NATIONAL HEALTH SERVICE, ENGLAND AND WALES Citation, commencement and interpretation 1 1 These Regulations may be cited as the National Health Service (Fund-holding Practices) (Amendment) Regulations 1992 and shall come into force on 1st April 1992. 2 In these Regulations, “the Application Regulations ” means the National Health Service (Fund-holding Practices)(Application and Recognition) Regulations 1990 and “the principal Regulations ” means the National Health Service (Fund-holding Practices)(General) Regulations 1991 . Amendment of regulation 5 of the Application Regulations 2 In regulation 5 of the Application Regulations (grant of recognition as a fund-holding practice), for paragraph (1) there shall be substituted the following paragraph:— 1 A relevant Regional Health Authority shall grant recognition as a fund-holding practice if it is satisfied— a that the conditions specified in regulation 6 are fulfilled; and b that the practice does not include both— i a member who practises in a partnership where the total number of patients on the lists of patients of the medical practitioners in the partnership exceeds 7,000, and ii a member who practises in another such partnership. . Amendment of regulation 6 of the Application Regulations 3 In regulation 6 of the Application Regulations (conditions for obtaining recognition), in paragraph (a) for “9,000” in both places where the figure occurs, there shall be substituted “7,000”. Amendment of regulation 8 of the Application Regulations 4 In regulation 8 of the Application Regulations (appeals to the Secretary of State)— a in paragraph (8), i after sub-paragraph (a) there shall be inserted “and”, and ii sub-paragraphs (c) and (d) shall be omitted; and b after paragraph (8) there shall be added the following new paragraph:— 9 Where the Secretary of State has determined an appeal in accordance with this regulation, he shall— a send to each member of the practice making the appeal and to the relevant Regional Health Authority notice in writing of his decision; and b include in the notice a statement of the reasons for his decision. . Amendment of regulation 3 of the principal Regulations 5 In regulation 3 of the principal Regulations (conditions for continuing recognition)— a in paragraph (2)— i in sub-paragraph (j) for “patient of a member of the practice”, there shall be substituted “an individual who is on the list of patients of a member of the practice”, ii for sub-paragraph (l) there shall be substituted the following sub-paragraph:— l the allotted sum is applied as required by regulations 16 and 17 and is not applied for purposes other than those specified in regulations 16, 17, 19 and 20; , iii after sub-paragraph (m) there shall be inserted the following sub-paragraph:— n where the members of a fund-holding practice employ a person or purchase any services, they first satisfy themselves that the employee has such qualifications, training and experience as are necessary for that employment or, as the case may be, that the provider of the services is suitably competent to provide those services. ; and b in paragraph (3)— i for “In this regulation”, there shall be substituted “For the purposes of this regulation”, ii in sub-paragraph (a) after head (v) there shall be inserted the following:— “or (vi) he provides or has provided any services to that body;”, iii for sub-paragraph (b), there shall be substituted the following sub-paragraph:— b a member of a fund-holding practice shall be treated as having a particular connection with a person if— i he is a close relative of the person, ii he is a partner of the person, iii he is in the employment of the person, or iv he provides or has provided any services to the person; . Amendment of regulation 4 of the principal Regulations 6 For regulation 4 of the principal Regulations (additions to existing fund-holding practices), there shall be substituted the following regulation:— Additions to existing fund-holding practices 4 1 Subject to paragraph (2), where a medical practitioner (whether or not he is a member of another fund-holding practice) wishes to become a member of an existing fund-holding practice— a he and the members of the existing fund-holding practice shall apply to the relevant Regional Health Authority for recognition as a fund-holding practice in accordance with the Application Regulations; but b regulations 4 and 5(2) of the Application Regulations (time of application and grant of recognition as a fund-holding practice) shall not apply in the case of that application. 2 Paragraph (1) shall not apply to a medical practitioner who becomes a partner of a member of a fund-holding practice as a result of the grant of an application made by the medical practitioner to a Family Health Services Authority under regulation 5 of the National Health Service (General Medical Services) Regulations 1992 (application for inclusion in the medical list or to succeed to a vacancy) . 3 Where a medical practitioner becomes a partner of a member of a fund-holding practice as a result of the grant of an application mentioned in paragraph (2), he shall, on giving notice in writing to that effect to the relevant Regional Health Authority, be a member of that fund-holding practice notwithstanding that he did not join in the making of an application under regulation 3 of the Application Regulations. . Amendment of regulation 5 of the principal Regulations 7 In regulation 5 of the principal Regulations (withdrawal of a member of a fund-holding practice), for paragraph (1) there shall be substituted the following paragraph— 1 Where— a a member of a fund-holding practice withdraws from the practice; and b the conditions specified in regulation 3(2) continue to be fulfilled in relation to the practice, of the practice shall not be affected by the withdrawal. . Amendment of regulation 9 of the principal Regulations 8 In regulation 9 of the principal Regulations (consequences of renunciation of recognition), in paragraph (2), for “regulation 4(2)(d), (e), (f), (g), (h) and (l)”, there shall be substituted “regulation 3(2)(d), (e), (f), (g), and (h)”. Amendment of regulation 14 of the principal Regulations 9 In regulation 14 of the principal Regulations (appeals to the Secretary of State) in paragraph (2), for “Regulation 8(2) to (8) of the Application Regulations”, there shall be substituted “Regulation 8(2) to (9) of the Application Regulations”. Amendment of regulation 17 of the principal Regulations 10 In regulation 17 of the principal Regulations (payment for goods and services), for paragraph (1) there shall be substituted the following paragraph:— 1 The members of a fund-holding practice shall apply the allotted sum so as to secure the purchase of such of the goods and services, other than general medical services, referred to in paragraph (2) as are necessary for the proper treatment of individuals on the lists of patients of the members of the practice. . Amendment of regulation 19 of the principal Regulations 11 In regulation 19 of the principal Regulations (payment of salaries) after paragraph (2), there shall be inserted the following new paragraph:— 3 The members of a fund-holding practice may apply the allotted sum for the purpose of paying fees to persons engaged to provide services which are necessary for the proper treatment of individuals who are on the lists of patients of the members of the practice, provided that such persons are engaged to provide those services at the practice premises. . William Waldegrave One of Her Majesty’s Principal Secretaries of State 10th March 1992