National Health Service, England Citation and commencement 1 1 These Regulations may be cited as the Responsibilities and Standing Rules, and Care and Support (Miscellaneous Amendments) Regulations 2018. 2 Save as provided in paragraphs (3) and (4), these Regulations come into force on 1st April 2018. 3 Regulation 2— a paragraphs (2)(a) and (d) and (3), come into force on 1st October 2018; b paragraph (4)(a), comes into force on 1st April 2019; c paragraph (4)(c), (d) and (e), comes into force on 1st April 2020. 4 Regulations 3 and 4 come into force on 1st October 2018. Amendment of the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 2 1 The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 are amended as follows. 2 In regulation 20 (interpretation), in paragraph (1), in the definition of— a “Fast Track Pathway Tool” for “28th November 2012” substitute “1st March 2018”; b “flat rate payment” for “£155.05” substitute “£158.16”; c “high band payment” for “£213.32” substitute “£217.59”; d “National Framework” for “28th November 2012” substitute “1st March 2018”; e “nursing care by a registered nurse” (which is included in the definition of “nursing care”), for “section 49(2) of the Health and Social Care Act 2001” substitute “section 22(8) of the Care Act 2014”; f “regulated activity” for “2010” substitute “2014”. 3 In regulation 21 (duty of relevant bodies: assessment and provision of NHS continuing healthcare)— a in paragraph (4)(a), for “28th November 2012” substitute “1st March 2018” ; b in paragraph (5)(a)(ii), for “28th November 2012” substitute “1st March 2018” ; c in paragraph (13), in the definition of “multi-disciplinary team”, in paragraph (b) for “persons for community care services” substitute “an adult’s needs for care and support”. 4 In Schedule 4 (services for rare and very rare conditions)— a after paragraph 20, insert— 20A Alpha 1 antitrypsin services. ; b after paragraph 36, insert— 36A Clinical genomic services. ; c after paragraph 57, insert— 57ZA Gonadal tissue cryopreservation services for children and young people at high risk of gonadal failure due to treatment or disease. ; d after paragraph 92, insert— 92A Psychological medicine inpatient services for severe and complex presentations of medically unexplained physical symptoms. ; e after paragraph 104, insert— 104A Specialist adult haematology services. ; f omit paragraph 112; g after paragraph 140A, insert— 140AA Termination services for expectant mothers with significant comorbidities that require either or both critical care and medical support. . Amendment of the Care and Support (Provision of Health Services) Regulations 2014 3 In the Care and Support (Provision of Health Services) Regulations 2014 , in regulation 1 (citation, commencement and interpretation), in paragraph (2), in the definition of “National Framework” for “28th November 2012” substitute “1st March 2018”. Amendment of the Care and Support (Assessment) Regulations 2014 4 In the Care and Support (Assessment) Regulations 2014 , in regulation 7 (NHS continuing healthcare), in paragraph (3), for “28th November 2012” substitute “1st March 2018”. Signed by authority of the Secretary of State for Health and Social Care. O’Shaughnessy Parliamentary Under-Secretary of State, Department of Health and Social Care 1st March 2018