Statutory Instrument 1998 No. 682

The National Health Service (General Medical Services) Amendment Regulations 1998

(The document as of February, 2008)

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STATUTORY INSTRUMENTS

1998 No. 682

NATIONAL HEALTH SERVICE, ENGLAND AND WALES

The National Health Service (General Medical Services) Amendment Regulations 1998

	Made	11th March 1998
	Laid before Parliament	11th March 1998
	Coming into force	1st April 1998

The Secretary of State for Health, in exercise of powers conferred on him by sections 15(1), 29, 33(2A), 34, 45(1) and 126(4) of the National Health Service Act 1977[1] and paragraphs 1 and 2 of Schedule 1 to the National Health Service (Primary Care) Act 1997[2], and of all other powers enabling him in that behalf, hereby makes the following Regulations: - 



PART I
INTRODUCTORY
Citation, commencement and interpretation
    1. - (1) These Regulations may be cited as the National Health Service (General Medical Services) Amendment Regulations 1998 and shall come into force on 1st April 1998.

    (2) In these Regulations, "the 1992 Regulations" means the National Health Service (General Medical Services) Regulations 1992[3].



PART II
AMENDMENTS CONSEQUENTIAL UPON THE NATIONAL HEALTH SERVICE (PRIMARY CARE) ACT 1997
Reason for amendments
    2.The amendments in this Part are made because of the coming into force on 1st April 1998 of certain provisions of the National Health Service (Primary Care) Act 1997[4] and of certain Regulations made under those provisions.

Amendments connected with the National Health Service (Choice of Medical Practitioner) Regulations 1998
Amendments of Parts I, IV and V of the 1992 Regulations
    3. - (1) The 1992 Regulations are amended in accordance with the following provisions of this regulation.

    (2) In regulation 2[5] (interpretation) - 

(a) in the appropriate alphabetical positions, insert - 

" "the 1997 Act" means the National Health Service (Primary Care) Act 1997[6];
"the Choice of Medical Practitioner Regulations" means the National Health Service (Choice of Medical Practitioner) Regulations 1998[7];
"personal medical services" has the meaning assigned to it in section 1(8) of the 1997 Act;
"pilot doctor" means a doctor who performs personal medical services in connection with a pilot scheme;
"pilot scheme" has the meaning assigned to it in section 1(1) of the 1997 Act;
"pilot scheme agreement" means an agreement which constitutes, or is one of the agreements which together constitute, a pilot scheme;
"pilot scheme provider" means a person who provides personal medical services in connection with a pilot scheme;
"pooled list" means a single list of the patients of two or more pilot doctors which is held in connection with a pilot scheme;";

(b) in the definition of "doctor", at the end, insert "and when section 35 of the 1997 Act comes into force, includes a person engaged in employment under section 10 of the Medical Act 1983[8] in an approved medical practice[9];"

(c) for the definition of "medical card", substitute - 

" "medical card" means a card issued by a Health Authority to a person for the purpose of enabling him to obtain, or establishing his title to receive, primary medical services[10], other than contraceptive services, maternity medical services, child health surveillance services and minor surgery services;"; and

(d) in the definition of "temporary resident", for "regulation 26" substitute "regulation 7 of the Choice of Medical Practitioner Regulations".

    (3) In regulation 19 (doctors' lists) - 

(a) in paragraph (1)(a), for "this Part" substitute "the Choice of Medical Practitioner Regulations";

(b) in paragraph (3), for "regulation 22(7)" substitute "regulation 3(3) of the Choice of Medical Practitioner Regulations";

(c) for paragraph (6), substitute - 

    " (6) Any removal of a person from a doctor's list caused by the transfer of a person to the list of another doctor or to a pooled list, other than a transfer under regulation 3(3) of the Choice of Medical Practitioner Regulations, or a transfer in pursuance of a notice under regulation 22(10), shall take effect - 


(a) from the date on which the Health Authority receives notification of the acceptance of the person by the last-named doctor or, in the case of a transfer to a pooled list, the pilot scheme provider; or

(b) subject to the consent of the Health Authority, from such date, being not earlier than the date of that consent, as may be agreed between the doctors or, as the case may be, between the doctor and the pilot scheme provider."; and



(d) in paragraph (6B)[11], for sub-paragraph (b) substitute - 



" (b) on receipt of the notification mentioned in sub-paragraph (1) of that paragraph, the Health Authority shall acknowledge it in writing and give written notice of the removal to the person concerned.".

    (4) Regulations 20 (application for services) and 21 (assignment of persons to doctors) are omitted.

    (5) In regulation 22 (change of doctor) - 

(a) paragraphs (1) to (3) and (5) to (8) are omitted; and

(b) in paragraph (4), at the end, insert ", or to a pooled list".

    (6) In regulation 25 (temporary provision of services), in paragraph (2), after "ceases to be included in the medical list", insert "(otherwise than in accordance with section 12(2) of the 1997 Act, to enable him to perform personal medical services in connection with a pilot scheme to which the Health Authority in whose list he was included is a party)".

    (7) For regulation 26 (temporary residents), substitute - 

" Temporary residents
    26. - (1) A person who is accepted as a temporary resident by a doctor under regulation 7 of the Choice of Medical Practitioner Regulations or by a pilot scheme provider under a pilot scheme agreement shall not be removed from the list of any doctor providing general medical services in which his name is included, unless the Health Authority for the area in which that doctor practises is satisfied, after due enquiry - 


(a) that the person's stay in the place of temporary residence has exceeded three months; and

(b) that he has not returned to his normal place of residence, or any other place within the practice area of the doctor in whose list his name is included.



    (2) If a Health Authority is satisfied as mentioned in paragraph (1), it shall remove the name of the person from the list of the doctor in which it is included and, if practicable, inform the person of that fact and of his entitlement to seek acceptance by any doctor, including the doctor by whom he has been treated as a temporary resident, in the area in which he is living, and of the name and address of the Health Authority for that area.".

    (8) In regulation 31 (obtaining maternity medical services), in paragraph (4), for "regulation 20" substitute "regulation 2 of the Choice of Medical Practitioner Regulations".

    (9) In regulation 33 (obtaining minor surgery services), in paragraph (1), for "regulation 20(2)", in both places, substitute "regulation 2(3) of the Choice of Medical Practitioner Regulations".

Amendments of Schedule 2 to the 1992 Regulations
    4. - (1) Schedule 2 to the 1992 Regulations (terms of service for doctors) is amended in accordance with the following provisions of this regulation.

    (2) In paragraph 4 (a doctor's patients) - 

(a) in sub-paragraph (1) - 


(i) in paragraph (d), for "regulation 21", substitute "regulation 4 of the Choice of Medical Practitioner Regulations", and

(ii) in paragraph (e), for "regulation 21(3)(b)", substitute "regulation 4(4) of the Choice of Medical Practitioner Regulations".



(b) in paragraph (b) of sub-paragraph (4)[12], for "regulation 26", substitute "regulation 7 of the Choice of Medical Practitioner Regulations (temporary residents)"; and

(c) in sub-paragraph (5), for "regulation 21(3)(b)", in both places, substitute "regulation 4(4) of the Choice of Medical Practitioner Regulations".

    (3) In paragraph 5 (relief from liability to give emergency treatment), for "regulation 21(11)", substitute "regulation 4(8) of the Choice of Medical Practitioner Regulations".

    (4) In paragraph 6 (acceptance of patients), in sub-paragraph (2) - 

(a) after "medical list", insert "(otherwise than in accordance with section 12(2) of the 1997 Act, to enable him to perform personal medical services in connection with a pilot scheme to which the Health Authority in whose list he was included is a party)"; and

(b) for "regulation 22", substitute "regulation 3 of the Choice of Medical Practitioner Regulations".

    (5) In paragraph 7 (acceptance of patients), for "regulation 26(1)", substitute "regulation 7(1) of the Choice of Medical Practitioner Regulations".

    (6) In paragraph 9 (termination of responsibility for patients), in each of paragraphs (1)(a) and (2)(b), after "another doctor", insert ", or is accepted for inclusion in a pooled list".

    (7) In each of - 

(a) paragraph 13(5)(a)[13] (provision of services to patients);

(b) paragraph 14(1) (newly registered patients); and

(c) paragraph 16(4) (patients aged 75 years and over),

for "regulation 21", substitute "regulation 4 of the Choice of Medical Practitioner Regulations".

Amendment of Schedule 5 to the 1992 Regulations
    5. - In Schedule 5 to the 1992 Regulations, in Part II (maternity medical services), in paragraph 3(b), for "regulation 20(1)", substitute "regulation 3 of the Choice of Medical Practitioner Regulations".

Amendments connected with the National Health Service (Pilot Schemes: Part II Practitioners) Regulations 1998
Further amendments of Schedule 2 to the 1992 Regulations
    6. - (1) Schedule 2 to the 1992 Regulations is amended in accordance with the following provisions of this regulation.

    (2) In paragraph 19[14] (obligation to give treatment personally) - 

(a) in sub-paragraph (3), after "on the obstetric list" in the second place where those words appear, insert "or is a pilot doctor who is named in a pilot scheme agreement as responsible for the performance of maternity medical services under the pilot scheme";

(b) in sub-paragraph (5), after "child health surveillance list", insert "or is a pilot doctor who is named in a pilot scheme agreement as responsible for the performance of child health surveillance services under the pilot scheme"; and

(c) in sub-paragraph (6), after "minor surgery list", insert "or is a pilot doctor who is named in a pilot scheme agreement as responsible for the performance of minor surgery services under the pilot scheme".

    (3) In paragraph 20[15] (responsibility for acts and omissions of deputies) - 

(a) in sub-paragraph (1), after "sub-paragraph (2)" insert "or for which the doctor is not responsible, under sub-paragraph (3)"; and

(b) after sub-paragraph (2), insert - 

    " (3) Where, in connection with arrangements under a pilot scheme whereby, outside normal hours, pilot doctors and doctors providing general medical services co-operate in such a way that one doctor will cover for another to secure the performance of personal medical services or, as the case may be, the provision of general medical services for their patients, a pilot doctor acts as a deputy to a doctor whose name is included in the medical list, that doctor is not responsible for the acts or omissions of the pilot doctor[16].".

    (4) In paragraph 22[17] (organisations providing deputy doctors), for paragraph (a) of sub-paragraph (1), substitute - 

" (a) consists only of - 


(i) doctors whose names are included in the list of a Health Authority and who arrange to act as deputies to each other, or

(ii) pilot doctors and doctors whose names are included in the list of a Health Authority who co-operate in such a way that one doctor will cover for another to secure the performance of personal medical services or, as the case may be, the provision of general medical services for their patients; and."

    (5) In paragraph 26 (issue of documents), after "the medical list", insert ", or a pilot doctor acting as a deputy to a doctor whose name is included in the medical list in connection with arrangements under a pilot scheme whereby, outside normal hours, pilot doctors and doctors providing general medical services co-operate in such a way that one doctor will cover for another to secure the performance of personal medical services or, as the case may be, the provision of general medical services for their patients".

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Notes:

[1] 1977 c. 49; see section 128(1) as amended by the National Health Service and Community Care Act 1990 (c. 19) ("the 1990 Act"), section 26(2)(g) and (i), for the definitions of "prescribed" and "regulations". Section 15(1) was amended by the Health and Social Security Act 1984 (c. 48) ("the 1984 Act"), section 5(2); by the 1990 Act, section 12(1); and by the Health Authorities Act 1995 (c. 17) ("the 1995 Act"), Schedule 1, paragraph 6. Section 29 was extended by the Health and Medicines Act 1988 (c. 49), section 17; and amended by the Health Services Act 1980 (c. 53), sections 1 and 7 and Schedule 1, paragraph 42(b); by the Health and Social Services and Social Security Adjudications Act 1983 (c. 41), Schedule 6, paragraph 2; by the Medical Act 1983 (c. 54), section 56(1) and Schedule 5, paragraph 16(a); by S.I. 1985/39, article 7(3); by the 1995 Act, Schedule 1, paragraph 18; and (from 1st April 1998) by the National Health Service (Primary Care) Act 1997 (c. 46), Schedule 2, paragraph 8. Section 33(2A) was inserted by the 1990 Act, section 23(2), and amended by the 1995 Act, Schedule 1, paragraph 22(d). Section 34 was amended by S.I. 1985/39, article 7(8); by the 1990 Act, section 23(7); and by the 1995 Act, Schedule 1, paragraph 23. Section 45(1) was amended by the 1984 Act, Schedule 3, paragraph 7(a); and by the 1995 Act, Schedule 1, paragrah 33. Section 126(4) was amended by the 1990 Act, section 65(2).back

[2] 1997 c. 46.back

[3] S.I. 1992/635; relevant amending instruments are S.I. 1993/540, 1994/633, 1994/3130, 1995/80, 1995/3093, 1996/702, 1997/730 and 1997/2468.back

[4] 1997 c. 46. The provisions in question are brought into force by the National Health Service (Primary Care) Act 1997 Commencement (No. 4) Order 1998 (S.I. 1998/631).back

[5] Regulation 2 was amended by S.I. 1995/3093, regulation 2, and by S.I. 1997/2468, regulation 3.back

[6] 1997 c. 46.back

[7] S.I. 1998.back

[8] 1983 c. 54.back

[9] See section 11(4), as prospectively amended by section 35 of the 1997 Act. No relevant Regulations under Section 11 had been made at the date on which these Regulations were made.back

[10] "Primary medical services" is defined in section 28F(6) of the Act, inserted by section 23(1) of the 1997 Act.back

[11] Paragraph (6B) was inserted by S.I. 1994/633, regulation 6.back

[12] Sub-paragraph (4) was substituted by S.I. 1994/633, regulation 8.back

[13] Paragraph 13 was substituted by S.I. 1995/80, regulation 3(2).back

[14] Paragraph 19 was amended by S.I. 1996/702, regulation 5(6).back

[15] Paragraph 20 was amended by S.I. 1994/633 and 1997/730.back

[16] See the National Health Service (Pilot Schemes: Part II Practitioners) Regulations 1998 (S.I. 1998), regulation 2(2)(b) for provision enabling doctors providing general medical services to participate in such arrangements.back

[17] Paragraph 22 was substituted by S.I. 1997/730, regulation 3(4).back

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