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Statutory Instrument 2002 No. 2548The National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations 2002(The document as of February, 2008) STATUTORY INSTRUMENTS2002 No. 2548NATIONAL HEALTH SERVICE, ENGLANDThe National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations 2002
The Secretary of State, in exercise of the powers conferred upon him by sections 15(1) and (1ZA), 17A(3), 29 and 126(4) of the National Health Service Act 1977[1] and sections 18 and 64(6) of the Health and Social Care Act 2001[2], and all other powers enabling him in that behalf, hereby makes the following Regulations: Citation, commencement and extent 1. - (1) These Regulations may be cited as the National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations 2002 and shall come into force on 1st November 2002. (2) These Regulations apply to England only. Interpretation 2.In these Regulations -
(b) a relevant service provider which has an arrangement in connection with a pilot scheme under which personal medical services are performed outside the normal hours, otherwise than by the doctors named in the pilot scheme agreement as primarily responsible for the performance of those services;
(b) a group of medical practitioners, whether in partnership or not, who provide out of hours services for each other under informal rota arrangements;
(b) in relation to an accredited service provider, the geographical area in England for which it is approved, to provide out of hours services.
(b) the period between 1pm on Saturday and 8am on the following Monday; and (c) Good Friday, Christmas Day and bank holidays. (3) In relation to the provision of personal medical services under a pilot scheme agreement, the "out of hours period" means any period which does not fall within the normal hours.
(b) after consultation with any such Primary Care Trust, determine which Primary Care Trust shall be the accrediting authority. (5) The accrediting authority shall arrange with a Primary Care Trust whose area is not included in any part of the specified area ("the assessing authority"), for that Primary Care Trust to assess the application.
(b) prepare a written report on the application and forward it to the relevant service provider; (c) invite the relevant service provider to make written representations on the report within 28 days of receipt of the report; and (d) having considered any such representations, recommend to the accrediting authority whether or not approval should be granted, and if it recommends approval, whether approval should be granted -
(ii) in relation to the whole of the specified area or any part of it. (8) The accrediting authority shall, taking into account the recommendation of the assessing authority, approve the application in accordance with regulation 5 or refuse it in accordance with regulation 6.
(ii) in relation to any respect in which it is not meeting the necessary quality standards, that its proposals to do so are realistic and achievable; (b) in any other case, that the relevant service provider has the capacity to provide the service, and that its proposals to meet the necessary quality standards are realistic and achievable. (2) In approving the application, the accrediting authority shall also specify the geographical area in respect of which approval is granted.
(b) does not meet the necessary quality standards and has not made satisfactory proposals to address the shortcomings. (2) When refusing an application, the accrediting authority shall notify the relevant service provider -
(b) of its right of appeal under regulation 10; and (c) that it has 28 days from the date of the decision in which to appeal, and how to do so. Requirements with which an accredited service provider must comply
(b) any other Primary Care Trust whose area is included in the specified area. (5) The report referred to in paragraph (4) shall be provided at such intervals as the accrediting authority may require, but in any case at least -
(b) monthly, where the accredited service provider is approved for a period of up to twelve months. Withdrawal of accreditation
(b) the accredited service provider has failed to comply with any requirement of regulation 7; or (c) the accrediting authority considers that it is necessary to do so for the protection of members of the public or is otherwise necessary in the public interest. (2) Where an accrediting authority is considering withdrawing approval from an accredited service provider under paragraph (1), it shall -
(b) inform the accredited service provider that it may within 28 days of the date of the notice, make written representations to the accrediting authority, to include, in a case to which paragraph (1)(a) applies, its proposals to address its shortcomings; and (c) inform the accredited service provider that it may request an oral hearing before the accrediting authority within the 28 day period mentioned in sub-paragraph (b). (3) In a case where paragraph (1)(a) applies, if, in the opinion of the accrediting authority any proposals provided in accordance with paragraph (2)(b), would, if implemented, rectify the shortcomings, the accrediting authority shall not withdraw approval for a period of six months, beginning with the date on which it notifies the accredited service provider that its proposals are accepted.
(b) the accrediting authority must then notify the accredited service provider of its decision, and the reasons for it (including any facts relied upon). (7) When an accrediting authority notifies an accredited service provider of any decision under paragraph (4), (5) or (6), it shall also notify it -
(b) that it has 28 days from the date of the decision in which to appeal, and how to do so. Suspension of approval
(b) where it has decided to withdraw approval under regulation 8(1)(c), but before that decision takes effect; or (c) pending an appeal of a decision under regulation 8(1)(c). (2) In a case falling within paragraph (1)(a), the accrediting authority must specify a period, which shall not exceed six months, as the period of suspension.
(b) give the accredited service provider at least 24 hours written notice of the date and time of an oral hearing at which it may, if it wishes, make representations to the accrediting authority. (8) If the accredited service provider does not wish to have an oral hearing or does not attend the oral hearing, the accrediting authority shall notify the accredited service provider of its decision and the reasons for it (including any facts relied upon), and may suspend the approval with immediate effect.
(b) a decision to withdraw the approval of an accredited service provider under regulation 8. (3) The appeal shall be by way of a redetermination of the accrediting authority's decision.
(b) withdraws approval under regulation 8; or (c) suspends approval under regulation 9, it shall notify the persons and bodies specified in paragraph (2) of the matters set out in paragraph (3).
(b) any Primary Care Trust whose area is included in the specified area; (c) any medical practitioner or party to a pilot scheme agreement who, to the knowledge of the Primary Care Trust, has made arrangements for the provision of out of hours services with the accredited service provider; (d) the local medical committee, being a committee recognised under section 44 of the 1977 Act as being representative of doctors in the area; (e) in a fraud case, the National Health Service Counter Fraud Service. (3) The matters referred to in paragraph (1) are -
(b) the date of, and a copy of the decision of the accrediting authority; (c) the name of an individual who may be contacted for further information. (4) The accrediting authority may also notify any person or body which it is satisfied is considering making arrangements with the relevant service provider for the provision of out of hours services or otherwise has a proper interest in receiving the information, of the matters set out in paragraph (3).
(zb) "Out of Hours Regulations" means the National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations 2002[9];"; (b) in sub-paragraph (1)(c), at the end, add "referred to in sub-paragraph (2)(b).". (3) For sub-paragraph (2) substitute -
(b) a doctor who is included in the medical list. (2A) An arrangement referred to in sub-paragraph (2)(a) shall -
(b) be suspended if the approval of the accredited service provider is suspended under regulation 9 of the Out of Hours Regulations. (2B) Where an arrangement terminates or is suspended in accordance with sub-paragraph (2A), the provisions of paragraphs 18B and 18C shall not apply. (2C) An arrangement referred to in sub-paragraph (2A)(b) shall terminate if the doctor with whom it is made ceases to be included in a medical list.". (4) In sub-paragraph (3), after "transferee doctors" insert "or accredited service providers".
(b) in sub-paragraphs (c), (d) and (g), after each time that the words "transferee doctor" appear insert "or accredited service provider". (7) In sub-paragraph (9) -
(b) after sub-paragraph (9)(b) insert -
(bc) that in the case of an arrangement referred to in sub-paragraph (2)(a), the practice premises are within the geographical area in respect of which approval is given under regulation 5 of the Out of Hours Regulations;". (8) In each of sub-paragraphs (14) and (15), after the words "has approved an out of hours arrangement" insert "with a transferee doctor".
(b) in sub-paragraph (c), omit the words "or such an organisation". (4) Paragraph 22 (organisations providing deputy doctors) shall be omitted.
(b) if the application is refused under regulation 6, the time allowed for any appeal has expired and no appeal has been submitted, or, where an appeal has been submitted, it has been determined by the FHSAA. Prescribed functions of Primary Care Trusts and Strategic Health Authorities
(b) at the end of sub-paragraph (ii), add -
Information 1.Name. 2.Address. 3.Details of services it intends to provide. 4.A description of the specified area in respect of which the application is made. 5.A plan in the form of a written statement setting out the action which the relevant service provider is taking, or proposes to take (as the case may be) in order to comply with the necessary quality standards. Undertakings to be complied with if approved 6.Undertaking only to provide service in the specified area. 7.Undertaking that it will not use the services of a doctor for the provision of out of hours services, whether as an employee or otherwise, unless the doctor's name is included in a medical list or a supplementary list or he is named in an agreement under section 2 of the 1997 Act as a performer of personal medical services. (This note is not part of the Regulations) These Regulations implement section 18 of the Health and Social Care Act 2001 (out of hours medical services), and make related provision, in respect of England only. In particular, the Regulations provide for the approval by a Primary Care Trust of providers of out of hours medical services, other than individual doctors, or groups of doctors operating an informal rota system. Regulation 3 defines the "out of hours" period. Regulation 4 sets out the procedure for approval. Regulations 5 and 6 set out the basis on which approval is given, or may be refused. By regulation 7 an accredited service provider must comply with certain requirements, in particular to report at periodic intervals on its performance of quality standards published by the Secretary of State. Regulations 8 and 9 make provision for the withdrawal and suspension of approval. Regulation 10 confers a right of appeal to the Family Health Service Appeals Authority in respect of the refusal or withdrawal of approval, and regulation 11 provides for the notifications to be given by a Primary Care Trust in connection with an out of hours service provider. Regulations 12 and 13 made amendments to the National Health Service (General Medical Services) Regulations 1992 so that a doctor providing general medical services may only make arrangements for out of hours services with a doctor who is included in the medical list, or an accredited service provider. By regulation 14, a service provider which makes an application for approval in accordance with these Regulations on or before 1 December 2002 is to be treated as an accredited service provider until the application is determined and any appeal right exhausted. Regulation 15 confers a new function of co-ordinating and facilitating the effective provision of out of hours services on each Primary Care Trust. In the case of personal medical services provided under a pilot scheme arrangement, the function is, in accordance with section 15(1ZA) conferred on each Strategic Health Authority. However the effect of regulation 16 is to require the function to be performed by Primary Care Trusts acting on behalf of Strategic Health Authorities. Notes: [1] 1977 c. 49. Section 15(1) was amended by the Health and Social Security Act 1984 (c. 48), section 5(2); the National Health Service and Community Care Act 1990 (c. 19) ("the 1990 Act"), section 12(1); the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 6, and the National Health Service Reform and Health Care Professions Act 2002 (c. 17) ("the 2002 Act"), Schedule 2, paragraph 2. Section 15(1ZA) was inserted by the National Health Service (Primary Care) Act 1997 (c. 46) ("the 1997 Act") Schedule 2, paragraph 4(2), and amended by Schedule 3, paragraph 11 of the 2002 Act. Section 17A(3) was inserted by the Health Act 1999 (c. 8), section 12(1), and is substituted by section 3(3) of the 2002 Act. Section 29 has been extended by the Health and Medicines Act 1988 (c. 49), section 17; and is amended by the following: Health Services Act 1980 (c. 53), sections 1 and 7 and Schedule 1, paragraph 42(b); Health and Social Services and Social Security Adjudications Act 1983 (c. 41), Schedule 6, paragraph 2; the Medical Act 1983 (c. 54), section 56(1) and Schedule 5, paragraph 16(a); by S.I. 1985/39, article 7(3); the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 18; the 1997 Act, Schedule 2, paragraph 8; the Health and Social Care Act 2001 ("the 2001 Act"), section 17, and the 2002 Act, Schedule 2, paragraph 3. See section 128(1) of the National Health Service Act 1977 as amended by the 1990 Act, section 26(2)(g) and (i) for the definitions of "prescribed" and "regulations". These functions of the Secretary of State under the 1977 Act are, so far as exercisable in relation to Wales, transferred to the National Assembly for Wales by virtue of article 2 of, and Schedule 1 to, the National Assembly for Wales (Transfer of Functions) Order 1999, S.I. 1999/672, as amended by section 66(5) of the Health Act 1999. See also section 40(1) of the 2002 Act.back [2] 2001 c. 15. Section 18 is amended by paragraph 72 of Schedule 2 to the 2002 Act. By section 66 of the 2001 Act, "regulations" means regulations made by the relevant authority which, in relation to England, is the Secretary of State.back [3] 1997 c. 46.back [4] By section 18(3) of the 2001 Act, "service provider" means, in relation to arrangements to which the section applies, the person or persons undertaking to provide out of hours services under the arrangements.back [5] By section 18(3) of the 2001 Act, "out of hours services" means general medical services or personal medical services (as the case may be) provided during part or all of an out of hours period.back [6] S.I. 1992/635. Relevant amendments are made by S.I. 1996/702, S.I. 1998/682, S.I. 2001/3742 and S.I. 2002/2469.back [7] The document "Quality Standards in the delivery of GP Out of Hours Services" published on 20th June 2002 is published by the Department of Health on its website at http://www.doh.gov.uk/pricare/qualitystandards.htm or a copy may be obtained by writing to Primary Care, Room 7E28, Department of Health, Quarry House, Quarry Hill, Leeds LS2 7UE, or by e-mailing OOHAccreditation&doh.gov.uk.back [8] By section 128(1) of the National Health Service Act 1977, the FHSAA means the Family Health Services Appeal Authority.back [9] S.I. 2002/2548.back [10] S.I. 2002/2375.back [11] S.I. 2002/2548.back ISBN 0 11 042895 1 -- Back --
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