NATIONAL HEALTH SERVICE, ENGLAND Citation, commencement and extent 1 1 These Regulations may be cited as the National Health Service (Functions of Health Authorities and Administration Arrangements) (England) Regulations 2001 and shall come into force on 1st April 2001. 2 These Regulations apply in relation to Health Authorities established for an area in England only. Interpretation 2 1 In these Regulations, unless the context otherwise requires— “ the Act ” means the National Health Service Act 1977; “the 1990 Act ” means the National Health Service and Community Care Act 1990 ; “the 1997 Act ” means the National Health Service (Primary Care) Act 1997 ; “financial year” means the period of 12 months ending with 31st March; “the Health Act ” means the Health Act 1999 ; “practice patient” means— in relation to a medical practitioner who practises otherwise than in partnership, an individual who is on that practitioner’s list of patients (or, if that practitioner and one or more other medical practitioners together have a single list of patients in connection with a pilot scheme under the 1997 Act , an individual who is on that single list); in relation to a medical practitioner who is one of two or more practitioners who practise in partnership with each other, an individual who is on the list of patients of any of those practitioners (or, if any of those practitioners together have a single list of patients in connection with a pilot scheme under the 1997 Act, an individual who is on that single list), other than an individual who is resident in Scotland; “the relevant date” means— 1st April in the financial year preceding the financial year in which the identity of the relevant Health Authority falls to be determined; in the case of a practitioner providing general medical services and who practices otherwise than in partnership, the date on which he first entered the Health Authority’s medical list; in the case of a practitioner providing general medical services who is one of two or more practitioners who practice in partnership with each other, the earliest date on which any one of those practitioners entered the Health Authority’s medical list; in the case of a practitioner performing personal medical services in connection with a pilot scheme under the 1997 Act, the date on which services were first performed under that scheme, whichever is the latest; “the relevant Health Authority” means— in relation to a medical practitioner— who provides general medical services under Part II of the Act and does not perform personal medical services in connection with a pilot scheme; whose name is included in the medical list of only one Health Authority; and who practises on his own or in partnership with others all of whom are medical practitioners who provide general medical services under Part II of the Act and do not perform personal medical services in connection with a pilot scheme and whose names are included only in that Authority’s medical list, that Authority; in relation to any other medical practitioner, the Health Authority in whose area, on the relevant date, most of the practice patients at that date were living; “specified health service functions” means the Secretary of State’s functions relating to the health service under the enactments specified in column (1) of Schedule 1 (the subject matter of the relevant functions being indicated in column (2) of that Schedule), including functions under any regulations made under any of those enactments. 2 In these Regulations, unless the context otherwise requires— a any reference to a numbered regulation or Schedule is a reference to the regulation or, as the case may be, the Schedule bearing that number in these Regulations, and any reference in a regulation to a numbered paragraph is a reference to the paragraph bearing that number in the regulation; b any reference to a Health Authority (other than in the definition of “relevant Health Authority” in regulation 2(1)) or a Primary Care Trust is to be construed as a reference to a Health Authority or, as the case may be, a Primary Care Trust established for an area in England; c any reference to a Special Health Authority is to be construed as a reference to a Special Health Authority exercising functions in respect of England; and d any reference to an NHS trust is to be construed as a reference to an NHS trust all or most of whose hospitals, establishments and facilities are situated in England. Functions exercisable by Health Authorities 3 1 Subject to regulation 4, every Health Authority shall exercise the specified health service functions— a in so far as those functions consists of providing or securing the provision of services to patients, other than the services referred to in sub-paragraph (b) of this paragraph, for the benefit of— i the practice patients of medical practitioners providing general medical services under the Act, or performing personal medical services in connection with a pilot scheme under the 1997 Act, in respect of whom the Health Authority is the relevant Health Authority; and ii persons usually resident in their area, or resident outside the United Kingdom who are present in their area, and who are not practice patients of any medical practitioner providing general medical services under the Act or performing personal medical services in connection with a pilot scheme under the 1997 Act; b in so far as those functions consist of providing or securing the provision of— i accident and emergency services and ambulance services; ii any other services which the Secretary of State may direct, for the benefit of all persons present in their area; and c in so far as those functions consist of any other functions, generally as respects their area. 2 In this regulation, references to accident and emergency services are references to those services provided at the accident and emergency department, or a minor injuries unit, of a health service hospital, and do not include any subsequent treatment connected with the provision of those services. 3 Nothing in regulation 3(1) limits the area in relation to which an approval of a medical practitioner for the purposes of section 12(2) of the Mental Health Act 1983 (approval of medical specialists) given by a Health Authority shall have effect. 4 Subject to any directions which the Secretary of State may give as to any particular case or class of case, if there is doubt as to where a person is usually resident for the purposes of this regulation— a he shall be treated as usually resident at the address which he gives, to the person or body providing him with services, as being that at which he usually resides; b where he gives no such address, he shall be treated as usually resident at the address which he gives, to the person or body providing him with services, as being his most recent address; c where his usual residence cannot be determined under sub-paragraphs (a) and (b) above, he shall be treated as usually resident in the area in which he is present. 5 Subject to any directions which the Secretary of State may give as to any particular case or class of case, if there is doubt as to whether a person is a practice patient of any medical practitioner, or as to the identity of the medical practitioner of which a person is a practice patient, for the purposes of these Regulations he shall be treated as a person who is not the practice patient of any medical practitioner. Restriction on the exercise of functions by Health Authorities 4 1 The exercise by a Health Authority of specified health service functions is subject to such limitations as the Secretary of State may direct, and shall be in accordance with any directions which are given by the Secretary of State. 2 Nothing in these Regulations is to be taken as giving directions for the exercise of any functions conferred on or vested in the Secretary of State with respect to— a the making of any order or regulations; b the giving of any directions; or c the determination of the amount of the remuneration, or of any allowance, which is, by virtue of these Regulations, to be paid by a Health Authority to their chairman and members. 3 The power under section 2 of the Act (Secretary of State’s general power as to services) is exercisable by a Health Authority only to such extent as is necessary for the proper exercise of one or more other functions exercisable by them. 4 In exercising the functions of the Secretary of State under section 4 of the Act a Health Authority may enter into an NHS contract for the provision of high security psychiatric services with the following providers only— a Ashworth Hospital Authority , or b an NHS trust approved under paragraph 10(2) and (3) of Schedule 2 to the 1990 Act— i in England, by the Secretary of State; or ii in Wales, by the National Assembly for Wales, and may not arrange with any other person or body (including voluntary organisations) for that person or body to provide such services. 5 Except where the Secretary of State otherwise directs, a Health Authority shall not exercise the functions of the Secretary of State under section 51(1) of the Act in so far as those functions are concerned with securing the availability of facilities for clinical teaching. 6 Where, in the exercise of specified health service functions, arrangements are made by a Health Authority with medical practitioners for the vaccination or immunisation of persons against disease, every medical practitioner providing general medical services, or performing personal medical services in connection with a pilot scheme under the 1997 Act, in that Authority’s area shall, so far as is reasonably practicable, be given an opportunity to participate in the arrangements. 7 Approval of a medical practitioner for the purposes of section 12(2) of the Mental Health Act 1983 (approval of medical specialists) as having special experience in the diagnosis and treatment of mental disorder shall be given only— a after carrying out such consultations, and the obtaining of such advice, as the Secretary of State may direct; and b for such periods as the Secretary of State may direct. Arrangements by Health Authorities for exercise of functions 5 1 Subject to paragraphs (3), (5) and (6) and to any directions which may be given by the Secretary of State with respect to its exercise, any function exercisable by a Health Authority under or by virtue of any provision of the Act, the 1990 Act or the Health Act, or any function to which paragraph (2) applies, may by arrangement with that Authority, and subject to such restrictions and conditions as that Authority may think fit, be exercised— a by another Health Authority, b by a Special Health Authority, c jointly with any one or more of the following— i Primary Care Trusts, and ii other Health Authorities, or d on behalf of the Authority by a committee, sub-committee or officer of the Authority. 2 This paragraph applies to— a any functions exercisable by a Health Authority in relation to piloted services by virtue of the Act, as extended by section 9(2) of the 1997 Act; and b any function exercisable by a Health Authority by virtue of sections 4, 6 and 18 of, and Schedule 1 to, the 1997 Act which does not fall within sub-paragraph (a). 3 If the Secretary of State has directed Health Authorities that a function specified in the directions is not to be exercisable by Primary Care Trusts , a Health Authority may not exercise that function jointly with a Primary Care Trust. 4 Subject to paragraphs (5) and (6) and to any directions which may be given by the Secretary of State with respect to its exercise, any function exercisable by a Health Authority jointly with Primary Care Trusts or other Health Authorities under paragraph (1)(c) may by arrangement with the health service bodies in question, and subject to such restrictions and conditions as the Authority may think fit, be exercised on behalf of those bodies by a joint committee or joint sub-committee. 5 Any function exercisable by a Health Authority under or in relation to arrangements made under section 63(1) of the Health Services and Public Health Act 1968 may by arrangement with that Authority be exercised jointly with one or more other Health Authorities, Special Health Authorities, Primary Care Trusts or NHS trusts. 6 Any functions which a Health Authority may be directed to exercise by virtue of section 51(1) of the Act in relation to the provision of facilities which are reasonably required by a university which has a medical or dental school in connection with clinical teaching may by arrangement with that Authority be exercised jointly with one or more other Health Authorities, Special Health Authorities, Primary Care Trusts or NHS trusts. 7 Any function exercisable by a Health Authority under section 15(2) of the Nurses, Midwives and Health Visitors Act 1997 may by arrangement with that Authority be exercised— a by another Health Authority, b jointly with any one or more other Health Authorities, c on behalf of the Authority by— i a committee, sub-committee or officer of the Authority, or ii a joint committee, or joint sub-committee, of that Authority and one or more other Health Authorities. Arrangements with health service bodies in Wales 6 1 Subject to any directions which may be given by the Secretary of State, an English Health Authority may enter into arrangements with a Welsh Health Authority for the functions specified in paragraph (3)— a which are exercisable by the English Health Authority, to be exercised by the Welsh Health Authority; b which are exercisable by the Welsh Health Authority, to be exercised by the English Health Authority. 2 Subject to any directions which may be given by the Secretary of State, one or more English Health Authorities may enter into arrangements with one or more Welsh Authorities for the functions specified in paragraph (3) which are exercisable by all the Health Authorities in question, to be exercised— a jointly by those Authorities, or b on behalf of those Authorities, by a joint committee or joint sub-committee. 3 The functions referred to in paragraphs (1) and (2) are any functions exercisable by a Health Authority— a under or by virtue of the Act or the 1990 Act; b in relation to piloted services by virtue of the Act, as extended by section 9(2) of the 1997 Act; c by virtue of sections 4, 6 and 18 of, and Schedule 1 to, the 1997 Act which do not fall within sub-paragraph (b); d under section 15(2) of the Nurses, Midwives and Health Visitors Act 1997; and e under or by virtue of the Health Act. 4 An English Health Authority may enter into arrangements with a Welsh Health Authority or NHS trust for any functions exercisable by the English Health Authority under or in relation to arrangements made under section 63(1) of the Health Service and Public Health Act 1968 to be exercised jointly by the English Health Authority with that Welsh Health Authority or NHS trust. 5 An English Health Authority may enter into arrangements with a Welsh Health Authority or NHS trust for any functions which the English Health Authority may be directed to exercise by virtue of section 51(1) of the Act in relation to the provision of facilities which are reasonably required by a university which has a medical or dental school in connection with clinical teaching to be exercised jointly by the English Health Authority with that Welsh Health Authority or NHS trust. 6 In this regulation— “English Health Authority” means a Health Authority established for an area in England only; “Welsh Health Authority” means a Health Authority established for an area in Wales only. “Welsh NHS trust” means an NHS trust all or most of whose hospitals, establishments and facilities are situated in Wales. Revocations 7 The regulations specified in column (1) of Schedule 2, in so far as they relate to England, are revoked to the extent specified in column (3) of that Schedule. Signed by authority of the Secretary of State for Health John Denham Minister of State, Department of Health 8th March 2001