NATIONAL HEALTH SERVICE PART I GENERAL Citation, commencement and interpretation 1 1 These Regulations may be cited as the National Health Service (Personal Medical Services) (Scotland) Regulations 2001 and shall come into force on 1st April 2001. 2 In these Regulations, unless the context otherwise requires– “the 1978 Act ” means the National Health Service (Scotland) Act 1978; “an agreement” means an agreement made between a Health Board and a provider pursuant to section 17C of the 1978 Act under which personal medical services are provided; “approved medical practice” means a medical practice approved for the purpose of section 10(2) of the Medical Act 1983 ; “child health surveillance services” means personal medical services which comprise– the monitoring– by the consideration of information concerning the child received by or on behalf of the performer; and on any occasion when the child is examined or observed by or on behalf of the performer, of the health, well-being and physical, mental and social development of the child while under the age of 5 years with a view to detecting any deviations from normal development; the examination of the child by or on behalf of the performer on so many occasions and at such intervals as shall be determined by the Health Board in whose area the child resides for the purposes of the provision of child health surveillance services generally; “the Choice of Medical Practitioner Regulations ” means the National Health Service (Choice of Medical Practitioner) (Scotland) Regulations 1998 ; “contraceptive services” means– the giving of advice to women on contraception; the medical examination of women seeking such advice; the contraceptive treatment of such women; and the supply to such women of contraceptive substances and appliances; “General Practice ( GP ) Registrar” has the meaning assigned to it in regulation 2(1) of the GMS Regulations 1995 ; “the GMS Regulations ” means the National Health Service (General Medical Services) (Scotland) Regulations 1995 ; “maternity medical services” means the provision of personal medical services which comprise– the provision of personal medical services to a woman during the ante natal period; the provision of personal medical services to a woman during labour; the provisions of personal medical services to a woman and to her baby, where the pregnancy has resulted in the birth of a live baby, including the provision of all necessary personal medical services to that baby during the period of 14 days following its birth, unless, during that period, another medical practitioner has accepted the baby for inclusion in that practitioner’s list pursuant to an application made on the baby’s behalf under regulation 2 of the Choice of Medical Practitioner Regulations, during the post-natal period; and the provision of a full post-natal examination; “minor surgery services” means the personal medical services described in Schedule 5; “Part II Practitioner” means a medical practitioner who provides general medical services; “performer” means any registered medical practitioner (including the provider) who performs personal medical services provided under an agreement; “performer’s list” means a list of persons who have been accepted by or assigned to a performer under the Choice of Medical Practitioner Regulations; “pooled list” means a list of persons who have been accepted by a provider for the provision of personal medical services, and who are not included in a performer’s list; “provider” means any person or body with whom a Health Board enters into an agreement; “Scheduled drug” has the meaning given in regulation 2(1) of the GMS Regulations; “the Tribunal” means the Tribunal constituted under section 29 of the 1978 Act. 3 In these Regulations unless the context otherwise requires, a reference to a regulation or Schedule is to a regulation of, or a Schedule to, these Regulations and a reference to a paragraph is to a paragraph of the regulation in which the reference is made. PART II AGREEMENTS Entering into an agreement 2 An agreement may be entered into only where it complies with the terms of Schedules 1 and 4. No undue compromise 3 No agreement shall be entered into where that would unduly compromise– a the right of any person in the Health Board’s area to choose the medical practitioner from whom that person is to receive medical services; or b the scope of the Health Board to require a person to be assigned to a performer’s list, having regard to the need of the Health Board to ensure that the number of performers who are primarily responsible for the performance of personal medical services is such that neither the right nor the scope is unduly compromised. Withdrawal from an agreement 4 Any provider may withdraw from an agreement by giving the Health Board not less than 3 months notice in writing of their intention to withdraw. Variation of an agreement 5 A Health Board and provider who have entered into an agreement may, after following such procedure as may be set out in the agreement, vary it by a further agreement in writing. Publication of Details of an Agreement 6 A provider shall display at every premises from which personal medical services are provided by the provider a notice containing the information set out in Schedule 2. PART III PERFORMANCE OF PERSONAL MEDICAL SERVICES Performance of personal medical services by medical practitioners 7 1 A Health Board shall not make an agreement under which a registered medical practitioner will perform personal medical services unless the Health Board would, if the registered medical practitioner had intended to provide general medical services instead, be able to enter into arrangements with that practitioner under section 19(1) of the 1978 Act. 2 No medical practitioner shall perform personal medical services where that medical practitioner– a is disqualified by direction of the Tribunal; b is suspended by direction of the Tribunal; c is disqualified or suspended under provisions, corresponding to sections 29(3), 32A(2) or 32B(1) of the 1978 Act, in force in England and Wales or Northern Ireland; d is no longer a registered medical practitioner; e is the subject of a direction given by the Professional Conduct Committee under section 36 of the Medical Act 1983 (erasure of name from the register or suspension of registration) or of an order made by that Committee under section 38(1) of that Act (immediate suspension); f has been convicted in the United Kingdom of murder; or g has been convicted in the United Kingdom of a criminal offence and sentenced to a term of imprisonment of at least six months. 3 Where, a medical practitioner who falls within paragraph (2) performs personal medical services, the agreement under which those services are provided shall terminate forthwith. 4 Schedule 3 applies to the performance of personal medical services by a medical practitioner under an agreement. Child health surveillance services and minor surgery services 8 1 Where the personal medical services which are to be provided under an agreement include child health surveillance services those services may only be provided by a performer who has satisfied the Health Board that that performer has such medical experience and training as are necessary to perform such services. 2 In satisfying itself for the purposes of a performer in paragraph (1), a Health Board shall, in particular, have regard to– a any post-graduate qualification held by the performer; and b any training undertaken and any medical experience gained by the performer during the period of five years immediately preceding the date on which the performer will start to perform child health surveillance services under the agreement, which is relevant to the provision of child health surveillance services, and shall seek and take into account any medical advice it considers necessary to enable it to so satisfy itself. 3 Subject to paragraph (5), where the personal medical services which are to be provided under an agreement include minor surgery services those services may only be provided by a performer who has satisfied the Health Board that that performer has such medical experience and training as are necessary to perform such services. 4 In satisfying itself for the purposes of a performer in paragraph (3), a Health Board shall, in particular, have regard to– a any post-graduate qualification held by the performer; and b any training undertaken and any medical experience gained by the performer during the period of five years immediately preceding the date on which the performer will start to perform minor surgery services under the agreement, which is relevant to the provision of minor surgery services, and shall seek to take into account any medical advice it considers necessary to enable it to so satisfy itself. 5 Where a performer has satisfied the Health Board for the purposes of paragraph (3), the performer shall not perform minor surgery services unless the performer has also satisfied the Health Board that the premises and equipment to be used by the performer are suitable for the performance of minor surgery services. 6 A Health Board shall be deemed not to be satisfied for the purposes of paragraphs (1), (3) and (5) unless a letter of satisfaction signed by an authorised officer of the Health Board is sent to the performer. PART IV PATIENT LISTS Lists of patients 9 1 A Health Board which enters into an agreement shall prepare and keep up to date a list of patients who receive personal medical services and that list shall be made up of– a a performer’s list in respect of each performer who is, under an agreement, to have such a list; and b if, in accordance with an agreement, there is to be a pooled list, that list. 2 Where a person is accepted by a performer for inclusion in the performer’s list or, as the case may be, by a provider for inclusion in a pooled list, the Health Board shall include that person in the list of patients who receive personal medical services from the date on which it receives notification of acceptance from the performer or, as the case may be, the provider. Removal from a list of patients who receive personal medical services 10 1 A person whose name is included in a performer’s list or in a pooled list and who no longer wishes to receive personal medical services may at any time give notice to the Health Board that that person wishes to have their name removed from that list, and at the expiration of 14 days from the date of receipt of the notice, the Health Board shall remove the name and inform the person and the performer or, as the case may be, the provider. 2 Where, in regard to a person whose name is included in a performer’s list or a pooled list, the Health Board after due enquiry including consultation in writing with the performer or, as the case may be, the provider is satisfied, either– a that the person no longer resides in that part of the area of the Health Board where personal medical services are provided by the provider; or b that the whereabouts of the person are no longer known to the Health Board, and that the performer or, as the case may be, the provider is no longer responsible for providing that person with personal medical services, the Health Board shall remove the name of that person from the performer’s list or, as the case may be, the pooled list. 3 Where, in accordance with the terms of an agreement, a provider notifies the Health Board in writing that the provider wishes to have any person removed from the performer’s list or the pooled list the Health Board shall, subject to paragraph (5), remove that person on the earlier of– a the date on which the person is accepted by or assigned to a registered medical practitioner under the Choice of Medical Practitioner Regulations, or is accepted for inclusion in a pooled list (where the list of the registered medical practitioner or, as the case may be, the pooled list, does not form part of the list of patients in which the person was included immediately before acceptance or assignment); or b the end of the period of eight days beginning with the day on which the Health Board receives the notification. 4 Where, at the date on which removal would take effect under paragraph (3), a performer is treating the person at intervals of less than seven days, the Health Board shall remove that person on the earlier of– a the date on which the person is accepted by or assigned to a registered medical practitioner under the Choice of Medical Practitioners Regulations, or is accepted for inclusion in a pooled list (where the list of the registered medical practitioner or, as the case may be, the pooled list, does not form part of the list of patients in which the person was included immediately before acceptance or assignment); or b the end of the period of eight days beginning with the day on which the Health Board receives notification from the provider that the person no longer needs such treatment. 5 Where, in the case of violence or threatened violence against a performer by a person whose name is included in a performers list or a pooled list, which the performer has reported to the police or the Procurator Fiscal, the provider notifies the Health Board, in accordance with the terms of an agreement that the provider wishes to have the name of the person removed from the performer’s list or, as the case may be, the pooled list with immediate effect, the Health Board shall remove the person on receipt of that notification and inform the person, the provider and the performer. 6 Where a person on a performer’s list or a pooled list– a dies; or b is absent from the United Kingdom for a period of more than 90 days; or c leaves the United Kingdom with the intention of being away for a period of more than 90 days; or d enlists in Her Majesty’s Forces; or e is serving a prison sentence or sentences totalling in aggregate more than two years, that person’s name shall be deleted from the list as from the date on which the Health Board first received notification of the death, absence, departure, enlistment or imprisonment. Transfer of patients from lists 11 1 This regulation applies to the transfer of a person from a performer’s list or a pooled list to– a the list of a Part II practitioner; or b a performer’s list; or c a pooled list, where, in the case of sub-paragraphs (b) and (c), the list to which the patient transfers does not form part of the list in which that person was included immediately before transfer. 2 Subject to paragraph (3), the Health Board shall give effect to the transfer– a on the date on which it receives notification of the acceptance of the person by the medical practitioner to whose list the patient has transferred or, in the case of a transfer to a pooled list, by the provider; or b subject to the consent of the Health Board, from such date, not being earlier than the date of that consent, as may be agreed between the performer or, in the case of a pooled list, the provider from whose list the person has transferred and the registered medical practitioner, or as the case may be, the provider who has accepted the person. 3 Paragraph (2) shall not apply to the transfer of a person in accordance with the Choice of Medical Practitioner Regulations, to a performer’s list where the performer is successor to a performer from whose performer’s list the person has transferred. 4 The Health Board shall, within 14 days of transfer, notify the person transferred, and the performer or, in the case of a pooled list, the provider from whose list the person has transferred and the Part II practitioner, the performer or, in the case of a pooled list, the provider, to whose list the person has transferred, of the transfer. PART V MISCELLANEOUS Parties treated as health service bodies 12 1 In the case of an agreement entered into, or to be entered into, by any person or body, that person or body may make an application in accordance with this regulation to become a health service body for the purposes of section 17A of the 1978 Act. 2 An application under paragraph (1) shall be made in writing to the Scottish Ministers and shall include the name and address of each applicant. 3 A copy of such application shall be sent by the applicant to the Health Board with which an agreement has been entered into or is to be entered into. 4 If an application is granted the Scottish Ministers must specify when it is to come into effect and, as from that time, the applicant shall be a health service body for the purposes of section 17A of the 1978 Act. 5 The grant of an application does not affect the nature of, or any rights or liabilities arising under, any contract entered into by an applicant before the date on which the application comes into effect. 6 The person or body to whom the status of health service body has been granted shall cease to be a health service body– a upon withdrawal from an agreement pursuant to regulation 4; or b upon termination of an agreement; or c upon that person or body giving notice in writing to the Scottish Ministers and to the Health Board with which an agreement has been entered into or is to be entered into that they have decided to cease to be a health service body. Enforcement of directions as to payments 13 Any directions, as to payments, made under section 17A(8) of the 1978 Act shall be enforceable in like manner as extract registered decrees arbitral bearing warrant for execution issued by the sheriff court of any sheriffdom in Scotland. Financial Assistance 14 1 A Health Board may make payments of financial assistance for preparatory work undertaken– a in connection with preparing proposals for arrangements under section 17C of the 1978 Act under which personal medical services are to be provided; or b in preparation for the provision of personal medical services under arrangements made under section 17C of the 1978 Act. 2 Such payments may be made only following receipt by the Health Board of a written application from one or more of the following:– a an NHS trust; b a suitably experienced medical practitioner; c an individual who is providing personal medical services in accordance with arrangements made under section 17C of the 1978 Act or section 28C of the National Health Service Act 1977 ; d an NHS employee; e a qualifying body, and shall be made to the applicant. 3 An application for financial assistance shall specify– a the purposes for which the applicant intends to use the payment of financial assistance for which the applicant has applied; and b in the case of an application from a person falling within (2)(b) or (c) above, in connection with preparing proposals for arrangements under section 17C of the 1978 Act, whether those proposals have the support of an NHS trust or a qualifying body and, if so, the identity of that NHS trust or qualifying body; c whether, in connection with preparing proposals for arrangements under section 17C of the 1978 Act, the applicant has consulted with i the Area Medical Committee; ii the Local Health Council; iii the local authority; and iv any other body representative of any group which is likely to be affected, and, if so, what observations have been made by them in respect of the proposals. Conditions in respect of financial assistance 15 1 A Health Board which makes payment of financial assistance to any person under these Regulations shall, on making that payment, require that person– a to use the payment only for the preparatory work specified in their application and, to the extent that it is unused on the relevant date, to return it to the authority; and b before the end of the period of four months beginning with the relevant date, to provide such information in writing to the Health Board about the uses to which the payment has been put as the Health Board may reasonably require, and a person receiving such a payment shall comply with any conditions which the Health Board may impose in writing in connection with those requirements. 2 A person to whom a payment of financial assistance is made who fails to comply with any of the conditions imposed by the Health Board shall, on demand by the Health Board repay the amount of the payment to the Health Board forthwith. 3 In this regulation “the relevant date” means– a in relation to preparing proposals under regulation 14(1)(a), the date on which those proposals are submitted to the Health Board; or b in relation to preparation for arrangements under regulation 14(1)(b), the date on which the agreement is entered into. Liability of performers who provide general medical services and Part II practitioners who perform personal medical services 16 1 A performer, who provides general medical services as a deputy to a Part II practitioner, shall be responsible for any act or omission on the part of the performer, which would have been contrary to the terms of service contained in Schedule 1 to the GMS Regulations or (as the case may be) Schedule 2 to the National Health Service (General Medical Services) Regulations 1992 , and that act or omission shall be treated as if it were a breach of those terms of service. 2 A Part II practitioner, who performs personal medical services as a deputy to a performer, shall be responsible for any act or omission on the part of the Part II practitioner, which both gives rise to a breach of an agreement and would, if the practitioner had been providing general medical services when the act or omission occurred, have been contrary to the terms of service contained in Schedule 1 of the GMS Regulations or (as the case may be) Schedule 1 to the National Health Service (General Medical Services) Regulations 1992, and that act or omission shall be treated as if it were a breach of those terms of service. SUSAN C DEACON A member of the Scottish Executive St Andrew’s House, Edinburgh 8th March 2001