph (3).

    (8) Where a decision is changed on review or appeal, or a suspension lapses, the Primary Care Trust shall notify the persons or bodies that were notified of the original decision of the later decision or the fact that that suspension has lapsed.

Amendment of or withdrawal from services list
    
17.  - (1) A doctor shall, unless it is impracticable for him to do so, give notice to the Primary Care Trust within 28 days of any occurrence requiring a change in the information recorded about him in the services list and of any change of his private address.

    (2) Where a doctor intends to withdraw from the services list, unless it is impracticable for him to do so, he shall give notice in writing to the Primary Care Trust at least three months in advance of that date.

    (3) A doctor shall give notice in writing to the Primary Care Trust that he intends to withdraw from its services list if he is accepted on to the medical list or supplementary list of the Primary Care Trust, or on to any list of another Primary Care Trust.

    (4) The Primary Care Trust shall on receiving notice - 

    (5) A doctor may withdraw a notice given pursuant to paragraph (1) or (2) at any time before the Primary Care Trust removes his name from its services list.

    (6) A notice given pursuant to paragraph (3) may not be withdrawn.

Restrictions on withdrawal from list
    
18.  - (1) Where a Primary Care Trust is investigating a doctor - 

the doctor may not withdraw from any list kept by a Primary Care Trust in which he is included, except where the Secretary of State has given his consent, until the matter has been finally determined by the Primary Care Trust.

    (2) Where a Primary Care Trust has decided to remove a doctor from its services list under regulation 10(3) to (6) or to contingently remove him from it under regulation 12, but has not yet given effect to its decision, the doctor may not withdraw from any list kept by a Primary Care Trust in which he is included, except where the Secretary of State has given his consent.

    (3) Where a Primary Care Trust has suspended a doctor under regulation 13(1)(b), the doctor may not withdraw from any list kept by a Primary Care Trust in which he is included, except where the Secretary of State has given his consent, until the decision of the relevant court or body is known and the matter has been considered and finally determined by the Primary Care Trust.

Review periods on national disqualification
    
19. The period for review shall be the different period specified below, instead of that in section 49N(8)[40], where the circumstances are that - 

Disclosure of information
     20. The Primary Care Trust may disclose information supplied to it or acquired by it pursuant to these Regulations to any of the following - 

Transitional provisions
    
21.  - (1) Subject to paragraphs (3), (4), (5), (6) and (9), any doctor, who was performing personal medical services on 2nd November 2003, may continue to do so, notwithstanding regulation 3(2), until - 

whichever is the earlier, provided that that doctor applies, in accordance with these Regulations, to a Primary Care Trust to be included in its services list not later than 3rd December 2003.

    (2) Subject to paragraphs (3), (4), (5), (6) and (9), any doctor, not falling within paragraph (1), who has applied to be included in a services list on or before 3rd December 2003, may perform personal medical services after the date of that application, notwithstanding regulation 3(2), until - 

whichever is the earlier.

    (3) Any doctor to whom paragraph (1) or (2) applies shall comply with regulation 9, if any of the events therein specified occur, as though he were included in the services list of a Primary Care Trust in whose area he is performing personal medical services.

    (4) A doctor may not perform personal medical services by virtue of paragraph (1) or (2) during any period in which he is the subject of a suspension notice given by a Primary Care Trust under paragraph (5)[
a].

    (5) A Primary Care Trust may give a suspension notice to a doctor to whom paragraph (1) or (2) applies where it is satisfied that it is necessary to do so for the protection of members of the public or is otherwise in the public interest.

    (6) A Primary Care Trust may withdraw a suspension notice it has given under paragraph (5)[a] at any time.

    (7) During a period of suspension payments may be made to or in respect of the doctor by the Primary Care Trust in accordance with a determination by the Secretary of State.

    (8) Where a Primary Care Trust - 

it shall immediately decide the doctor's application to be included in its services list.

    (9) A Primary Care Trust may publish a list of doctors whose applications it has approved for inclusion in its services list prior to 3rd February 2004.

    (10) In this regulation any reference to a doctor performing personal medical services shall be taken as including a doctor, whose name was not included in either a medical list or a supplementary list on 2nd November 2003, but who was assisting in the provision of general medical services on that date, when named as a performer of personal medical services in an agreement under section 2 of the Primary Care Act (provision of personal medical services under a pilot scheme)[41].



PART II

AMENDMENTS TO THE SUPPLEMENTARY LIST REGULATIONS

Interpretation
     22. In this Part "the Supplementary List Regulations" means the National Health Service (General Medical Services Supplementary List) Regulations 2001[42].

Amendment of regulation 2
     23.  - (1) Regulation 2 (interpretation) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) For the definitions of "equivalent body", "licensing or regulatory body", "professional registration number" and "services list" there shall be substituted respectively the following - 

    (3) The following definitions shall be inserted at the appropriate alphabetical place - 

    (4) The definitions of "General Practice (GP) Registrar" and "National Health Service Counter Fraud Service" shall be omitted.

Amendment of regulation 3
     24.  - (1) Regulation 3 (supplementary list) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) After paragraph (1) there shall be inserted the following paragraph - 

    (3) In paragraph (2) - 

Amendment of regulation 4
    
25.  - (1) Regulation 4 (application for inclusion in the supplementary list) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) For paragraph (1) there shall be substituted the following paragraph - 

    (3) In paragraph (2) - 

    (4) In paragraph (3) - 

    (5) After paragraph (3) there shall be inserted the following paragraph - 

    (6) In paragraph (4), there shall be - 

    (7) In paragraph (5) "to his knowledge", in the first place where it occurs, shall be deleted.

    (8) At the end there shall be added the following paragraphs - 

Amendment of regulation 5
     26. Regulation 5 (readmission) of the Supplementary List Regulations shall be re-numbered as regulation 5(1) and to it there shall be added the following paragraph - 

Amendment of regulation 6
    
27.  - (1) Regulation 6 (grounds for refusal) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (1) - 

    (3) In paragraph (2) - 

    (4) In paragraph (3) - 

    (5) At the end of paragraph (4)(f) there shall be added "or, if it had been committed in England or Wales, would have applied; and".

Amendment of regulation 7
     28.  - (1) Regulation 7 (deferment of decision on application) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (1) - 

    (2) For paragraph (4) there shall be substituted - 

Amendment of regulation 8
    
29.  - (1) Regulation 8 (conditional inclusion) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) For paragraph (2) there shall be substituted - 

    (3) In paragraph (3)(c) there shall be omitted "calendar".

    (4) At the end of each of paragraphs (4), (5) and (6) there shall be added the words "within 7 days of making that decision".

Amendment of regulation 9
    
30.  - (1) Regulation 9 (requirements with which a doctor on the supplementary list must comply) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (1) - 

    (3) In paragraph (2), in the first place where it occurs, "to his knowledge" shall be deleted and for sub-paragraph (f) there shall be substituted - 

    (4) At the end there shall be added the following paragraph - 

Amendment of regulation 10
     31.  - (1) Regulation 10 (removal from supplementary list) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (1) there shall be inserted, after sub-paragraph (g), the following - 

    (3) In paragraph (2), after "shall remove the doctor", there shall be inserted "from its supplementary list".

    (4) In paragraph (6), after "may also remove a doctor", there shall be inserted "from its supplementary list".

    (5) For paragraph (8)(a) there shall be substituted - 

    (6) At the end of each of paragraphs (11), (12) and (13) there shall be added "within 7 days of making that decision".

Amendment of regulation 11
     32.  - (1) Regulation 11 (criteria for removal) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) For paragraph (1) there shall be substituted the following paragraph - 

    (3) In paragraph (2) - 

    (4) For paragraph (3) there shall be substituted - 

    (5) In paragraph (4) - 

    (6) For paragraph (5) there shall be substituted the following paragraph - 

    (7) In paragraph (6) - 

Amendment of regulation 13
     33. In regulation 13 of the Supplementary List Regulations (suspension) - 

Amendment of regulation 14
    
34. In regulation 14 (reviews) of the Supplementary List Regulations there shall be added - 

Amendment of regulation 16
    
35.  - (1) Regulation 16 (notification) of the Supplementary List Regulations shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (2) - 

    (3) For sub-paragraph (4)(a) there shall be substituted - 

    (4) At the end of paragraph (8) there shall be added "or the fact that that suspension has lapsed".

Amendment of regulation 17
    
36. For regulation 17(4)(c) of the Supplementary List Regulations (amendment or withdrawal from list) there shall be substituted - 

Disclosure of Information
    
37. At the end of the Supplementary List Regulations there shall be added the following regulation - 



PART III

AMENDMENTS TO THE MEDICAL REGULATIONS

Interpretation
    
38. In this Part "the Medical Regulations" means the National Health Service (General Medical Services) Regulations 1992[62].

Amendment of regulation 2
     39.  - (1) Regulation 2 of the Medical Regulations (interpretation)[63] shall be amended in accordance with the following provisions of this regulation.

    (2) For the definition of "equivalent body", "GP Registrar", "licensing or regulatory body" and "Medical Supplementary List" there shall be substituted respectively - 

    (3) The following definitions shall be inserted at the appropriate alphabetical place - 

    (4) The definition of "the National Health Service Counter Fraud Service" shall be omitted.

Amendment of regulation 6
     40.  - (1) Regulation 6 of the Medical Regulations (amendment of or withdrawal from the medical list)[68] shall be amended in accordance with the following provisions of this regulation.

    (2) After paragraph (2) there shall be inserted the following paragraph - 

    (3) At the end of paragraph (3) there shall be added - 

    (4) After paragraph (4) there shall be inserted the following paragraph - 

Amendment of regulation 7
     41. In regulation 7(1) of the Medical Regulations (removal from the medical list)[69] there shall be inserted, after sub-paragraph (c), the following sub-paragraphs - 

Amendment of regulation 7B
     42.  - (1) Regulation 7B of the Medical Regulations (criteria for decisions on removal)[70] shall be amended in accordance with the following provisions of this regulation.

    (2) For paragraph (1) there shall be substituted the following paragraph - 

    (3) In paragraph (2), for "criteria" there shall be substituted "matters" and, for sub-paragraphs (b) to (f), there shall be substituted - 

    (4) For paragraph (3) there shall be substituted - 

    (5) In paragraph (4) there shall be substituted - 

    (6) For paragraph (5) there shall be substituted - 

    (7) In paragraph (6) - 

Amendment of regulation 7D
     43.  - (1) Regulation 7D of the Medical Regulations (notifications)[72] shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (2) - 

    (3) For sub-paragraph (4)(a) there shall be substituted - 

    (4) For paragraph (7) there shall be substituted - 

Amendment of regulation 7E
     44. At the end of each of paragraphs (4), (5) and (6) of regulation 7E of the Medical Regulations (procedure on removal)[73] there shall be added "within 7 days of making that decision".

Amendment of regulation 7F
     45. At the end of each of paragraphs (2) and (5) of regulation 7F of the Medical Regulations (procedure on suspension)[74] there shall be added "within 7 days of making that decision".

Amendment of regulation 7G
     46. At the end of regulation 7G(5) of the Medical Regulations (procedure on review)[75] there shall be added "within 7 days of making that decision".

Amendment of regulation 18E
     47. For regulation 18E(1)(f) of the Medical Regulations (criteria for approval and nomination)[76] there shall be substituted the following sub-paragraphs - 

Amendment of regulation 18EE
     48.  - (1) Regulation 18EE of the Medical Regulations (grounds for refusal)[77] shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph (1) - 

    (3) At the end of paragraph (3)(f) there shall be added "or, if it had been committed in England or Wales, would have applied".

Amendment of regulation 18EF
     49. Paragraph (1) of regulation 18EF of the Medical Regulations (deferment of decision)[78] shall be amended by - 

Amendment of regulation 18M
     50. After regulation 18M(15)(f) of the Medical Regulations (conditional inclusion)[79] there shall be inserted the following sub-paragraph - 

Amendment of regulation 35
     51. At the end of regulation 35(2) of the Medical Regulations (recovery of overpayments)[80] there shall be added ", except to the extent that the Secretary of State has determined otherwise pursuant to regulation 11(1) of the National Health Service (Service Committees and Tribunal) Regulations 1992[81]".

Amendment of Schedule 2
     52.  - (1) Schedule 2 to the Medical Regulations (terms of service for doctors)[82] shall be amended in accordance with the following provisions of this regulation.

    (2) In paragraph 23A - 

    (3) In paragraph 36A - 

    (4) After paragraph 36B there shall be inserted the following paragraph - 

Amendment of Part III of Schedule 3
     53. In paragraph 6A of Part III of Schedule 3 to the Medical Regulations (information and undertakings to be given by a practitioner in connection with an application)[86] - 


Rosie Winterton
Minister of State Department of Health

10th October 2003



EXPLANATORY NOTE

(This note is not part of the Regulations)


These Regulations provide for a services list for performing personal medical services to be kept by Primary Care Trusts in accordance with the provisions of section 8ZA of the National Health Service (Primary Care) Act 1997.

Regulation 2 provides some definitions for the Regulations.

Regulation 3 provides that each Primary Care Trust must prepare and publish a services list. It also provides that no doctor may perform personal medical services unless included in such a list.

Regulation 4 sets out how to apply to be included in the list and requires certain information to be given. It relaxes those requirements, in respect of any information already provided, for a doctor who is in the medical or supplementary list of that Trust.

Regulation 5 provides for a doctor to be readmitted to the services list on a successful appeal against conviction.

Regulation 6 sets out the grounds on which the Primary Care Trust may or must refuse to admit a doctor to the services list, and the matters to which it must have regard.

Regulation 7 sets out the circumstances in which a Primary Care Trust may defer consideration of an application to include a doctor in the services list and the procedure to be followed.

Regulation 8 allows Primary Care Trusts to enter a doctor's name in the services list subject to condition. It also allows a doctor's name to be included in that list, until any appeal has been decided, provided he agrees to be bound by the condition until the appeal is determined.

Regulation 9 provides for a requirement that a doctor notify the Primary Care Trust in writing, within 7 days, if he, or a company of which he is a director, incurs any criminal convictions or other specified matters occur.

Regulation 10 provides for the mandatory removal from its services list by a Primary Care Trust of any doctor convicted of murder or of a criminal offence and sentenced to over 6 months, and for the discretionary removal on specified grounds.

Regulation 11 sets out the criteria for decisions on discretionary removals from the services list.

Regulation 12 provides for a Primary Care Trust to impose conditions on a doctor who is in the services list and for him to be removed if he fails to comply with those conditions.

Regulation 13 provides for a Primary Care Trust to suspend a doctor from the services list, if certain conditions are met, for the procedure to be then followed and provides for payment to suspended doctors.

Regulation 14 provides for review and the procedure to be followed by Primary Care Trusts where the Primary Care Trust decides to conditionally include, contingently remove, or suspend a doctor from the services list.

Regulation 15 provides for appeals from specified decisions to be heard by the FHSAA.

Regulation 16 provides for a Primary Care Trust to notify specified persons of specified information relating to decisions to refuse to admit, impose conditions, remove (or contingently remove) or suspend a doctor from the services list.

Regulation 17 provides for the circumstances in which a doctor may or may not withdraw from the services list and regulation 18 provides for the circumstances in which a doctor may not withdraw from the services list.

Regulation 19 amends the statutory period for review set out in section 49N of the National Health Service Act 1977 in specified circumstances.

Regulation 20 provides for the disclosure of information to specified persons.

Regulation 21 makes transitional provision for doctors, already performing personal medical services before the coming into force of these Regulations, to continue to do so for a period of not more than three months, while their applications for inclusion in a services list are determined. It also makes like provision for those applying for inclusion in a list in the first month after the coming into force of these Regulations.

Part II (regulations 22 to 37) amends the National Health Service (General Medical Services Supplementary List) Regulations 2001 to ensure like provision in relation to supplementary lists to that provided in these Regulations for services lists.

Part III (regulations 38 to 53) amends the National Health Service (General Medical Services) Regulations 1992 to ensure like provision in relation to medical lists to that provided in these Regulations for services lists. It also provides for doctors to report any deaths on their practise premises to the Primary Care Trust and clarifies the position on the duty to recover overpayments.


Notes:

[1] 1977 c. 49; see section 128(1) as amended by the National Health Service and Community Care Act 1990 (c. 19) ("the 1990 Act"), section 26(2)(g) and (i), for the definitions of "prescribed" and "regulations". Section 29 was amended by the Health Services Act 1980 (c. 53), s.7; the Health and Social Services and Social Security Adjudications Act 1983 (c. 41), Schedule 6, paragraph 2; the Medical Act 1983 (c. 54), Schedule 5, paragraph 16; S.I. 1985/39; the Schedule to the Medical (Professional Performance) Act 1995, (c. 51) ("the 1995 Act"); the National Health Service (Primary Care) Act 1997 (c. 46) ("the 1997 Act"), Schedule 2, paragraph 71; the Health and Social Care Act 2001 (c. 15) ("the 2001 Act"), s.23, Schedule 6, part I and Schedule 8, paragraphs 1 and 2 and the National Health Service and Health Care Professions Act 2002 (c. 17) ("the 2002 Act"), Schedule 2, paragraphs 1 and 3. Section 29A was inserted by the 1997 Act, s. 32(1) and amended by the Health Act 1999 (c. 8) ("the 1999 Act"), s. 9(2) and Schedule 4, paragraphs 4 and 17; the 2001 Act, s. 20 and Schedule 5, paragraph 5 and the 2002 Act, Schedule 2, paragraphs 1 and 4. Section 29B was inserted by the 1997 Act, s. 32(1) and amended by the 2001 Act, sections 15 and 20 and the 2002 Act, Schedule 2, paragraphs 1 and 5. Sections 43ZA and 43D were inserted by the 2001 Act, sections 21 and 24 and amended by the 2002 Act, Schedule 2, paragraphs 1, 18 and 20. Sections 49F, 49I, 49L, 49N, 490, 49P and 49Q were inserted by the 2001 Act, s. 25 and amended by the 2002 Act, Schedule 2, paragraphs 1, 21, 23, 25, 26, 27 and 28. Section 126(4) was amended by the 1990 Act, section 65(2); by the 1999 Act, Schedule 4, paragraph 37(6) and by the 2001 Act, Schedule 5, paragraph 5(13)(b). As regards Wales, the functions of the Secretary of State under section 29 and 126(4) of the 1977 Act are transferred to the National Assembly for Wales under article 2 of, and Schedule 1 to, the National Assembly for Wales (Transfer of Functions) Order 1999, S.I. 1999/672; section 68 of the 2001 Act provides that Schedule 1 shall be construed so as to include the amendments made by that Act to the 1977 Act; these Regulations therefore extend only to England.back

[2] 1997 c. 46; section 2 was amended by the 1999 Act, section 65(1) and Schedule 4, paragraph 88(1) and (3)(a). Section 8ZA was inserted by section 26(2) of the 2001 Act and amended by the 2002 Act, Schedule 3, paragraph 3. Section 9 was amended by the 1999 Act, section 65(1) and Schedule 4, paragraph 88(1) and (5)(a) and (b).back

[3] 2001 c. 15.back

[4] S.I. 2001/3744.back

[5] S.I. 2002/1920.back

[6] Sections 49G to 49R were inserted by section 25 of the 2001 Act and amended by the 2002 Act, Schedule 2, paragraphs 21 to 28.back

[7] Section 49S was inserted by the 2001 Act, section 27(1) and amended by the 2002 Act, Schedule 1, paragraph 18.back

[8] Sections 49F and 49H were inserted by the 2001 Act, section 25; section 49F was amended by the 2002 Act, Schedule 2, paragraph 21.back

[9] 1983 c. 54.back

[10] S.I. 1992/635.back

[11] The NCAA was established by S.I. 2000/2961; section 11 was amended by the 1995 Act, Schedule 1, paragraphs 1 and 2 and by the 1999 Act, section 65 and Schedule 4, paragraphs 4 and 6.back

[12] S.I 2002/3039. The NHS Counter Fraud and Security Management Service replaces the National Health Service Counter Fraud Service.back

[13] 1997 c. 46.back

[14] S.I. 2001/3740; amended by S.I. 2002/848, 1920 and 2469.back

[15] Section 46 was revoked by the 2001 Act, s. 67, Schedule 5, paragraph 5 and Schedule 6, part I.back

[16] See S.I. 2001/3738, article 2(5) and (6)(b), which sets out the prescribed cases for England and S.I. 2002/1919, article 2(2) and (3)(b), which sets out the prescribed cases for Wales.back

[17] S.I. 1997/2817, as amended by S.I. 1998/669.back

[18] Relevant amendments to sections 15 and 21 are S.I. 1996/1591 and s. 41(10) of and paragraph 61(1) and (4) to the 1997 Act.back

[19] Relevant amendments are s. 35(1) and (4) of the 1997 Act.back

[20] Section 31 was amended by the 1997 Act, section 32(3).back

[21] S.I. 1994/3130, as amended by S.I. 1998/669.back

[22] 1995 c. 46.back

[23] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[24] Section 36 was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 5 and by S.I. 2000/1803, articles 2 and 5.back

[25] Section 37 was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 6 and by S.I. 2000/1803, articles 2 and 7.back

[26] Section 36A was inserted by the 1995 Act, section 1 and amended by S.I. 2000/1803, articles 2 and 6 and paragraph 5A of Schedule 4 was added by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 20.back

[27] Section 41A was inserted by S.I. 2000/1803, articles 2 and 10.back

[28] S.I. 1994/3130; regulation 5 was amended by S.I. 1998/669.back

[29] 1997 c. 51.back

[30] 1995 c. 46.back

[31] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[32] 1997 c. 50.back

[33] Section 36 was amended by S.I. 2000/1803.back

[34] Section 38(1) was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 7.back

[35] 1984 c. 22.back

[36] 1952 c. 52.back

[37] Section 37 was amended by paragraphs 1 and 6 of the Schedule to the 1995 Act and by S.I. 2000/1803, articles 2 and 7.back

[38] Section 41A was inserted by S.I. 2000/1803, articles 2 and 10.back

[39] 1997 c. 51.back

[40] Section 49N was inserted by section 25 of the 2001 Act.back

[41] Section 2 was amended by the 1999 Act, Schedule 3, paragraph 88.back

[42] S.I. 2001/3740; amended by S.I. 2002/848, 1920 and 2469.back

[43] Section 49N was inserted by section 25 of the 2001 Act.back

[44] Regulation 4 was amended by S.I. 1996/702, 1998/682, 2838, 2001/3742, 2002/554 and 2469.back

[45] S.I. 1992/ 635.back

[46] S.I. 2002/3039. The NHS Counter Fraud and Security Management Service replaces the National Health Service Counter Fraud Service.back

[47] S.I. 2003/2644.back

[48] S.I. 1997/2817, as amended by S.I. 1998/669.back

[49] Section 31 was amended by the 1997 Act, section 32(3).back

[50] S.I. 1994/3130, as amended by S.I. 1998/669.back

[51] 1995 c. 46.back

[52] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[53] Section 36 was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 5 and by S.I. 2000/1803, articles 2 and 5.back

[54] Section 37 was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 6 and by S.I. 2000/1803, articles 2 and 7.back

[55] Section 36A was inserted by the 1995 Act, section 1 and amended by S.I. 2000/1803, articles 2 and 6 and paragraph 5A of Schedule 4 was added by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 20.back

[56] Section 41A was inserted by S.I. 2000/1803, articles 2 and 10.back

[57] 1995 c. 46.back

[58] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[59] 1997 c. 50.back

[60] Section 37 was amended by paragraphs 1 and 6 of the Schedule to the 1995 Act and by S.I. 2000/1803, articles 2 and 7.back

[61] 1997 c. 51.back

[62] 1992/635.back

[63] Regulation 2 was amended, in relation to England, by S.I. 1997/2468, 1998/682, 2838, 1999/326, 2001/3742, 2002/554, 682, 1920, 2469, 2861 and 3135.back

[64] S.I. 1997/2817, as amended by S.I. 1998/669.back

[65] S.I. 2002/3039. The NHS Counter Fraud and Security Management Service replaces the National Health Service Counter Fraud Service.back

[66] S.I. 2003/2644.back

[67] S.I. 2001/3740; amended by S.I. 2002/848, 1920 and 2469.back

[68] Regulation 6 was amended, in relation to England, by S.I. 1998/2838, 2001/3742, 2002/554, and 2469.back

[69] Regulation 7 was amended, in relation to England, by S.I. 1995/3093, 2000/220, 2001/3742, 2002/2469, and 3135.back

[70] Regulation 7B was inserted, in relation to England, by S.I. 2001/3742 and amended by S.I. 2002/554 and 2469.back

[71] 1997 c. 51.back

[72] Regulation 7D was inserted, in relation to England, by S.I. 2001/3742 and amended by S.I. 2002/554 and 2469.back

[73] Regulation 7E was inserted, in relation to England, by S.I. 2001/3742 and amended by S.I. 2002/554 and 2469.back

[74] Regulation 7F was inserted, in relation to England, by S.I. 2001/3742 and amended by S.I. 2002/554 and 2469.back

[75] Regulation 7G was inserted, in relation to England, by S.I. 2001/3742 and amended by S.I. 2002/2469.back

[76] Regulation 18E was inserted by S.I. 1998/2828 and amended by S.I. 2000/220, 2001/3742, 2002/554, 2469 and 3135.back

[77] Regulation 18EE was inserted, in relation to England, by S.I. 2001/ 3742 and amended by S.I. 2002/554 and 2469.back

[78] Regulation 18EF was inserted, in relation to England, by S.I. 2001/ 3742 and amended by S.I. 2002/554 and 2469.back

[79] Regulation 18F was inserted by S.I. 1998/2838 and amended by S.I. 2001/3742, 2002/554 and 2469.back

[80] Regulation 35(2) was amended by S.I. 2001/3742 and 2002/2469.back

[81] S.I. 1992/664.back

[82] Schedule 2 was amended by S.I. 1993/540, 1994/633, 3130, 1995/80, 3093, 1996/702, 1997/730, 2468, 1998/682, 1664, 2383, 1999/326, 2000/2383, 2001/706, 2890, 3742, 2002/551, 2469, 2548, 2861, 2890, 3135 and 2003/26.back

[83] 1995 c. 46.back

[84] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[85] 1997 c. 50.back

[86] Paragraph 6A was inserted by S.I. 2000/220 and amended, in relation to England, by S.I. 2001/3742.back


[a] Amended by Correction Slip. On page 22, in regulation 21(4) and (6), replace the bracketed (6) witha bracketed (5). back




ISBN 0 11 047894 0


  Prepared 16 October 2003


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