The National Health Service (Charges for Drugs and Appliances), (Dental Charges) and (Travel Expenses and Remission of Charges) (Amendment) Regulations 2013

Amendment of regulation 2 of the Charges Regulations

4.—(1) Regulation 2 of the Charges Regulations (interpretation) is amended as follows.

(2) After the definition of “accepted disablement”, insert the following definition—

““another primary care organisation” means—

(a)

as regards Wales—

(i)

a Local Health Board, or

(ii)

in relation to any time prior to 1st April 2003, a Health Authority;

(b)

as regards Scotland, a Health Board;

(c)

as regards Northern Ireland—

(i)

the Regional Health and Social Care Board, or

(ii)

in relation to any time prior to 1st April 2010, a Health and Social Services Board; and

(d)

as regards England in relation to any time prior to 1st April 2013, a Primary Care Trust;”.

(3) For the definition of “appliance”, substitute the following definition—

““appliance” means an appliance included in a list approved by the Secretary of State for the purposes of section 126 of the 2006 Act(1) (arrangements for pharmaceutical services), but does not include a contraceptive appliance;”.

(4) After the definition of “appliance”, insert the following definition—

““arrangements for recharging” means arrangements under paragraph 3 of Schedule 12A to the 2006 Act(2) (pharmaceutical remuneration-other pharmaceutical remuneration) under which the Board requires a person to reimburse it for any pharmaceutical remuneration to which that paragraph applies;”.

(5) For the definition of “batch issue”, substitute—

““batch issue” means a form, in the format required by the Board (or a person exercising its functions) and approved by the Secretary of State, which—

(a)

is issued by a prescriber at the same time as a non-electronic repeatable prescription to enable a chemist or a dispensing doctor to receive payment for the provision of repeat dispensing services;

(b)

relates to a particular non-electronic repeatable prescription and contains the same date as that prescription;

(c)

is generated by a computer and not signed by a prescriber;

(d)

is issued as one of a sequence of forms, the number of which is equal to the number of occasions on which the drugs or appliances ordered on the non-electronic repeatable prescription may be provided; and

(e)

has included on it a number denoting its place in the sequence referred to in paragraph (d);”.

(6) After the definition of “batch issue”, insert the following definition—

““CCG” means a clinical commissioning group;”.

(7) For the definition of “chemist”, substitute—

““chemist” means an NHS chemist or an LPS chemist;”.

(8) After the definition of “chemist”, insert the following definition—

““chiropodist or podiatrist independent prescriber” means a chiropodist or podiatrist who is registered in Part 2 of the register maintained under article 5 of the Health and Social Work Professions Order 2001(3) (establishment and maintenance of register), and against whose name in that register is recorded an annotation signifying that the chiropodist or podiatrist is qualified to order drugs and appliances as a chiropodist or podiatrist independent prescriber;”.

(9) After the definition of “community treatment order”, insert the following definition—

““court” means any court in which criminal proceedings against a person are heard;”.

(10) In sub-paragraph (b) of the definition of “detainee”, for “by, or under” to the end of sub-paragraph (b), substitute “under arrangements made by the Board pursuant to Parts 4 to 7 of the 2006 Act or regulation 10 of the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 (services for prisoners and other detainees)(4),”.

(11) For the definition of “dispensing services”, substitute—

““dispensing services” means services arising out of which a prescriber completed a prescription form provided under the terms of a GMS contract under Part 3 of Schedule 6 to the GMS Contract Regulations or under the terms of a PMS agreement under Part 3 of Schedule 5 to the National Health Service (Personal Medical Services Agreements) Regulations 2004;”.

(12) After the definition of “detainee”, insert the following definitions—

““directed services” means additional pharmaceutical services provided in accordance with directions under section 127 of the 2006 Act(5);

“dispensing doctor” is to be construed in accordance with regulation 46(1) of the Pharmaceutical Services Regulations (dispensing doctor lists);”.

(13) Omit the definition of “Drug Tariff”.

(14) For the definitions of “electronic prescription form” and “electronic repeatable prescription”, substitute the following definitions—

““electronic prescription form” means data created in an electronic form for the purpose of ordering a drug or appliance, which—

(a)

is compatible with the systems used by the Board (or a person exercising its functions) for—

(i)

the remuneration of persons providing pharmaceutical services, and

(ii)

any apportionment of, or any arrangements for recharging in respect of, that remuneration,

unless the chemist or dispensing doctor dispensing the prescription is to receive no pharmaceutical remuneration of any kind in respect of any drug or appliance ordered on the form;

(b)

is signed with a prescriber’s advanced electronic signature;

(c)

is transmitted as an electronic communication to a nominated dispensing contractor by the Electronic Prescription Service; and

(d)

does not indicate that the drug or appliance ordered may be provided more than once;

“electronic repeatable prescription” means data created in an electronic form, which—

(a)

is signed with a prescriber’s advanced electronic signature;

(b)

is transmitted as an electronic communication to a nominated dispensing contractor by the Electronic Prescription Service;

(c)

indicates that the drugs or appliances ordered may be provided more than once; and

(d)

specifies the number of occasions on which they may be provided;”.

(15) For the definition of “ETP service”, substitute the following definition—

““Electronic Prescription Service” means the service of that name which is managed by the Information Centre;”.

(16) After the definition of “electronic signature”, insert the following definition—

““enhanced services” means the directed services which the Board is authorised (as opposed to required) to arrange by virtue of directions under section 127 of the 2006 Act;”.

(17) In the definition of “GMS contract”, omit “under section 28Q of the Act”.

(18) After the definition of “GMS contract”, insert the following definition—

““Health Board”, except in the context of “Local Health Board”, means a Health Board constituted under section 2 of the National Health Service (Scotland) Act 1978(6) (Health Boards);”.

(19) After the definition of “independent nurse prescriber”, insert the following definition—

““Information Centre” means the Health and Social Care Information Centre established under section 252 of the Health and Social Care Act 2012 (the Health and Social Care Information Centre);”.

(20) Omit the definition of “local pharmaceutical services”.

(21) Immediately prior to the definition of “mental disorder”, insert the following definitions—

““LPS chemist” means a party to an LPS scheme other than the commissioning body;

“LPS scheme” includes a pilot scheme within the meaning given in section 134(2) of the 2006 Act (pilot schemes);”.

(22) Omit the definitions of “NHS Care Record” and “NHS Care Record Service”.

(23) After the definition of “mental disorder”, insert the following definitions—

““NHS chemist” means a person included in a pharmaceutical list of the type referred to in regulation 10(2)(a) or (b) of the Pharmaceutical Services Regulations (pharmaceutical lists and EPS lists);

“NHS services” means services provided as part of the health service (including services provided as part of the health service in pursuance of the public health functions of the Secretary of State or local authorities);

“nominated dispensing contractor” means a chemist or a dispensing doctor who has been nominated in a particular patient’s PDS patient details to dispense the electronic prescriptions of that patient;”.

(24) For the definition of “non-electronic prescription form”, substitute the following definition—

““non-electronic prescription form” means a form for ordering a drug or appliance which—

(a)

is compatible with the systems used by the Board (or a person exercising its functions) for—

(i)

the remuneration of persons providing pharmaceutical services, and

(ii)

any apportionment of, or any arrangements for recharging in respect of, that remuneration,

unless the chemist or dispensing doctor dispensing the prescription is to receive no pharmaceutical remuneration of any kind in respect of any drug or appliance ordered on the form;

(b)

has been provided for use by a prescriber by—

(i)

the Board,

(ii)

another primary care organisation,

(iii)

a local authority, under arrangements for providing NHS services which include, with the consent of the Board, the dispensing of prescriptions as part of pharmaceutical or local pharmaceutical services,

(iv)

the Secretary of State,

(v)

a CCG, under arrangements for providing NHS services which include, with the consent of the Board, the dispensing of prescriptions as part of pharmaceutical or local pharmaceutical services,

(vi)

an NHS trust, or

(vii)

an NHS foundation trust;

(c)

if—

(i)

it has been so provided for use by a prescriber in England, and

(ii)

a prescription charge may be payable in relation to the prescription or a prescription charge exemption in these Regulations may apply to it,

is in a format that has been approved by the Secretary of State;

(d)

has been issued by a prescriber; and

(e)

does not indicate that the drug or appliance ordered may be provided more than once;”.

(25) For the definition of “non-electronic repeatable prescription”, substitute the following definition—

““non-electronic repeatable prescription” means a repeatable prescription which is not an electronic repeatable prescription;”.

(26) After the definition of “optometrist independent prescriber” insert the following definition—

““other secure accommodation” means—

(a)

a court;

(b)

a secure training centre; or

(c)

a secure children’s home;”.

(27) Omit the definition of “patient”.

(28) After the definition of “Patient Group Direction”, insert the following definitions—

““PDS patient details” means the information held about a patient in the Patient Demographics Service managed by the Information Centre;

“person detained in other secure accommodation” means a person who is detained in other secure accommodation in which medical, dental, ophthalmic, pharmaceutical or nursing services are provided under the 2006 Act under arrangements made by the Board pursuant to Parts 4 to 7 of the 2006 Act or regulation 10 of the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012;”.

(29) After the definition of “pharmacist independent prescriber”, insert the following definition—

““the Pharmaceutical Services Regulations” means the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013;”.

(30) For the definition of “pharmacist independent prescriber”, substitute the following definition—

““pharmacist independent prescriber” means a registered pharmacist (P)—

(a)

against whose name in Part 1 of the register maintained under article 19 of the Pharmacy Order 2010(7) (establishment, maintenance of and access to the register) or in the register maintained under Articles 6 and 9 of the Pharmacy (Northern Ireland) Order 1976(8) (which relate to the registers and the registrar) is recorded an annotation signifying that P is qualified to order drugs and appliances as a pharmacist independent prescriber; and

(b)

who is prescribing under arrangements for the provision of NHS services, but for these purposes those arrangements must not be arrangements for the provision of—

(i)

pharmaceutical services, unless they are arrangements for the provision of enhanced services, or

(ii)

local pharmaceutical services, unless they are arrangements that have been made by the Board with an LPS chemist for the provision of services that are equivalent to services provided as enhanced services;”.

(31) After the definition of “pharmacist independent prescriber”, insert the following definition—

““physiotherapist independent prescriber” means a physiotherapist who is registered in Part 9 of the register maintained under article 5 of the Health and Social Work Professions Order 2001, and against whose name in that register is recorded an annotation signifying that the physiotherapist is qualified to order drugs and appliances as a physiotherapist independent prescriber;”.

(32) In the definition of “PMS agreement” for “section 28C of the Act” substitute “section 92 of the 2006 Act (arrangements by the Board for the provision of primary medical services)”.

(33) For the definition of “prescriber” substitute—

““prescriber” means a doctor, a dental practitioner, a pharmacist independent prescriber, a supplementary prescriber, a chiropodist or podiatrist independent prescriber, a physiotherapist independent prescriber, an independent nurse prescriber or an optometrist independent prescriber;”.

(34) For the definition of “prescription form”, substitute the following definition—

““prescription form”, except in the context of the expression “electronic prescription form” or “non-electronic prescription form”, means an electronic prescription form or a non-electronic prescription form;”.

(35) For the definition of “prison” substitute—

““prison” includes a young offender institution but not a naval, military or air force prison;”.

(36) In the definition of “prisoner”, for “under the Act” to the end of the definition, substitute “under the 2006 Act under arrangements made by the Board pursuant to Parts 4 to 7 of the 2006 Act or regulation 10 of the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012;”.

(37) After the definition of “prisoner”, insert the following definition—

““provider of NHS services” means a person or body which provides services under the 2006 Act pursuant to arrangements made with—

(a)

the Board;

(b)

a CCG;

(c)

an NHS trust;

(d)

an NHS foundation trust;

(e)

a local authority in the exercise of its public health functions under sections 2B (functions of local authorities and Secretary of State as to improvement of public health) and 111 (dental public health) of, and paragraphs 1 to 7B and 13 of Schedule 1 (further provision about the Secretary of State and services under this Act) to, and pursuant to regulations made under section 6C (regulations as to the exercise by local authorities of certain public health functions) of, the 2006 Act(9);

(f)

the Secretary of State when exercising the public health functions of the Secretary of State (as defined in section 1H(5)(a) of the 2006 Act(10) (the Board and its commissioning functions)).”.

(38) In the definition of “provider of out of hours services”—

(a) for the definition of “APMS contractor”, substitute—

““APMS contractor” means a person or partnership that provides primary medical services under contractual arrangements with the Board under section 83(2) of the 2006 Act (primary medical services)(11), and “APMS” contract is to be construed accordingly;”;

(b) omit sub-paragraph (b); and

(c) omit the definition of “practice”.

(39) After the definition of “provider of out of hours services”, insert the following definitions—

““Regional Health and Social Care Board” means the Regional Health and Social Care Board established under section 7 of the Health and Social Care (Reform) Act (Northern Ireland) 2009(12) (Regional Health and Social Care Board);

“registered pharmacist” means a person who is registered in Part 1 or 4 of the register maintained under article 19 of the Pharmacy Order 2010 or in the register maintained under articles 6 and 9 of the Pharmacy (Northern Ireland) Order 1976;”.

(40) Omit the definition of “repeatable prescriber”.

(41) For the definition of “repeatable prescription”, substitute the following definition—

““repeatable prescription” means an electronic repeatable prescription or a form for ordering drugs or appliances which—

(a)

is compatible with the systems used by the Board (or a person exercising its functions) for—

(i)

the remuneration of persons providing pharmaceutical services, and

(ii)

any apportionment of, or any arrangements for recharging in respect of, that remuneration,

unless the chemist or dispensing doctor dispensing the prescription is to receive no pharmaceutical remuneration of any kind in respect of any drug or appliance ordered on the form;

(b)

has been provided for use by a prescriber by—

(i)

the Board,

(ii)

another primary care organisation,

(iii)

a local authority, under arrangements for providing NHS services which include, with the consent of the Board, the dispensing of prescriptions as part of pharmaceutical or local pharmaceutical services,

(iv)

the Secretary of State,

(v)

a CCG, under arrangements for providing NHS services which include, with the consent of the Board, the dispensing of prescriptions as part of pharmaceutical or local pharmaceutical services,

(vi)

an NHS trust, or

(vii)

an NHS foundation trust;

(c)

if—

(i)

it has been so provided for use by a prescriber in England, and

(ii)

a prescription charge may be payable in relation to the prescription or a prescription charge exemption in these Regulations may apply to it,

is in a format that has been approved by the Secretary of State;

(d)

has been issued by a prescriber;

(e)

indicates that the drugs or appliances ordered may be provided more than once; and

(f)

specifies the number of occasions on which they may be provided;”.

(42) After the definition of “repeatable prescription”, insert the following definitions—

““secure children’s home” means accommodation which is provided in a children’s home, within the meaning of the Care Standards Act 2000(13), which provides accommodation for the purposes of restricting liberty and in respect of which a person is registered under Part 2 of that Act;

“secure training centre” means a place in which offenders in respect of whom detention and training orders have been made under section 100 of the Powers of Criminal Courts (Sentencing) Act 2000(14) (offenders under 18: detention and training orders) may be detained and given training and education and prepared for their release and in which children who have been remanded to youth detention accommodation under section 91(4) of the Legal Aid, Sentencing and Punishment of Offenders Act 2012 may be detained;”.

(43) For the definition of “supplementary prescriber”, substitute the following definition—

““supplementary prescriber” means—

(a)

a registered pharmacist against whose name in Part 1 of the register maintained under article 19 of the Pharmacy Order 2010 or in the register maintained under Articles 6 and 9 of the Pharmacy (Northern Ireland) Order 1976 is recorded an annotation signifying that they are qualified to order drugs and appliances as a supplementary prescriber;

(b)

a person—

(i)

who is registered in a part of the register maintained under article 5 of the Health and Social Work Professions Order 2001(15) (establishment and maintenance of register) which relates to chiropodists and podiatrists, physiotherapists or radiographers, and

(ii)

against whose name in that register is recorded an annotation signifying that they are qualified to order drugs and appliances as a supplementary prescriber; or

(c)

an optometrist against whose name in the register of optometrists maintained under section 7 of the Opticians Act 1989(16) (which relates to the register of optometrists and the register of dispensing opticians) is recorded an annotation signifying that the optometrist is qualified to order drugs and appliances as a supplementary prescriber;”.

(44) In the definition of “Walk-in Centre”, for “or on behalf of the Secretary of State” substitute “the Board or a CCG”.

(45) After the definition of “Walk-in Centre”, insert the following definition—

““young offender institution” means a place for the detention of offenders sentenced to detention in a young offender institution or to custody for life or other persons who may be lawfully detained there.”.

(1)

See section 126(9) of that Act, which provides a definition of “listed” that includes the power for the Secretary of State to approve lists for the purposes of section 126.

(2)

Schedule 12A was inserted by Schedule 3 to the Health and Social Care Act 2012 (c.7).

(3)

S.I. 2002/254; article 5 has been amended by S.I. 2009/1182. The Order was so renamed by section 213(1), (4) and (6) of the Health and Social Care Act 2012.

(4)

S.I. 2012/2996; regulation 10 has been amended by S.I. 2013/261.

(5)

Section 127 has been amended by section 55(1) of, and paragraphs 64(1) to (4) of Schedule 4 to, the Health and Social Care Act 2012.

(6)

1978 c. 29. Section 2 has been amended by: the Health and Social Services and Social Security Adjudications Act 1983 (c.41), Schedule 7, paragraph 1; the National Health Service and Community Care Act 1990 (c.19), section 28, Schedule 9, paragraph 19(1), and Schedule 10; the National Health Service Reform (Scotland) Act 2004 (asp 7), Schedule 1, paragraph 1(2); the Smoking, Health and Social Care (Scotland) Act 2005 (asp 13), Schedule 2, paragraph 2(2); and the Health Boards (Membership and Elections) (Scotland) Act 2009 (asp 5), section 2(1).

(7)

S.I. 2010/231.

(8)

S.I. 1976/1213 (N.I. 22).

(9)

Section 2B was inserted by section 12 of the Health and Social Care Act 2012 (“the 2012 Act). Section 6C was inserted by section 18(1) of the 2012 Act. Section 111 was amended by section 29(1) and (2) of the 2012 Act. Paragraphs 7A and 7B of Schedule 1 were inserted by section 143(1) of the 2012 Act. Paragraph 13 of Schedule 1 was substituted by section 17(2) and (13) of the 2012 Act.

(10)

Section 1H was inserted by section 9(1) of the 2012 Act.

(11)

Section 83(2) was substituted by section 55(1) of, and paragraph 30(2) of Schedule 4 to, the Health and Social Care Act 2012.

(12)

2009 c.1 (N.I.).

(13)

2000 c. 14.

(14)

2000 c. 6 Section 100 was amended by paragraph 184 of Schedule 7 to the Criminal Justice and Court Services Act 2000 (c.43), by paragraph 111 of Schedule 32 to the Criminal Justice Act 2003 (c.44), and by paragraph 11 of Schedule 26 and paragraph 13 of Schedule 21 to the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (c.10).

(15)

S.I. 2002/254; article 5 has been amended by S.I. 2009/1182. This Order was so renamed by section 213(4) and (6) of the Health and Social Care Act 2012 (c. 7).

(16)

1989 c.44; amended by S.I. 2005/848.