NATIONAL HEALTH SERVICE Citation, commencement and interpretation 1 1 These Regulations may be cited as the National Health Service (General Medical Services Contracts) (Scotland) Amendment Regulations 2005 and shall come into force on 1st July 2005. 2 In these Regulations, “the principal Regulations ” means the National Health Service (General Medical Services Contracts) (Scotland) Regulations 2004 . Amendment of regulation 2 of the principal Regulations 2 1 Regulation 2(1) (interpretation) of the principal Regulations is amended as follows. 2 In the definition of “general medical practitioner”– a after “means” insert “, unless the context otherwise requires”; b in sub-paragraph (a), omit “otherwise than by virtue of paragraph 1(d) of Schedule 6 to that Order”; c in sub-paragraph (b)(i) before “; or” insert “or a person who has an acquired right to practise as a general medical practitioner pursuant to regulation 5(1)(d) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994 ”; and d in sub-paragraph (b)(ii) omit “other than by virtue of having an acquired right under paragraph 1(d) of Schedule 6 to the 2003 Order”. 3 For the definition of “ GP Registrar”, substitute– “GP Registrar” means a medical practitioner who is being trained in general practice by– until the coming into force for all purposes of article 4(5)(d) of the 2003 Order, a general medical practitioner who– has been approved for that purpose by the Joint Committee on Postgraduate Training for General Practice under regulation 7 of the National Health Service (Vocational Training for General Medical Practice) (Scotland) Regulations 1998 ; and performs primary medical services; and from the coming into force for all purposes of that article, a general medical practitioner who is approved under that article for the purpose of providing training under article 5(1)(c)(i) of the 2003 Order, whether as part of training leading to the award of a CCT or otherwise; . 4 Omit the definition of “GP Trainer”. 5 In the definition of “out of hours services”, in sub-paragraph (a) after “provided” insert “by a contractor to its registered patients” 6 In the definition of “supplementary prescriber”– a in sub-paragraph (b)(ii) omit “or”; and b at the end of sub-paragraph (b)(iii) for “and” in the second place where it occurs, substitute– or iv the part of the register maintained by the Health Professions Council in pursuance of article 5 of the Health Professions Order 2001 relating to– aa chiropodists and podiatrists; bb physiotherapists; or cc radiographers: diagnostic or therapeutic, and . Amendment of regulation 4 of the principal Regulations 3 At the end of regulation 4 (conditions relating solely to medical practitioners) of the principal Regulations insert– 4 In paragraph (1), (2)(a) and (3)(a), “general medical practitioner” does not include– a from the coming into force of article 10 of the 2003 Order , a medical practitioner whose name is included in the General Practitioner Register by virtue of– i paragraph 1(a) of Schedule 6 to that Order by virtue of his having been a restricted services principal included in a list specified in that paragraph; ii paragraph 1(d) of that Schedule; or iii article 11(2) of that Order because of an exemption under regulation 5(1)(d) of the regulations specified in paragraph (5); b until the coming into force of article 10 of the 2003 Order, a medical practitioner who either– i until the coming force of paragraph 22 of Schedule 8 to that Order – aa has an acquired right to practise as a general medical practioner pursuant to regulation 5(1)(a) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994 only by virtue of having been a restricted services principal included in a list specified in that paragraph, or regulation 5(1)(d) of those Regulations; or bb is exempt from the need to be suitably experienced by virtue of regulation 5(1)(d) of the regulations specified in paragraph (5); or ii upon the coming into force of that paragraph of that Schedule to that Order, is an eligible general practitioner pursuant to that paragraph by virtue of an acquired right under the provisions listed in sub-paragraph (a)(i) to (iii). 5 The regulations referred to in paragraph (4)(a)(iii) and (b)(i)(bb) are the National Health Service (Vocational Training for General Medical Practice) (Scotland) Regulations 1998 , the National Health Service (Vocational Training for General Medical Practice) Regulations 1997 and the Medical Practitioners (Vocational Training) Regulations (Northern Ireland) 1998 . 6 In paragraph (4) “restricted services principal” has the same meaning as in the 2003 Order. . Amendment of Schedule 1 to the principal Regulations 4 In paragraph 4(2)(a) (vaccinations and immunisations) of Schedule 1 (additional services) to the principal Regulations, for “influenza vaccination” substitute “influenza and pneumococcal vaccinations”. Amendment of Schedule 5 to the principal Regulations 5 1 Schedule 5 (other contractual terms) to the principal Regulations is amended as follows. 2 After paragraph 1 (premises), insert– Telephone services 1A 1 The contractor shall not be a party to any contract or other arrangement under which the number for telephone services to be used– a by patients to contact the practice for any purpose related to the contract; or b by any other person to contact the practice in relation to services provided as part of the health service, starts with the digits 087, 090 or 091 or consists of a personal number, unless the service is provided free to the caller. 2 In this paragraph, “personal number” means a telephone number which starts with the number 070 followed by a further 8 digits. . 3 In paragraph 31 (rejection of closure notice by the Health Board), after sub-paragraph (7) insert– 7A Subject to sub-paragraph (7B), the contractor’s list of patients shall remain closed for the period specified by the assessment panel in accordance with sub-paragraph (7)(b). 7B The contractor’s list of patients shall re-open before the expiry of the period mentioned in sub-paragraph (7A) if– a the number of the contractor’s registered patients falls to the number specified by the assessment panel in accordance with sub-paragraph (7)(b) as the number of registered patients which, if that number were reached, would trigger the re-opening of the contractor’s list of patients; or b the Health Board and the contractor agree that the list of patients should re-open. 7C If the contractor’s list of patients has re-opened pursuant to sub-paragraph (7B)(a), it shall nevertheless close again if, during the period specified by the assessment panel as the period for which the list should remain closed, the number of the contractor’s registered patients rise to the number specified by the assessment panel in accordance with sub-paragraph (7)(b) as the number of registered patients which, if that number were reached, would trigger the re-closure of the contractor’s list of patients. 7D Except in cases where the contractor’s list of patients is already open pursuant to paragraph (7B), the Health Board shall notify the contractor in writing between seven and fourteen days before the expiry of the closure period specified in paragraph (7A), confirming the date on which the contractor’s list of patients will re-open. . 4 In paragraph 41 (restrictions on prescribing by supplementary prescribers) omit sub-paragraphs (2)(b), (4)(c) and (f) and (6). 5 In paragraph 46(2) (qualifications of performers)– a for paragraph (c) substitute– c a GP Registrar who has applied to the Health Board to have the GP Registrar’s name included in the primary medical services performers list of the Health Board, until the first of the following events arises:– i the Health Board notifies the GP Registrar of the Board’s decision on that application; ii the end of a period of 2 months, starting with the date on which the GP Registrar’s vocational training scheme begins. ; and b at the end insert– 3 In this paragraph, “vocational training scheme” has the meaning given in regulation 2 (interpretation) of the National Health Service (Primary Medical Services Performers Lists) (Scotland) Regulations 2004 . . 6 In paragraph 57 (arrangements for GP Registrars) in sub-paragraph (1) omit “for the purpose of being trained by a GP Trainer with the agreement of the Scottish Ministers and”. 7 For paragraph 65(2) (withdrawal and variation of approval under paragraph 63) substitute– 2 A notice served under sub-paragraph (1) shall take effect on the date on which it is received by the contractor. . 8 In paragraph 70 (provision of information), at the end insert– 3 The contractor shall produce the information requested, or as the case may be, allow access to it– a by such date as has been agreed as reasonable between the contractor and the Health Board; or b in the absence of such agreement, within 28 days of the request being made. . 9 In paragraph 73 (annual return and review)– a after sub-paragraph (1), insert– 1A One such return may be requested by the Health Board at any time during each financial year in relation to such period (not including any period covered by a previous annual return) as may be specified in the request. 1B The contractor shall submit the completed return to the Health Board– a by such date as has been agreed as reasonable between the contractor and the Health Board; or b in the absence of such agreement, within 28 days of the request being made. ; and b at the end insert– 6 In this paragraph, “financial year” means the twelve months ending with 31st March. . 10 In paragraph 77 (notice provisions specific to a contract with a company limited by shares)– a after sub-paragraph (1)(a) insert– aa a new director or secretary is appointed; ; and b after sub-paragraph (2) insert– 3 A notice under sub-paragraph (1)(aa) shall confirm that the new director or, as the case may be, secretary meets the conditions imposed on directors and secretaries by virtue of regulation 5. . 11 In paragraph 91(6) ( NHS dispute resolution procedure) at the end insert “under dispute”. 12 After paragraph 95 (termination by agreement), insert– Termination on the death of an individual medical practitioner 95A 1 Where the contract is with an individual medical practitioner and that practitioner dies, the contract shall terminate at the end of the period of seven days after the date of the practitioner’s death unless, before the end of that period– a the Health Board has agreed in writing with the contractor’s personal representatives that the contract should continue for a further period, not exceeding 28 days after the end of the period of seven days; and b the contractor’s personal representatives have consented in writing to the Health Board employing or supplying one or more general medical practitioners to assist in the provision of clinical services under the contract throughout the period for which it continues. 2 In sub-paragraph (1), “general medical practitioner” has the same meaning as in regulation 4(1). 3 Sub-paragraph (1) does not affect any other rights to terminate the contract which the Health Board may have under paragraphs 100 to 103. . 13 In paragraph 100 (termination by the Health Board for the provision of untrue etc. information) for “before the contract” to the end substitute– – a before the contract was entered into; or b pursuant to paragraphs 77(2) or (3) or 78(2), in relation to the conditions set out in regulations 4 and 5 (and compliance with those conditions) was, when given, untrue or inaccurate in a material respect. . 14 In paragraph 107 (termination of the NHS dispute resolution procedure) – a in sub-paragraph (1) for “or 103(4) or (6)” substitute “103(4) or (6), or 104” ; and b in sub-paragraph (5) for “impose the contract sanction” substitute “terminate the contract”. 15 In paragraph 112(3)(b) (insurance) for “an employee of the contractor in connection with clinical services which that employee” substitute “a person employed or engaged by the contractor in connection with clinical services which that person”. Transitional arrangements in relation to conditions in regulation 4 of the principal Regulations 6 1 This regulation applies where, in relation to a general medical services contract entered into before 1st July 2005, the only person who was a general medical practitioner for the purposes of regulation 4(1), (2)(a) or (3)(a) of the principal Regulations before that date, falls from that date within regulation 4(4) of the principal Regulations (as inserted by regulation 3 of these Regulations). 2 A Health Board may not terminate a general medical services contract pursuant to paragraph 99 of Schedule 5 to the principal Regulations on the grounds that the person referred to in paragraph (1) is no longer a general medical practitioner for the purposes of regulation 4(1), (2)(a) or (3)(a) of the principal Regulations. Transitional arrangements in relation to telephone services 7 1 Where– a pursuant to paragraph 94 of Schedule 5 to the principal Regulations, a general medical services contract has been varied to include a term which gives effect to paragraph 1A of Schedule 5 to the principal Regulations (as inserted by regulation 5(2) of these Regulations); and b as a result of that variation, a contractor is, by virtue of a contract or other arrangements for the provision of telephone services which it entered into before the date on which that variation took effect, in breach of its general medical services contract, no action shall be taken against the contractor by the Health Board in respect of that breach, provided the contractor complies with the conditions specified in paragraph (2). 2 The conditions referred to in paragraph (1) are that the contractor– a provides such details of the contract or other arrangement for telephone services as the Health Board may request, within the time specified by the Health Board in that request; and b varies or terminates that contract or other arrangement when required to do so by the Health Board, where the Health Board is acting in accordance with directions from the Scottish Ministers under section 2(5) of the National Health Service (Scotland) Act 1978 . ANDREW P KERR A member of the Scottish Executive St Andrew’s House, Edinburgh 8th June 2005