http://www.legislation.gov.uk/uksi/1991/582/madeThe National Health Service (Fund-holding Practices) (General) Regulations 1991National Health Service (NHS)CareHealth care services and specialismsKing's Printer of Acts of Parliament2017-03-20NATIONAL HEALTH SERVICE, ENGLAND AND WALESThese Regulations contain provisions relating to the operation of recognised fund-holding practices.Statutory Instruments1991 No. 582NATIONAL HEALTH SERVICE, ENGLAND AND WALESThe National Health Service (Fund-holding Practices) (General) Regulations 1991Made8th March 1991Laid before Parliament11th March 1991Coming into force1st April 1991

The Secretary of State for Health, as respects England, and the Secretary of State for Wales, as respects Wales, in exercise of powers conferred by sections 126(4) and (5) and 128(1) of the National Health Service Act 1977

1977 c. 49; section 126(4) was amended by, and section 126(5) was inserted by, section 65(2) of the National Health Service and Community Care Act 1990 (“the 1990 Act”); section 128(1) was amended by section 26(2) of the 1990 Act and is cited for the definition of “regulations”.

and sections 14(6), 15(7), 16(1) to (4) and 17 of the National Health Service and Community Care Act 1990

l990 c.19.

and of all other powers enabling them in that behalf, hereby make the following Regulations:

PART IGeneralCitation, commencement and interpretation1.(1)

These Regulations may be cited as the National Health Service (Fund-holding Practices) (General) Regulations 1991 and shall come into force on 1st April 1991.

(2)

In these Regulations, unless the context otherwise requires—

the Act” means the National Health Service and Community Care Act 1990;

“the 1977 Act” means the National Health Service Act 1977

1977 c. 49.

;

“allotted sum” has the same meaning as in section 15 of the Act;

“the Application Regulations” means the National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990

S.I. 1990/1753.

;

“bank account” includes an account with a building society incorporated under the Building Societies Act 1986

1986 c. 53.

;

“former fund-holding practice” means one or more medical practitioners who were members of a fund-holding practice and either—

(a)

have renounced recognition as a fund-holding practice in accordance with regulations 7 and 8, or

(b)

from whom recognition has been removed in accordance with regulations 10 and 11 or 12 and 13

whichever is appropriate;

“fund-holding account” has the meaning assigned by regulation 3(2)(d);

“fund-holding practice” means a recognised fund-holding practice;

“health service body” has the same meaning as in section 4 of the Act;

“recognised fund-holding practice” shall he construed in accordance with section 14 of the Act;

“relevant Regional Health Authority” has the meaning assigned by section 14(3) of the Act.

(3)

For the purposes of these Regulations, any reference to a fund-holding practice renouncing recognition is a reference to a fund-holding practice renouncing its status as a recognised fund-holding practice and “renunciation of recognition” shall be construed accordingly.

(4)

For the purposes of these Regulations, any reference to a relevant Regional Health Authority removing recognition is a reference to that Authority removing recognition from the members of a fund-holding practice and “removal of recognition” shall be construed accordingly.

(5)

For the purposes of these Regulations, any reference to the rights and liabilities of members of a fund-holding practice is a reference to rights and liabilities incurred in connection with the application of an allotted sum and in particular to rights and liabilities under NHS contracts.

(6)

Unless the context otherwise requires, any reference in these Regulations to a numbered regulation is a reference to the regulation 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 that regulation.

(7)

In these Regulations any reference to the sending of a document is a reference to the sending of the document in a prepaid letter addressed, in the case of a medical practitioner, to him at the address given in the medical list in which he is included and, in the case of the Secretary of State or a Regional Health Authority, to them at their principal office.

Application of Regulations in Wales2.(1)

Subject to paragraph (2), in the application of these Regulations to any fund-holding practice whose recognition has been granted by the Secretary of State

See regulation 2 of the Application Regulations.

, for any reference to the relevant Regional Health Authority there shall be substituted at reference to the Secretary of State.

(2)

Regulations 11(4)(c)(i) and (5)(c)(i), 13(c)(i) and 14 do not apply to any fund-holding practice whose recognition has been granted by the Secretary of State.

PART IIContinuing RecognitionConditions for continuing recognition3.(1)

The members of at fund-holding practice shall continue to be entitled to recognition as a fund-holding practice if and so long as the conditions specified ill paragraph (2) are fulfilled in relation to the practice.

(2)

The conditions referred to in paragraph (1) are that—

(a)

the practice does not include—

(i)

a member who practises in a partnership where the total number of patients on the lists of patients of the medical practitioners in the partnership exceeds 9,000, and

(ii)

a member who practises in another such partnership;

(b)

there is at total of at least 9,000 patients on the lists of patients of the members of the practice or, though there is at total of less than 9,000 patients on those lists, there is likely, in the opinion of the relevant Regional Health Authority, to be at total of at least 9,000 on those lists by the 1st April following the date on which it came to the notice of the relevant Regional Health Authority that the total number of patients on the lists of members of the practice was less than 9,000;

(c)

where the members of the practice are not partners in a single partnership, there is in force an agreement such as is mentioned in regulation 6(d) of the Application Regulations;

(d)

the members of the practice maintain a bank account (“the fund-holding account”) for the purpose of receiving an allotted sum or any part of it;

(e)

except where liability to pay an allotted sum to the members of the fund-holding practice is discharged pursuant to section 15(3)(b) of the Act, the members of the practice deal with the allotted sum or any part of it only through the fund-holding account;

(f)

no sums are paid into the fund-holding account other than the allotted sum of any part of it;

(g)

the members of the practice send to the relevant Family Health Services Authority, before the end of each month, such information relating to the preceding month as the relevant Family Health Services Authority may reasonably require in relation to the management of the allotted sum and in particular to—

(i)

transactions effected through the fund-holding account,

(ii)

the amount standing in the fund-holding account at the end of the preceding month,

(iii)

whether any such amount includes an amount which may be applied for the purposes specified in regulation 20 (savings from the allotted sum), and

(iv)

the arrangements made for the purchase of goods and services referred to in regulation 17(2);

(h)

the annual accounts of a fund-holding practice which are required to be kept under section 98(2B)(c) of the 1977 Act

Section 98(2B) was inserted by section 20(2)(b) of the Act.

shall be submitted to the relevant Family Health Services Authority within six weeks of the end of the financial year to which the accounts relate;

(i)

the members of the practice shall not, except in the circumstances specified in sub-paragraphs (c), (d), (f) and (h) to (m) of paragraph 32 of Schedule 1 to the National Health Service (General Medical and Pharmaceutical Services) Regulations 1974

S.I. 1974/160; paragraph 32 was amended by S.I. 1975/719, regulation 3(14)(c); S.I. 1982/1283, regulation 2(7)(d); and S.I. 1989/1897, regulation 11.

(acceptance of fees), demand or accept from any patient of a member of the practice for whom general medical services are provided a payment (including a payment in kind) in respect of any treatment—

(i)

provided by a member of the practice, or

(ii)

which a member of the practice has arranged to be provided for the patient,

whether or not the treatment is to be provided under the Act or the 1977 Act;

(j)

no goods or services specified in a list approved under regulation 17(2) shall be purchased for a patient of a member of the practice from any person or body with which any member of the practice has a particular connection unless—

(i)

the relevant Regional Health Authority has consented in writing to the purchase of those goods or services from that person or body, or

(ii)

it is impracticable, having regard to the condition of the patient, to obtain the consent and no alternative is available, or

(iii)

the body is a health service body other than a fund-holding practice;

(k)

where the members of a practice have obtained the consent of the relevant Regional Health Authority under sub-paragraph above, the members of the practice shall inform that Authority of any change either in the facilities available at, or the charges made by, the person or body in respect of which the consent is given;

(l)

the allotted sum shall be applied only for the purposes specified in regulations 16, 17, 19 and 20;

(m)

the members of the fund-holding practice shall manage the allotted sum effectively and efficiently.

(3)

In this regulation—

(a)

a member of a fund-holding practice shall be treated as having a particular connection with a body if—

(i)

he is a director of, or is in the employment of, the body, or

(ii)

he is a partner of, or is in the employment of, or is a close relative of, a person who is a director of the body, or

(iii)

where the body is a fund-holding practice, he is a close relative of a member of the practice, or

(iv)

he is a close relative of a person in the employment of the body, or

(v)

he has a beneficial interest in the securities of the body;

(b)

a member of a fund-holding practice shall be treated as having a particular interest in a person if he is a close relative of, or is a partner of, or is in the employment of, the person.

(c)

“close relative” means a husband, wife, brother, sister, father, mother, son or daughter.

Additions to existing fund-holding practices4.(1)

Where a medical practitioner (whether or not he is a member of another fund-holding practice) wishes to become a member of an existing fund-holding practice then, except in the circumstances specified in paragraph (2), he and the members of the existing fund-holding practice shall apply to the relevant Regional Health Authority for recognition as a fund-holding practice in accordance with the Application Regulations.

(2)

Paragraph (1) shall not apply to a medical practitioner who becomes a partner of a member of a fund-holding practice as a result of the grant of an application made by the medical practitioner to a Family Health Services Authority under section 30(1) of the 1977 Act

1977 c. 49; section 30 was amended by the Health Services Act 1980 (c. 53), Schedule 1, paragraph 43 and Schedule 7, S.I. 1981/432, article 3(1), the Health and Social Security Act 1984 (c. 48), Schedule 3, paragraph 4 and S.I. 1985/39, article 7(4).

to be included in the list of names of medical practitioners undertaking to provide general medical services in the Authority’s locality.

(3)

A medical practitioner who becomes a partner of a member of a fund-holding practice in the circumstances described in paragraph (2) shall, on having his name included in the list referred to in that paragraph, be a member of that fund-holding practice notwithstanding that he did not join in the making of an application under regulation 3 of the Application Regulations.

Withdrawal of a member of a fund-holding practice5.(1)

Subject to paragraph (2), a member of a fund-holding practice may withdraw from the practice and the recognition as a fund-holding practice of the remaining members of the practice shall not be affected by the withdrawal.

(2)

A member of a fund-holding practice who is a partner of another member of the practice may not withdraw from the fund-holding practice unless he also ceases to be a partner of that other member.

Death of a member of a fund-holding practice6.

Where a member of a fund-holding practice dies, the recognition as a fund-holding practice of the remaining members of the practice shall not be affected by the death.

PART IIIRenunciation of RecognitionRenunciation of recognition7.

The circumstances in which the members of a fund-holding practice may renounce recognition are that a majority of the members of the practice have sent to the relevant Regional Health Authority notice of their intention to renounce recognition in accordance with regulation 8.

Procedure for renunciation of recognition8.

The notice referred to in regulation 7 shall—

(a)

be in writing;

(b)

be signed by a majority of the members of the fund-holding practice;

(c)

be sent at least one month before the 31st March following the sending of the notice;

(d)

be expressed to expire on 31st March; and

(c)

be accompanied by a statement including information relating to—

(i)

the NHS contracts into which the members of the practice have entered;

(ii)

the amount standing in the fund-holding account;

(iii)

the amount standing in the fund-holding account which may be applied for the purposes specified in regulation 20 (savings from the allotted sum) and;

(iv)

the liabilities of the members of the fund-holding practice.

Consequences of renunciation of recognition9.(1)

Subject to paragraphs (2) and (4), the consequences of renunciation are that the members of a fund-holding practice cease, as from the 31st March specified in the notice referred to in regulation 8, to be recognised as a fund-holding practice.

(2)

Notwithstanding a renunciation of recognition and subject to paragraph (5), a former fund-holding practice shall continue to fulfil the conditions specified in regulation 4(2)(d), (e), (f), (g), (h) and (l) until the relevant Regional Health Authority is satisfied that all the liabilities of the former fund-holding practice have been discharged.

(3)

When the relevant Regional Health Authority is satisfied that all liabilities of the fund-holding practice have been discharged it shall send a notice to that effect to each member of the former fund-holding practice.

(4)

If, after a notice under the preceding paragraph has been sent, part of the allotted sum remains in the fund-holding account, the former fund-holding practice shall—

(a)

continue to maintain the fund-holding account until no amount remains standing in that account;

(b)

apply that sum only for the purposes specified in regulation 20 (savings from the allotted sum); and

(c)

each month send to the relevant Regional Health Authority a statement specifying any withdrawal from the fund-holding account.

(5)

If, at any time after the renunciation of recognition has taken effect, the relevant Regional Health Authority is satisfied that—

(a)

no part of the allotted sum remains in the fund-holding account; and

(b)

the liabilities of the former fund-holding practice have not been discharged

all the rights and liabilities of the former fund-holding practice shall, upon notice being sent to that effect to each member of the former fund-holding practice, transfer to the relevant Regional Health Authority.

PART IVRemoval of RecognitionGrounds for removal of recognition10.(1)

Where, by 28th February in any year, the relevant Regional Health Authority has notified the members of a fund-holding practice of the amount of the allotted sum for the financial year beginning on the next 1st April and the members of the practice have not, within one month from the date on which that notice is sent, notified the relevant Regional Health Authority that they are prepared to accept that amount as their allotted sum, the relevant Regional Health Authority may remove recognition from them with effect from that 1st April (whether or not the recognition is one which has taken effect in accordance with regulation 5(2) of the Application Regulations).

(2)

The relevant Regional Health Authority may remove recognition from the members of a fund-holding practice if a condition specified in regulation 3(2) is no longer fulfilled in relation to the practice.

Procedure for removal of recognition11.(1)

Except as provided by regulations 12 and 13, where a relevant Regional Health Authority proposes to remove recognition from the members of a fund-holding practice on the ground specified in regulation 10(2), the Authority shall—

(a)

send to each member of the practice a notice in writing specifying—

(i)

the reason for the proposal, and

(ii)

the date, which shall be at least 3 months from the date on which the notice is sent, on which the removal of recognition is proposed to have effect; and

(b)

inform the members of the practice that they may, subject to paragraphs (2) and (3), make representations to the Authority concerning the matter either orally or in writing.

(2)

Representations in writing shall be sent to the relevant Regional Health Authority within two months of the date on which the notice referred to in paragraph (1) is sent.

(3)

Where the members of the practice wish to make representations orally they shall, within two weeks of the date on which the notice referred to in paragraph (1) is sent, send notice to that effect to the relevant Regional Health Authority and the Authority shall, within six weeks of the date on which the members of the fund-holding practice send notice under this paragraph, give them an opportunity of appearing before and being heard by the Authority or a committee, sub-committee or officer of the Authority appointed for the purpose.

(4)

If the relevant Regional Health Authority decide, having taken into account any representations made by the members of the fund-holding practice, to adopt the proposal, the Authority shall—

(a)

send to each member of the fund-holding practice a notice in writing of its decision;

(b)

include in the notice—

(i)

a statement of the reasons for the decision, and

(ii)

the date on which the removal of recognition takes effect; and

(c)

inform each member of the practice of—

(i)

the right to appeal to the Secretary of State against the removal of recognition, and

(ii)

the consequences of removal of recognition.

(5)

In the circumstances specified in regulation 10(1), the relevant Regional Health Authority shall—

(a)

send to each member of the practice notice of removal of recognition;

(b)

include in the notice a statement of the reasons for the removal of recognition and that the removal has effect from the 1st April following the sending of the notice; and

(c)

inform each member of the practice of—

(i)

the right to appeal to the Secretary of State against the removal of recognition, and

(ii)

except where recognition has not taken effect in accordance with regulation 5(2) of the Application Regulations, the consequences of the removal of recognition.

Removal of recognition with immediate effect12.

Where it appears to a relevant Regional Health Authority that it is necessary either—

(a)

in the interests of patients of members of the practice; or

(b)

for the purpose of ensuring the proper management of the allotted sum

that recognition should be removed under regulation 10(2) with immediate effect, the relevant Regional Health Authority shall remove recognition with immediate effect.

Procedure for removal of recognition with immediate effect13.

In the circumstances specified in regulation 12, the relevant Regional Health Authority shall—

(a)

send to each member of the practice notice of removal of recognition;

(b)

include in the notice a statement of the reasons for the removal of recognition; and

(c)

inform each member of the practice of—

(i)

the right to appeal to the Secretary of State against the removal of recognition, and

(ii)

the consequences of the removal of recognition.

Appeals to the Secretary of State14.(1)

The members of a fund-holding practice or, where removal of recognition has taken effect, a former fund-holding practice, may appeal to the Secretary of State against the removal of recognition by the relevant Regional Health Authority.

(2)

Regulation 8(2) to (8) of the Application Regulations shall apply in relation to an appeal against removal of recognition as if—

(a)

a reference to the members of the practice were a reference to the members of a fund-holding practice or, where removal of recognition has taken effect, a former fund-holding practice;

(b)

a reference to a decision to refuse to grant a practice recognition as a fund-holding practice were to a decision to remove recognition as a fund-holding practice; and

(c)

for paragraph (8)(b) there were substituted the following paragraph—(b)

determine the appeal in accordance with regulation 10 of the National Health Service (Fund-holding Practices) (General) Regulations 1991.

.

Consequences of removal15.(1)

On the day on which removal of recognition takes effect, all the rights and liabilities of a fund-holding practice shall transfer to the relevant Regional Health Authority.

(2)

Subject to paragraph (3), on the day on which the removal of recognition takes effect, the fund-holding account shall be treated as having been opened by the relevant Regional Health Authority and that Authority may deal with the allotted sum or any part of it remaining in that account as though it were the fund-holding practice.

(3)

Where, on the day on which removal of recognition takes effect, there remains in the fund-holding account any part of the allotted sum which may be applied for the purposes specified in regulation 20 (savings from the allotted sum) the relevant Regional Health Authority shall apply that part of the allotted sum for such of those purposes as the former fund-holding practice may require.

PART VAllotted Sum — Authorised PurposesPayment for drugs, medicines and listed appliances16.(1)

The members of a fund-holding practice shall pay to the relevant Regional Health Authority out of the allotted sum an amount determined in accordance with the following paragraphs of this regulation as the basic cost of the drugs, medicines and listed appliances supplied pursuant to orders given by or on behalf of members of the practice.

(2)

The amount referred to in paragraph (1) shall, subject to paragraph (7), be—

(a)

the price of the drugs, medicines or listed appliances calculated in accordance with paragraphs (3) and (4); minus

(b)

an amount representing a percentage of the price of the drug, medicine or listed appliance, calculated in accordance with paragraph (5), plus

(c)

except in the case of listed appliances supplied with, or in connection with, the supply of oxygen or drugs and medicines supplied in bulk, an amount representing the cost of the container or packaging in which the drug, medicine or listed appliance is supplied calculated in accordance with paragraph (6).

(3)

The price referred to in paragraph (2)(a) of a drug or medicine shall be—

(a)

where the name of the drug or medicine is listed in a list in the Drug Tariff which specifies a price for a specified quantity of that drug or medicine, the price so specified;

(b)

where the name of the drug or medicine is not so listed, the manufacturer’s list price.

(4)

The price referred to in paragraph (2)(a) of a listed appliance shall be the price of the appliance specified in the Drug Tariff.

(5)

The percentage referred to in paragraph (2)(b) shall be—

(a)

9.67 per cent. of the price of the drug, medicine or listed appliance where that drug, medicine or listed appliance has been supplied pursuant to an order given by or on behalf of a member of a fund-holding practice whose recognition has been granted by a Regional Health Authority; and

(b)

9.10 per cent. of the price of the drug, medicine or listed appliance where that drug, medicine or listed appliance has been supplied pursuant to an order given by or on behalf of a member of a fund-holding practice whose recognition has been granted by the Secretary of State.

(6)

The amount referred to in paragraph (2)(c) shall be 3.80 pence for each listed appliance and each quantity of a drug or medicine.

(7)

Where an amount calculated under paragraph 2(a), (b) or (c) is in any month not an exact number of pounds, any amount of fifty pence or more shall be rounded up to, and any amount less than fifty pence shall be rounded down to, the nearest whole pound.

(8)

In this regulation—

“the Drug Tariff” means the statement published under regulation 28 of the National Health Service (General Medical and Pharmaceutical Services) Regulations 1974

S.I. 1974/160; regulation 28 was amended by S.I. 1985/955, article 2(6).

;

“listed appliance” means an appliance which is included in a list for the time being approved by the Secretary of State for the purposes of section 41 of the 1977 Act.

“manufacturer’s list price” means the price which the manufacturer of a drug or medicine or his agent publishes as being the price of that drug or medicine;

“medicine” includes such chemical re-agents as are included in a list for the time being approved by the Secretary of State for the purposes of section 41 of the 1977 Act.

(9)

In this regulation, a drug or medicine is supplied in bulk when—

(a)

it is ordered by a member of a fund-holding practice for two or more patients of his;

(b)

those patients reside in a school or institution in which at least twenty persons reside;

(c)

the name of that school or institution is written on the order;

(d)

at least ten of the persons residing in the school or institution are patients of the member of the fund-holding practice ordering the drug or medicine.

Payment for goods and services17.(1)

The members of a fund-holding practice may apply the allotted sum to the purchase of the goods and services, other than general medical services, referred to in paragraph (2) and shall apply the allotted sum to the purchase of such of those goods and services as are necessary for the proper treatment of patients of members of the practice.

(2)

The goods and services referred to in paragraph (1) shall be the goods and services specified in a list approved from time to time by the Secretary of State for the purposes of this regulation.

Limit on provision of goods and services18.

There shall be a limit of £5000 on the amount which may be spent out of an allotted sum on the provision of goods and services for any one individual, being a limit above which the cost of any goods and services for that individual in the financial year in question will fall to be met by the District Health Authority whose primary functions include the provision of goods and services (not necessarily the goods and services in question) to the individual concerned.

Payment of salaries19.(1)

The members of a fund-holding practice may apply the allotted sum for the purpose of paying the salaries of those employees of members of the practice whose employment by a member of the practice began after the date on which the members of the practice were granted recognition as a fund-holding practice.

(2)

Where a Family Health Services Authority has, before the date on which the members of a fund-holding practice were granted recognition as a fund-holding practice, reimbursed a member of the practice in respect of a proportion of the salary of an employee of his, then the members of the fund-holding practice may apply the allotted sum for the purpose of paying, in respect of periods after that date, that proportion of the salary of that employee.

Savings from the allotted sum20.

Where the accounts for a financial year of members of a fund-holding practice have been audited in accordance with Part III of the Local Government Finance Act 1982

1982 c. 32.

the members of a fund-holding practice may continue to apply any part of the allotted sum paid to them in respect of that financial year for the purposes specified in regulations 17 and 19 and, in addition, for a period of four years after the end of that financial year, for any one or more of the following purposes—

(a)

the purchase of material or equipment which—

(i)

can be used for the treatment of patients of the practice,

(ii)

enhances the comfort or convenience of patients of the practice,

(iii)

enables the practice to be managed more effectively and efficiently; or

(b)

the purchase of material or equipment relating to health education; or

(c)

the improvement of any premises from which the members of the practice carry on their practice whether by improving the structure of the premises or the purchase of furniture and furnishings for the premises.

PART VITransfer of FunctionsTransfer of functions in England21.(1)

With effect from 1st April 1991, the function of a Regional Health Authority under section 15(1) of the Act of being liable to pay a sum to the members of a fund-holding practice shall become the function of a Family Health Services Authority.

(2)

The Family Health Services Authority which is to exercise the function referred to in paragraph (1) in relation to the members of any existing fund-holding practice is the relevant Family Health Services Authority.

(3)

Section 15 of the Act shall have effect subject to the following modifications—

(a)

in subsection (1), for the words “Regional Health Authority” in both places where they occur, there shall be substituted the words “Family Health Services Authority”, and after the word “determined” there shall be inserted the words “by the relevant Regional Health Authority”; and

(b)

in subsection (4)—

(i)

in paragraph (a), for the words “Regional Health Authority” there shall be substituted the words “Family Health Services Authority which has a locality in England”,

(ii)

in paragraph (b), for the words “another Regional Health Authority” there shall be substituted the words “a Regional Health Authority which is not the relevant Regional Health Authority in respect of the members of the practice”, and

(iii)

for the words “other Authority” there shall be substituted the words “Regional Health Authority”.

Transfer of functions in Wales22.(1)

With effect from 1st April 1991, the function of the Secretary of State under section 15(2) of being liable to pay a sum to the members of each fund-holding practice whose relevant Family Health Services Authority has a locality in Wales shall become the function of a Family Health Services Authority.

(2)

The Family Health Services Authority which is to exercise the function referred to in paragraph (1) in relation to the members of any existing fund-holding practice is the relevant Family Health Services Authority.

(3)

Section 15 of the Act shall have effect subject to the following modifications—

(a)

in subsection (2)—

(i)

for the words “the Secretary of State” in the first place where they occur there shall be substituted the words “every Family Health Services Authority which has a locality in Wales”,

(ii)

for the words “whose relevant Family Health Services Authority has a locality in Wales” there shall be substituted the words “in respect of whom it is the relevant Family Health Services Authority”, and

(iii)

after the word “determined” there shall be inserted the words “by the Secretary of State”, and

(iv)

for the words “the Secretary of State” in the second place where they occur there shall be substituted the word “he”; and

(b)

in subsection (5)—

(i)

for the words “the Secretary of State” in the first place where they occur there shall be substituted the words “a Family Health Services Authority which has a locality in Wales”,

(ii)

for the words “the Secretary of State” in the second place where they occur there shall be substituted the words “the Authority making the payment”, and

(iii)

for the words “that Authority” there shall be substituted the words “that Regional Health Authority”.

PART VIIAmendment of RegulationsAmendment of regulations23.

In regulation 3 of the Application Regulations (applications for recognition as a fund-holding practice), for paragraph (5) there is substituted the following paragraph—(5)

Where at least one of the members of a practice wishing to make an application is on the medical list of a Health Board, section 14 of the Act shall operate subject to the modification that at the end of subsection (1) there shall be added the words “except, if at least one of those practitioners is also providing general medical services in accordance with arrangements under section 19 of the National Health Service (Scotland) Act 1978

1978 c. 29.

, where more patients on the lists of members of the practice reside in Scotland than in England”.

William WaldegraveSecretary of State for Health8th March 1991David HuntSecretary of State for Wales8th March 1991(This note is not part of the Reglulations

These Regulations contain provisions relating to the operation of recognised fund-holding practices.

A recognised fund-holding practice is a practice comprising one or more medical practitioners who are providing general medical services in accordance with arrangements under section 29 of the National Health Service Act 1977 which has been recognised by a Regional Health Authority under section 14 of the National Health Service and Community Care Act 1990 is a recognised fund-holding practice and which in consequence of recognition is entitled to be paid an allotted sum in accordance with section 15(1) of the 1990 Act. An allotted sum may only be applied for purposes specified in these Regulations.

The Regulations include provision about—

(1)

the interpretation of the Regulations and their application in Wales (Part I),

(2)

the conditions for continuing to be entitled to recognition as a recognised fund-holding practice and additions to and withdrawals from a recognised fund-holding practice (Part II),

(3)

renunciation of recognition including the procedure for renunciation and its consequences (Part III),

(4)

removal of recognition as a recognised fund-holding practice, including specifying the grounds for removal, the procedure for removal, appeals against removal and the consequences of removal (Part IV),

(5)

the purposes for which allotted sums may be applied (Part V),

(6)

the transfer of some of the functions of Regional Health Authorities in England and similar functions of the Secretary of State in Wales to Family Health Services Authorities (Part VI).

They also amend the National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 in relation to applications from medival practitioners who have patients in England and Scotland.

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<dc:title>The National Health Service (Fund-holding Practices) (General) Regulations 1991</dc:title>
<dc:subject>National Health Service (NHS)</dc:subject>
<dc:subject>Care</dc:subject>
<dc:subject>Health care services and specialisms</dc:subject>
<dc:publisher>King's Printer of Acts of Parliament</dc:publisher>
<dc:modified>2017-03-20</dc:modified>
<dc:subject scheme="SIheading">NATIONAL HEALTH SERVICE, ENGLAND AND WALES</dc:subject>
<dc:description>These Regulations contain provisions relating to the operation of recognised fund-holding practices.</dc:description>
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<block name="banner">Statutory Instruments</block>
<block name="number">
<docNumber>1991 No. 582</docNumber>
</block>
<container name="subjects">
<container name="subject">
<block name="subject">
<concept refersTo="#">NATIONAL HEALTH SERVICE, ENGLAND AND WALES</concept>
</block>
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</container>
<block name="title">
<docTitle>The National Health Service (Fund-holding Practices) (General) Regulations 1991</docTitle>
</block>
<container name="dates">
<block name="madeDate" refersTo="#date-made">
<span>Made</span>
<docDate date="1991-03-08">8th March 1991</docDate>
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<span>Laid before Parliament</span>
<docDate date="1991-03-11">11th March 1991</docDate>
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<span>Coming into force</span>
<docDate date="1991-04-01">1st April 1991</docDate>
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<p>
The Secretary of State for Health, as respects England, and the Secretary of State for Wales, as respects Wales, in exercise of powers conferred by sections 126(4) and (5) and 128(1) of the National Health Service Act 1977
<authorialNote class="footnote" eId="f00001" marker="1">
<p>
<ref eId="c00001" href="http://www.legislation.gov.uk/id/ukpga/1977/49">1977 c. 49</ref>
; section 126(4) was amended by, and section 126(5) was inserted by, section 65(2) of the National Health Service and Community Care Act 1990 (“the
<abbr title="National Health Service and Community Care Act 1990 c. 19">1990 Act</abbr>
”); section 128(1) was amended by section 26(2) of the
<abbr title="National Health Service and Community Care Act 1990 c. 19">1990 Act</abbr>
and is cited for the definition of “regulations”.
</p>
</authorialNote>
and sections 14(6), 15(7), 16(1) to (4) and 17 of the National Health Service and Community Care Act 1990
<authorialNote class="footnote" eId="f00002" marker="2">
<p>
<ref eId="c00002" href="http://www.legislation.gov.uk/id/ukpga/1990/19">l990 c.19</ref>
.
</p>
</authorialNote>
and of all other powers enabling them in that behalf, hereby make the following Regulations:
</p>
</formula>
</preamble>
<body>
<part eId="part-I">
<num>PART I</num>
<heading>General</heading>
<hcontainer name="regulation" eId="regulation-1">
<heading>Citation, commencement and interpretation</heading>
<num>1.</num>
<paragraph eId="regulation-1-1">
<num>(1)</num>
<content>
<p>These Regulations may be cited as the National Health Service (Fund-holding Practices) (General) Regulations 1991 and shall come into force on 1st April 1991.</p>
</content>
</paragraph>
<paragraph eId="regulation-1-2">
<num>(2)</num>
<intro>
<p>In these Regulations, unless the context otherwise requires—</p>
</intro>
<hcontainer name="definition">
<content>
<p>
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
” means the National Health Service and Community Care Act 1990;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“the
<abbr title="National Health Service Act 1977 c. 49">1977 Act</abbr>
” means the National Health Service Act 1977
<authorialNote class="footnote" eId="f00003" marker="3">
<p>
<ref eId="c00003" href="http://www.legislation.gov.uk/id/ukpga/1977/49">1977 c. 49</ref>
.
</p>
</authorialNote>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“allotted sum” has the same meaning as in section 15 of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
” means the National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990
<authorialNote class="footnote" eId="f00004" marker="4">
<p>
<ref eId="c00004" href="http://www.legislation.gov.uk/id/uksi/1990/1753">S.I. 1990/1753</ref>
.
</p>
</authorialNote>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“bank account” includes an account with a building society incorporated under the Building Societies Act 1986
<authorialNote class="footnote" eId="f00005" marker="5">
<p>
<ref eId="c00005" href="http://www.legislation.gov.uk/id/ukpga/1986/53">1986 c. 53</ref>
.
</p>
</authorialNote>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<intro>
<p>“former fund-holding practice” means one or more medical practitioners who were members of a fund-holding practice and either—</p>
</intro>
<level class="para1">
<num>(a)</num>
<content>
<p>have renounced recognition as a fund-holding practice in accordance with regulations 7 and 8, or</p>
</content>
</level>
<level class="para1">
<num>(b)</num>
<content>
<p>from whom recognition has been removed in accordance with regulations 10 and 11 or 12 and 13</p>
</content>
</level>
<wrapUp>
<p>whichever is appropriate;</p>
</wrapUp>
</hcontainer>
<hcontainer name="definition">
<content>
<p>“fund-holding account” has the meaning assigned by regulation 3(2)(d);</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>“fund-holding practice” means a recognised fund-holding practice;</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“health service body” has the same meaning as in section 4 of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“recognised fund-holding practice” shall he construed in accordance with section 14 of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“relevant Regional Health Authority” has the meaning assigned by section 14(3) of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
.
</p>
</content>
</hcontainer>
</paragraph>
<paragraph eId="regulation-1-3">
<num>(3)</num>
<content>
<p>For the purposes of these Regulations, any reference to a fund-holding practice renouncing recognition is a reference to a fund-holding practice renouncing its status as a recognised fund-holding practice and “renunciation of recognition” shall be construed accordingly.</p>
</content>
</paragraph>
<paragraph eId="regulation-1-4">
<num>(4)</num>
<content>
<p>For the purposes of these Regulations, any reference to a relevant Regional Health Authority removing recognition is a reference to that Authority removing recognition from the members of a fund-holding practice and “removal of recognition” shall be construed accordingly.</p>
</content>
</paragraph>
<paragraph eId="regulation-1-5">
<num>(5)</num>
<content>
<p>
For the purposes of these Regulations, any reference to the rights and liabilities of members of a fund-holding practice is a reference to rights and liabilities incurred in connection with the application of an allotted sum and in particular to rights and liabilities under
<abbr class="acronym" title="National Health Service">NHS</abbr>
contracts.
</p>
</content>
</paragraph>
<paragraph eId="regulation-1-6">
<num>(6)</num>
<content>
<p>Unless the context otherwise requires, any reference in these Regulations to a numbered regulation is a reference to the regulation 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 that regulation.</p>
</content>
</paragraph>
<paragraph eId="regulation-1-7">
<num>(7)</num>
<content>
<p>In these Regulations any reference to the sending of a document is a reference to the sending of the document in a prepaid letter addressed, in the case of a medical practitioner, to him at the address given in the medical list in which he is included and, in the case of the Secretary of State or a Regional Health Authority, to them at their principal office.</p>
</content>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-2">
<heading>Application of Regulations in Wales</heading>
<num>2.</num>
<paragraph eId="regulation-2-1">
<num>(1)</num>
<content>
<p>
Subject to paragraph (2), in the application of these Regulations to any fund-holding practice whose recognition has been granted by the Secretary of State
<authorialNote class="footnote" eId="f00006" marker="6">
<p>
<i>See</i>
regulation 2 of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
.
</p>
</authorialNote>
, for any reference to the relevant Regional Health Authority there shall be substituted at reference to the Secretary of State.
</p>
</content>
</paragraph>
<paragraph eId="regulation-2-2">
<num>(2)</num>
<content>
<p>Regulations 11(4)(c)(i) and (5)(c)(i), 13(c)(i) and 14 do not apply to any fund-holding practice whose recognition has been granted by the Secretary of State.</p>
</content>
</paragraph>
</hcontainer>
</part>
<part eId="part-II">
<num>PART II</num>
<heading>Continuing Recognition</heading>
<hcontainer name="regulation" eId="regulation-3">
<heading>Conditions for continuing recognition</heading>
<num>3.</num>
<paragraph eId="regulation-3-1">
<num>(1)</num>
<content>
<p>The members of at fund-holding practice shall continue to be entitled to recognition as a fund-holding practice if and so long as the conditions specified ill paragraph (2) are fulfilled in relation to the practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-3-2">
<num>(2)</num>
<intro>
<p>The conditions referred to in paragraph (1) are that—</p>
</intro>
<level class="para1" eId="regulation-3-2-a">
<num>(a)</num>
<intro>
<p>the practice does not include—</p>
</intro>
<level class="para2" eId="regulation-3-2-a-i">
<num>(i)</num>
<content>
<p>a member who practises in a partnership where the total number of patients on the lists of patients of the medical practitioners in the partnership exceeds 9,000, and</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-a-ii">
<num>(ii)</num>
<content>
<p>a member who practises in another such partnership;</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-3-2-b">
<num>(b)</num>
<content>
<p>there is at total of at least 9,000 patients on the lists of patients of the members of the practice or, though there is at total of less than 9,000 patients on those lists, there is likely, in the opinion of the relevant Regional Health Authority, to be at total of at least 9,000 on those lists by the 1st April following the date on which it came to the notice of the relevant Regional Health Authority that the total number of patients on the lists of members of the practice was less than 9,000;</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-c">
<num>(c)</num>
<content>
<p>
where the members of the practice are not partners in a single partnership, there is in force an agreement such as is mentioned in regulation 6(d) of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
;
</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-d">
<num>(d)</num>
<content>
<p>the members of the practice maintain a bank account (“the fund-holding account”) for the purpose of receiving an allotted sum or any part of it;</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-e">
<num>(e)</num>
<content>
<p>
except where liability to pay an allotted sum to the members of the fund-holding practice is discharged pursuant to section 15(3)(b) of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
, the members of the practice deal with the allotted sum or any part of it only through the fund-holding account;
</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-f">
<num>(f)</num>
<content>
<p>no sums are paid into the fund-holding account other than the allotted sum of any part of it;</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-g">
<num>(g)</num>
<intro>
<p>the members of the practice send to the relevant Family Health Services Authority, before the end of each month, such information relating to the preceding month as the relevant Family Health Services Authority may reasonably require in relation to the management of the allotted sum and in particular to—</p>
</intro>
<level class="para2" eId="regulation-3-2-g-i">
<num>(i)</num>
<content>
<p>transactions effected through the fund-holding account,</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-g-ii">
<num>(ii)</num>
<content>
<p>the amount standing in the fund-holding account at the end of the preceding month,</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-g-iii">
<num>(iii)</num>
<content>
<p>whether any such amount includes an amount which may be applied for the purposes specified in regulation 20 (savings from the allotted sum), and</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-g-iv">
<num>(iv)</num>
<content>
<p>the arrangements made for the purchase of goods and services referred to in regulation 17(2);</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-3-2-h">
<num>(h)</num>
<content>
<p>
the annual accounts of a fund-holding practice which are required to be kept under section 98(2B)(c) of the
<abbr title="National Health Service Act 1977 c. 49">1977 Act</abbr>
<authorialNote class="footnote" eId="f00007" marker="7">
<p>
Section 98(2B) was inserted by section 20(2)(b) of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
.
</p>
</authorialNote>
shall be submitted to the relevant Family Health Services Authority within six weeks of the end of the financial year to which the accounts relate;
</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-i">
<num>(i)</num>
<intro>
<p>
the members of the practice shall not, except in the circumstances specified in sub-paragraphs (c), (d), (f) and (h) to (m) of paragraph 32 of Schedule 1 to the National Health Service (General Medical and Pharmaceutical Services) Regulations 1974
<authorialNote class="footnote" eId="f00008" marker="8">
<p>
<ref eId="c00006" href="http://www.legislation.gov.uk/id/uksi/1974/160">S.I. 1974/160</ref>
; paragraph 32 was amended by
<ref eId="c00007" href="http://www.legislation.gov.uk/id/uksi/1975/719">S.I. 1975/719</ref>
, regulation 3(14)(c);
<ref eId="c00008" href="http://www.legislation.gov.uk/id/uksi/1982/1283">S.I. 1982/1283</ref>
, regulation 2(7)(d); and
<ref eId="c00009" href="http://www.legislation.gov.uk/id/uksi/1989/1897">S.I. 1989/1897</ref>
, regulation 11.
</p>
</authorialNote>
(acceptance of fees), demand or accept from any patient of a member of the practice for whom general medical services are provided a payment (including a payment in kind) in respect of any treatment—
</p>
</intro>
<level class="para2" eId="regulation-3-2-i-i">
<num>(i)</num>
<content>
<p>provided by a member of the practice, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-i-ii">
<num>(ii)</num>
<content>
<p>which a member of the practice has arranged to be provided for the patient,</p>
</content>
</level>
<wrapUp>
<p>
whether or not the treatment is to be provided under
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
or the
<abbr title="National Health Service Act 1977 c. 49">1977 Act</abbr>
;
</p>
</wrapUp>
</level>
<level class="para1" eId="regulation-3-2-j">
<num>(j)</num>
<intro>
<p>no goods or services specified in a list approved under regulation 17(2) shall be purchased for a patient of a member of the practice from any person or body with which any member of the practice has a particular connection unless—</p>
</intro>
<level class="para2" eId="regulation-3-2-j-i">
<num>(i)</num>
<content>
<p>the relevant Regional Health Authority has consented in writing to the purchase of those goods or services from that person or body, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-j-ii">
<num>(ii)</num>
<content>
<p>it is impracticable, having regard to the condition of the patient, to obtain the consent and no alternative is available, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-2-j-iii">
<num>(iii)</num>
<content>
<p>the body is a health service body other than a fund-holding practice;</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-3-2-k">
<num>(k)</num>
<content>
<p>where the members of a practice have obtained the consent of the relevant Regional Health Authority under sub-paragraph above, the members of the practice shall inform that Authority of any change either in the facilities available at, or the charges made by, the person or body in respect of which the consent is given;</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-l">
<num>(l)</num>
<content>
<p>the allotted sum shall be applied only for the purposes specified in regulations 16, 17, 19 and 20;</p>
</content>
</level>
<level class="para1" eId="regulation-3-2-m">
<num>(m)</num>
<content>
<p>the members of the fund-holding practice shall manage the allotted sum effectively and efficiently.</p>
</content>
</level>
</paragraph>
<paragraph eId="regulation-3-3">
<num>(3)</num>
<intro>
<p>In this regulation—</p>
</intro>
<level class="para1" eId="regulation-3-3-a">
<num>(a)</num>
<intro>
<p>a member of a fund-holding practice shall be treated as having a particular connection with a body if—</p>
</intro>
<level class="para2" eId="regulation-3-3-a-i">
<num>(i)</num>
<content>
<p>he is a director of, or is in the employment of, the body, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-3-a-ii">
<num>(ii)</num>
<content>
<p>he is a partner of, or is in the employment of, or is a close relative of, a person who is a director of the body, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-3-a-iii">
<num>(iii)</num>
<content>
<p>where the body is a fund-holding practice, he is a close relative of a member of the practice, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-3-a-iv">
<num>(iv)</num>
<content>
<p>he is a close relative of a person in the employment of the body, or</p>
</content>
</level>
<level class="para2" eId="regulation-3-3-a-v">
<num>(v)</num>
<content>
<p>he has a beneficial interest in the securities of the body;</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-3-3-b">
<num>(b)</num>
<content>
<p>a member of a fund-holding practice shall be treated as having a particular interest in a person if he is a close relative of, or is a partner of, or is in the employment of, the person.</p>
</content>
</level>
<level class="para1" eId="regulation-3-3-c">
<num>(c)</num>
<content>
<p>“close relative” means a husband, wife, brother, sister, father, mother, son or daughter.</p>
</content>
</level>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-4">
<heading>Additions to existing fund-holding practices</heading>
<num>4.</num>
<paragraph eId="regulation-4-1">
<num>(1)</num>
<content>
<p>
Where a medical practitioner (whether or not he is a member of another fund-holding practice) wishes to become a member of an existing fund-holding practice then, except in the circumstances specified in paragraph (2), he and the members of the existing fund-holding practice shall apply to the relevant Regional Health Authority for recognition as a fund-holding practice in accordance with the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
.
</p>
</content>
</paragraph>
<paragraph eId="regulation-4-2">
<num>(2)</num>
<content>
<p>
Paragraph (1) shall not apply to a medical practitioner who becomes a partner of a member of a fund-holding practice as a result of the grant of an application made by the medical practitioner to a Family Health Services Authority under section 30(1) of the
<abbr title="National Health Service Act 1977 c. 49">1977 Act</abbr>
<authorialNote class="footnote" eId="f00009" marker="9">
<p>
<ref eId="c00010" href="http://www.legislation.gov.uk/id/ukpga/1977/49">1977 c. 49</ref>
; section 30 was amended by the Health Services Act
<ref eId="c00011" href="http://www.legislation.gov.uk/id/ukpga/1980/53">1980 (c. 53)</ref>
, Schedule 1, paragraph 43 and Schedule 7,
<ref eId="c00012" href="http://www.legislation.gov.uk/id/uksi/1981/432">S.I. 1981/432</ref>
, article 3(1), the Health and Social Security Act
<ref eId="c00013" href="http://www.legislation.gov.uk/id/ukpga/1984/48">1984 (c. 48)</ref>
, Schedule 3, paragraph 4 and
<ref eId="c00014" href="http://www.legislation.gov.uk/id/uksi/1985/39">S.I. 1985/39</ref>
, article 7(4).
</p>
</authorialNote>
to be included in the list of names of medical practitioners undertaking to provide general medical services in the Authority’s locality.
</p>
</content>
</paragraph>
<paragraph eId="regulation-4-3">
<num>(3)</num>
<content>
<p>
A medical practitioner who becomes a partner of a member of a fund-holding practice in the circumstances described in paragraph (2) shall, on having his name included in the list referred to in that paragraph, be a member of that fund-holding practice notwithstanding that he did not join in the making of an application under regulation 3 of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
.
</p>
</content>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-5">
<heading>Withdrawal of a member of a fund-holding practice</heading>
<num>5.</num>
<paragraph eId="regulation-5-1">
<num>(1)</num>
<content>
<p>Subject to paragraph (2), a member of a fund-holding practice may withdraw from the practice and the recognition as a fund-holding practice of the remaining members of the practice shall not be affected by the withdrawal.</p>
</content>
</paragraph>
<paragraph eId="regulation-5-2">
<num>(2)</num>
<content>
<p>A member of a fund-holding practice who is a partner of another member of the practice may not withdraw from the fund-holding practice unless he also ceases to be a partner of that other member.</p>
</content>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-6">
<heading>Death of a member of a fund-holding practice</heading>
<num>6.</num>
<content>
<p>Where a member of a fund-holding practice dies, the recognition as a fund-holding practice of the remaining members of the practice shall not be affected by the death.</p>
</content>
</hcontainer>
</part>
<part eId="part-III">
<num>PART III</num>
<heading>Renunciation of Recognition</heading>
<hcontainer name="regulation" eId="regulation-7">
<heading>Renunciation of recognition</heading>
<num>7.</num>
<content>
<p>The circumstances in which the members of a fund-holding practice may renounce recognition are that a majority of the members of the practice have sent to the relevant Regional Health Authority notice of their intention to renounce recognition in accordance with regulation 8.</p>
</content>
</hcontainer>
<hcontainer name="regulation" eId="regulation-8">
<heading>Procedure for renunciation of recognition</heading>
<num>8.</num>
<intro>
<p>The notice referred to in regulation 7 shall—</p>
</intro>
<level class="para1" eId="regulation-8-a">
<num>(a)</num>
<content>
<p>be in writing;</p>
</content>
</level>
<level class="para1" eId="regulation-8-b">
<num>(b)</num>
<content>
<p>be signed by a majority of the members of the fund-holding practice;</p>
</content>
</level>
<level class="para1" eId="part-III-regulation-8-cn1">
<num>(c)</num>
<content>
<p>be sent at least one month before the 31st March following the sending of the notice;</p>
</content>
</level>
<level class="para1" eId="regulation-8-d">
<num>(d)</num>
<content>
<p>be expressed to expire on 31st March; and</p>
</content>
</level>
<level class="para1" eId="part-III-regulation-8-cn2">
<num>(c)</num>
<intro>
<p>be accompanied by a statement including information relating to—</p>
</intro>
<level class="para2" eId="regulation-8-c-i">
<num>(i)</num>
<content>
<p>
the
<abbr class="acronym" title="National Health Service">NHS</abbr>
contracts into which the members of the practice have entered;
</p>
</content>
</level>
<level class="para2" eId="regulation-8-c-ii">
<num>(ii)</num>
<content>
<p>the amount standing in the fund-holding account;</p>
</content>
</level>
<level class="para2" eId="regulation-8-c-iii">
<num>(iii)</num>
<content>
<p>the amount standing in the fund-holding account which may be applied for the purposes specified in regulation 20 (savings from the allotted sum) and;</p>
</content>
</level>
<level class="para2" eId="regulation-8-c-iv">
<num>(iv)</num>
<content>
<p>the liabilities of the members of the fund-holding practice.</p>
</content>
</level>
</level>
</hcontainer>
<hcontainer name="regulation" eId="regulation-9">
<heading>Consequences of renunciation of recognition</heading>
<num>9.</num>
<paragraph eId="regulation-9-1">
<num>(1)</num>
<content>
<p>Subject to paragraphs (2) and (4), the consequences of renunciation are that the members of a fund-holding practice cease, as from the 31st March specified in the notice referred to in regulation 8, to be recognised as a fund-holding practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-9-2">
<num>(2)</num>
<content>
<p>Notwithstanding a renunciation of recognition and subject to paragraph (5), a former fund-holding practice shall continue to fulfil the conditions specified in regulation 4(2)(d), (e), (f), (g), (h) and (l) until the relevant Regional Health Authority is satisfied that all the liabilities of the former fund-holding practice have been discharged.</p>
</content>
</paragraph>
<paragraph eId="regulation-9-3">
<num>(3)</num>
<content>
<p>When the relevant Regional Health Authority is satisfied that all liabilities of the fund-holding practice have been discharged it shall send a notice to that effect to each member of the former fund-holding practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-9-4">
<num>(4)</num>
<intro>
<p>If, after a notice under the preceding paragraph has been sent, part of the allotted sum remains in the fund-holding account, the former fund-holding practice shall—</p>
</intro>
<level class="para1" eId="regulation-9-4-a">
<num>(a)</num>
<content>
<p>continue to maintain the fund-holding account until no amount remains standing in that account;</p>
</content>
</level>
<level class="para1" eId="regulation-9-4-b">
<num>(b)</num>
<content>
<p>apply that sum only for the purposes specified in regulation 20 (savings from the allotted sum); and</p>
</content>
</level>
<level class="para1" eId="regulation-9-4-c">
<num>(c)</num>
<content>
<p>each month send to the relevant Regional Health Authority a statement specifying any withdrawal from the fund-holding account.</p>
</content>
</level>
</paragraph>
<paragraph eId="regulation-9-5">
<num>(5)</num>
<intro>
<p>If, at any time after the renunciation of recognition has taken effect, the relevant Regional Health Authority is satisfied that—</p>
</intro>
<level class="para1" eId="regulation-9-5-a">
<num>(a)</num>
<content>
<p>no part of the allotted sum remains in the fund-holding account; and</p>
</content>
</level>
<level class="para1" eId="regulation-9-5-b">
<num>(b)</num>
<content>
<p>the liabilities of the former fund-holding practice have not been discharged</p>
</content>
</level>
<wrapUp>
<p>all the rights and liabilities of the former fund-holding practice shall, upon notice being sent to that effect to each member of the former fund-holding practice, transfer to the relevant Regional Health Authority.</p>
</wrapUp>
</paragraph>
</hcontainer>
</part>
<part eId="part-IV">
<num>PART IV</num>
<heading>Removal of Recognition</heading>
<hcontainer name="regulation" eId="regulation-10">
<heading>Grounds for removal of recognition</heading>
<num>10.</num>
<paragraph eId="regulation-10-1">
<num>(1)</num>
<content>
<p>
Where, by 28th February in any year, the relevant Regional Health Authority has notified the members of a fund-holding practice of the amount of the allotted sum for the financial year beginning on the next 1st April and the members of the practice have not, within one month from the date on which that notice is sent, notified the relevant Regional Health Authority that they are prepared to accept that amount as their allotted sum, the relevant Regional Health Authority may remove recognition from them with effect from that 1st April (whether or not the recognition is one which has taken effect in accordance with regulation 5(2) of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
).
</p>
</content>
</paragraph>
<paragraph eId="regulation-10-2">
<num>(2)</num>
<content>
<p>The relevant Regional Health Authority may remove recognition from the members of a fund-holding practice if a condition specified in regulation 3(2) is no longer fulfilled in relation to the practice.</p>
</content>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-11">
<heading>Procedure for removal of recognition</heading>
<num>11.</num>
<paragraph eId="regulation-11-1">
<num>(1)</num>
<intro>
<p>Except as provided by regulations 12 and 13, where a relevant Regional Health Authority proposes to remove recognition from the members of a fund-holding practice on the ground specified in regulation 10(2), the Authority shall—</p>
</intro>
<level class="para1" eId="regulation-11-1-a">
<num>(a)</num>
<intro>
<p>send to each member of the practice a notice in writing specifying—</p>
</intro>
<level class="para2" eId="regulation-11-1-a-i">
<num>(i)</num>
<content>
<p>the reason for the proposal, and</p>
</content>
</level>
<level class="para2" eId="regulation-11-1-a-ii">
<num>(ii)</num>
<content>
<p>the date, which shall be at least 3 months from the date on which the notice is sent, on which the removal of recognition is proposed to have effect; and</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-11-1-b">
<num>(b)</num>
<content>
<p>inform the members of the practice that they may, subject to paragraphs (2) and (3), make representations to the Authority concerning the matter either orally or in writing.</p>
</content>
</level>
</paragraph>
<paragraph eId="regulation-11-2">
<num>(2)</num>
<content>
<p>Representations in writing shall be sent to the relevant Regional Health Authority within two months of the date on which the notice referred to in paragraph (1) is sent.</p>
</content>
</paragraph>
<paragraph eId="regulation-11-3">
<num>(3)</num>
<content>
<p>Where the members of the practice wish to make representations orally they shall, within two weeks of the date on which the notice referred to in paragraph (1) is sent, send notice to that effect to the relevant Regional Health Authority and the Authority shall, within six weeks of the date on which the members of the fund-holding practice send notice under this paragraph, give them an opportunity of appearing before and being heard by the Authority or a committee, sub-committee or officer of the Authority appointed for the purpose.</p>
</content>
</paragraph>
<paragraph eId="regulation-11-4">
<num>(4)</num>
<intro>
<p>If the relevant Regional Health Authority decide, having taken into account any representations made by the members of the fund-holding practice, to adopt the proposal, the Authority shall—</p>
</intro>
<level class="para1" eId="regulation-11-4-a">
<num>(a)</num>
<content>
<p>send to each member of the fund-holding practice a notice in writing of its decision;</p>
</content>
</level>
<level class="para1" eId="regulation-11-4-b">
<num>(b)</num>
<intro>
<p>include in the notice—</p>
</intro>
<level class="para2" eId="regulation-11-4-b-i">
<num>(i)</num>
<content>
<p>a statement of the reasons for the decision, and</p>
</content>
</level>
<level class="para2" eId="regulation-11-4-b-ii">
<num>(ii)</num>
<content>
<p>the date on which the removal of recognition takes effect; and</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-11-4-c">
<num>(c)</num>
<intro>
<p>inform each member of the practice of—</p>
</intro>
<level class="para2" eId="regulation-11-4-c-i">
<num>(i)</num>
<content>
<p>the right to appeal to the Secretary of State against the removal of recognition, and</p>
</content>
</level>
<level class="para2" eId="regulation-11-4-c-ii">
<num>(ii)</num>
<content>
<p>the consequences of removal of recognition.</p>
</content>
</level>
</level>
</paragraph>
<paragraph eId="regulation-11-5">
<num>(5)</num>
<intro>
<p>In the circumstances specified in regulation 10(1), the relevant Regional Health Authority shall—</p>
</intro>
<level class="para1" eId="regulation-11-5-a">
<num>(a)</num>
<content>
<p>send to each member of the practice notice of removal of recognition;</p>
</content>
</level>
<level class="para1" eId="regulation-11-5-b">
<num>(b)</num>
<content>
<p>include in the notice a statement of the reasons for the removal of recognition and that the removal has effect from the 1st April following the sending of the notice; and</p>
</content>
</level>
<level class="para1" eId="regulation-11-5-c">
<num>(c)</num>
<intro>
<p>inform each member of the practice of—</p>
</intro>
<level class="para2" eId="regulation-11-5-c-i">
<num>(i)</num>
<content>
<p>the right to appeal to the Secretary of State against the removal of recognition, and</p>
</content>
</level>
<level class="para2" eId="regulation-11-5-c-ii">
<num>(ii)</num>
<content>
<p>
except where recognition has not taken effect in accordance with regulation 5(2) of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
, the consequences of the removal of recognition.
</p>
</content>
</level>
</level>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-12">
<heading>Removal of recognition with immediate effect</heading>
<num>12.</num>
<intro>
<p>Where it appears to a relevant Regional Health Authority that it is necessary either—</p>
</intro>
<level class="para1" eId="regulation-12-a">
<num>(a)</num>
<content>
<p>in the interests of patients of members of the practice; or</p>
</content>
</level>
<level class="para1" eId="regulation-12-b">
<num>(b)</num>
<content>
<p>for the purpose of ensuring the proper management of the allotted sum</p>
</content>
</level>
<wrapUp>
<p>that recognition should be removed under regulation 10(2) with immediate effect, the relevant Regional Health Authority shall remove recognition with immediate effect.</p>
</wrapUp>
</hcontainer>
<hcontainer name="regulation" eId="regulation-13">
<heading>Procedure for removal of recognition with immediate effect</heading>
<num>13.</num>
<intro>
<p>In the circumstances specified in regulation 12, the relevant Regional Health Authority shall—</p>
</intro>
<level class="para1" eId="regulation-13-a">
<num>(a)</num>
<content>
<p>send to each member of the practice notice of removal of recognition;</p>
</content>
</level>
<level class="para1" eId="regulation-13-b">
<num>(b)</num>
<content>
<p>include in the notice a statement of the reasons for the removal of recognition; and</p>
</content>
</level>
<level class="para1" eId="regulation-13-c">
<num>(c)</num>
<intro>
<p>inform each member of the practice of—</p>
</intro>
<level class="para2" eId="regulation-13-c-i">
<num>(i)</num>
<content>
<p>the right to appeal to the Secretary of State against the removal of recognition, and</p>
</content>
</level>
<level class="para2" eId="regulation-13-c-ii">
<num>(ii)</num>
<content>
<p>the consequences of the removal of recognition.</p>
</content>
</level>
</level>
</hcontainer>
<hcontainer name="regulation" eId="regulation-14">
<heading>Appeals to the Secretary of State</heading>
<num>14.</num>
<paragraph eId="regulation-14-1">
<num>(1)</num>
<content>
<p>The members of a fund-holding practice or, where removal of recognition has taken effect, a former fund-holding practice, may appeal to the Secretary of State against the removal of recognition by the relevant Regional Health Authority.</p>
</content>
</paragraph>
<paragraph eId="regulation-14-2">
<num>(2)</num>
<intro>
<p>
Regulation 8(2) to (8) of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
shall apply in relation to an appeal against removal of recognition as if—
</p>
</intro>
<level class="para1" eId="regulation-14-2-a">
<num>(a)</num>
<content>
<p>a reference to the members of the practice were a reference to the members of a fund-holding practice or, where removal of recognition has taken effect, a former fund-holding practice;</p>
</content>
</level>
<level class="para1" eId="regulation-14-2-b">
<num>(b)</num>
<content>
<p>a reference to a decision to refuse to grant a practice recognition as a fund-holding practice were to a decision to remove recognition as a fund-holding practice; and</p>
</content>
</level>
<level class="para1" eId="regulation-14-2-c">
<num>(c)</num>
<content>
<p>
<mod>
for paragraph (8)(b) there were substituted the following paragraph—
<quotedStructure startQuote="" endQuote="" uk:context="unknown" uk:docName="unknown" ukl:TargetClass="unknown" ukl:TargetSubClass="unknown" ukl:Context="unknown" ukl:Format="default">
<level class="para1">
<num>(b)</num>
<content>
<p>determine the appeal in accordance with regulation 10 of the National Health Service (Fund-holding Practices) (General) Regulations 1991.</p>
</content>
</level>
</quotedStructure>
<inline name="appendText">.</inline>
</mod>
</p>
</content>
</level>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-15">
<heading>Consequences of removal</heading>
<num>15.</num>
<paragraph eId="regulation-15-1">
<num>(1)</num>
<content>
<p>On the day on which removal of recognition takes effect, all the rights and liabilities of a fund-holding practice shall transfer to the relevant Regional Health Authority.</p>
</content>
</paragraph>
<paragraph eId="regulation-15-2">
<num>(2)</num>
<content>
<p>Subject to paragraph (3), on the day on which the removal of recognition takes effect, the fund-holding account shall be treated as having been opened by the relevant Regional Health Authority and that Authority may deal with the allotted sum or any part of it remaining in that account as though it were the fund-holding practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-15-3">
<num>(3)</num>
<content>
<p>Where, on the day on which removal of recognition takes effect, there remains in the fund-holding account any part of the allotted sum which may be applied for the purposes specified in regulation 20 (savings from the allotted sum) the relevant Regional Health Authority shall apply that part of the allotted sum for such of those purposes as the former fund-holding practice may require.</p>
</content>
</paragraph>
</hcontainer>
</part>
<part eId="part-V">
<num>PART V</num>
<heading>Allotted Sum — Authorised Purposes</heading>
<hcontainer name="regulation" eId="regulation-16">
<heading>Payment for drugs, medicines and listed appliances</heading>
<num>16.</num>
<paragraph eId="regulation-16-1">
<num>(1)</num>
<content>
<p>The members of a fund-holding practice shall pay to the relevant Regional Health Authority out of the allotted sum an amount determined in accordance with the following paragraphs of this regulation as the basic cost of the drugs, medicines and listed appliances supplied pursuant to orders given by or on behalf of members of the practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-16-2">
<num>(2)</num>
<intro>
<p>The amount referred to in paragraph (1) shall, subject to paragraph (7), be—</p>
</intro>
<level class="para1" eId="regulation-16-2-a">
<num>(a)</num>
<content>
<p>the price of the drugs, medicines or listed appliances calculated in accordance with paragraphs (3) and (4); minus</p>
</content>
</level>
<level class="para1" eId="regulation-16-2-b">
<num>(b)</num>
<content>
<p>an amount representing a percentage of the price of the drug, medicine or listed appliance, calculated in accordance with paragraph (5), plus</p>
</content>
</level>
<level class="para1" eId="regulation-16-2-c">
<num>(c)</num>
<content>
<p>except in the case of listed appliances supplied with, or in connection with, the supply of oxygen or drugs and medicines supplied in bulk, an amount representing the cost of the container or packaging in which the drug, medicine or listed appliance is supplied calculated in accordance with paragraph (6).</p>
</content>
</level>
</paragraph>
<paragraph eId="regulation-16-3">
<num>(3)</num>
<intro>
<p>The price referred to in paragraph (2)(a) of a drug or medicine shall be—</p>
</intro>
<level class="para1" eId="regulation-16-3-a">
<num>(a)</num>
<content>
<p>where the name of the drug or medicine is listed in a list in the Drug Tariff which specifies a price for a specified quantity of that drug or medicine, the price so specified;</p>
</content>
</level>
<level class="para1" eId="regulation-16-3-b">
<num>(b)</num>
<content>
<p>where the name of the drug or medicine is not so listed, the manufacturer’s list price.</p>
</content>
</level>
</paragraph>
<paragraph eId="regulation-16-4">
<num>(4)</num>
<content>
<p>The price referred to in paragraph (2)(a) of a listed appliance shall be the price of the appliance specified in the Drug Tariff.</p>
</content>
</paragraph>
<paragraph eId="regulation-16-5">
<num>(5)</num>
<intro>
<p>The percentage referred to in paragraph (2)(b) shall be—</p>
</intro>
<level class="para1" eId="regulation-16-5-a">
<num>(a)</num>
<content>
<p>9.67 per cent. of the price of the drug, medicine or listed appliance where that drug, medicine or listed appliance has been supplied pursuant to an order given by or on behalf of a member of a fund-holding practice whose recognition has been granted by a Regional Health Authority; and</p>
</content>
</level>
<level class="para1" eId="regulation-16-5-b">
<num>(b)</num>
<content>
<p>9.10 per cent. of the price of the drug, medicine or listed appliance where that drug, medicine or listed appliance has been supplied pursuant to an order given by or on behalf of a member of a fund-holding practice whose recognition has been granted by the Secretary of State.</p>
</content>
</level>
</paragraph>
<paragraph eId="regulation-16-6">
<num>(6)</num>
<content>
<p>The amount referred to in paragraph (2)(c) shall be 3.80 pence for each listed appliance and each quantity of a drug or medicine.</p>
</content>
</paragraph>
<paragraph eId="regulation-16-7">
<num>(7)</num>
<content>
<p>Where an amount calculated under paragraph 2(a), (b) or (c) is in any month not an exact number of pounds, any amount of fifty pence or more shall be rounded up to, and any amount less than fifty pence shall be rounded down to, the nearest whole pound.</p>
</content>
</paragraph>
<paragraph eId="regulation-16-8">
<num>(8)</num>
<intro>
<p>In this regulation—</p>
</intro>
<hcontainer name="definition">
<content>
<p>
“the Drug Tariff” means the statement published under regulation 28 of the National Health Service (General Medical and Pharmaceutical Services) Regulations 1974
<authorialNote class="footnote" eId="f00010" marker="10">
<p>
<ref eId="c00015" href="http://www.legislation.gov.uk/id/uksi/1974/160">S.I. 1974/160</ref>
; regulation 28 was amended by
<ref eId="c00016" href="http://www.legislation.gov.uk/id/uksi/1985/955">S.I. 1985/955</ref>
, article 2(6).
</p>
</authorialNote>
;
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“listed appliance” means an appliance which is included in a list for the time being approved by the Secretary of State for the purposes of section 41 of the
<abbr title="National Health Service Act 1977 c. 49">1977 Act</abbr>
.
</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>“manufacturer’s list price” means the price which the manufacturer of a drug or medicine or his agent publishes as being the price of that drug or medicine;</p>
</content>
</hcontainer>
<hcontainer name="definition">
<content>
<p>
“medicine” includes such chemical re-agents as are included in a list for the time being approved by the Secretary of State for the purposes of section 41 of the
<abbr title="National Health Service Act 1977 c. 49">1977 Act</abbr>
.
</p>
</content>
</hcontainer>
</paragraph>
<paragraph eId="regulation-16-9">
<num>(9)</num>
<intro>
<p>In this regulation, a drug or medicine is supplied in bulk when—</p>
</intro>
<level class="para1" eId="regulation-16-9-a">
<num>(a)</num>
<content>
<p>it is ordered by a member of a fund-holding practice for two or more patients of his;</p>
</content>
</level>
<level class="para1" eId="regulation-16-9-b">
<num>(b)</num>
<content>
<p>those patients reside in a school or institution in which at least twenty persons reside;</p>
</content>
</level>
<level class="para1" eId="regulation-16-9-c">
<num>(c)</num>
<content>
<p>the name of that school or institution is written on the order;</p>
</content>
</level>
<level class="para1" eId="regulation-16-9-d">
<num>(d)</num>
<content>
<p>at least ten of the persons residing in the school or institution are patients of the member of the fund-holding practice ordering the drug or medicine.</p>
</content>
</level>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-17">
<heading>Payment for goods and services</heading>
<num>17.</num>
<paragraph eId="regulation-17-1">
<num>(1)</num>
<content>
<p>The members of a fund-holding practice may apply the allotted sum to the purchase of the goods and services, other than general medical services, referred to in paragraph (2) and shall apply the allotted sum to the purchase of such of those goods and services as are necessary for the proper treatment of patients of members of the practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-17-2">
<num>(2)</num>
<content>
<p>The goods and services referred to in paragraph (1) shall be the goods and services specified in a list approved from time to time by the Secretary of State for the purposes of this regulation.</p>
</content>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-18">
<heading>Limit on provision of goods and services</heading>
<num>18.</num>
<content>
<p>There shall be a limit of £5000 on the amount which may be spent out of an allotted sum on the provision of goods and services for any one individual, being a limit above which the cost of any goods and services for that individual in the financial year in question will fall to be met by the District Health Authority whose primary functions include the provision of goods and services (not necessarily the goods and services in question) to the individual concerned.</p>
</content>
</hcontainer>
<hcontainer name="regulation" eId="regulation-19">
<heading>Payment of salaries</heading>
<num>19.</num>
<paragraph eId="regulation-19-1">
<num>(1)</num>
<content>
<p>The members of a fund-holding practice may apply the allotted sum for the purpose of paying the salaries of those employees of members of the practice whose employment by a member of the practice began after the date on which the members of the practice were granted recognition as a fund-holding practice.</p>
</content>
</paragraph>
<paragraph eId="regulation-19-2">
<num>(2)</num>
<content>
<p>Where a Family Health Services Authority has, before the date on which the members of a fund-holding practice were granted recognition as a fund-holding practice, reimbursed a member of the practice in respect of a proportion of the salary of an employee of his, then the members of the fund-holding practice may apply the allotted sum for the purpose of paying, in respect of periods after that date, that proportion of the salary of that employee.</p>
</content>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-20">
<heading>Savings from the allotted sum</heading>
<num>20.</num>
<intro>
<p>
Where the accounts for a financial year of members of a fund-holding practice have been audited in accordance with Part III of the Local Government Finance Act 1982
<authorialNote class="footnote" eId="f00011" marker="11">
<p>
<ref eId="c00017" href="http://www.legislation.gov.uk/id/ukpga/1982/32">1982 c. 32</ref>
.
</p>
</authorialNote>
the members of a fund-holding practice may continue to apply any part of the allotted sum paid to them in respect of that financial year for the purposes specified in regulations 17 and 19 and, in addition, for a period of four years after the end of that financial year, for any one or more of the following purposes—
</p>
</intro>
<level class="para1" eId="regulation-20-a">
<num>(a)</num>
<intro>
<p>the purchase of material or equipment which—</p>
</intro>
<level class="para2" eId="regulation-20-a-i">
<num>(i)</num>
<content>
<p>can be used for the treatment of patients of the practice,</p>
</content>
</level>
<level class="para2" eId="regulation-20-a-ii">
<num>(ii)</num>
<content>
<p>enhances the comfort or convenience of patients of the practice,</p>
</content>
</level>
<level class="para2" eId="regulation-20-a-iii">
<num>(iii)</num>
<content>
<p>enables the practice to be managed more effectively and efficiently; or</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-20-b">
<num>(b)</num>
<content>
<p>the purchase of material or equipment relating to health education; or</p>
</content>
</level>
<level class="para1" eId="regulation-20-c">
<num>(c)</num>
<content>
<p>the improvement of any premises from which the members of the practice carry on their practice whether by improving the structure of the premises or the purchase of furniture and furnishings for the premises.</p>
</content>
</level>
</hcontainer>
</part>
<part eId="part-VI">
<num>PART VI</num>
<heading>Transfer of Functions</heading>
<hcontainer name="regulation" eId="regulation-21">
<heading>Transfer of functions in England</heading>
<num>21.</num>
<paragraph eId="regulation-21-1">
<num>(1)</num>
<content>
<p>
With effect from 1st April 1991, the function of a Regional Health Authority under section 15(1) of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
of being liable to pay a sum to the members of a fund-holding practice shall become the function of a Family Health Services Authority.
</p>
</content>
</paragraph>
<paragraph eId="regulation-21-2">
<num>(2)</num>
<content>
<p>The Family Health Services Authority which is to exercise the function referred to in paragraph (1) in relation to the members of any existing fund-holding practice is the relevant Family Health Services Authority.</p>
</content>
</paragraph>
<paragraph eId="regulation-21-3">
<num>(3)</num>
<intro>
<p>
Section 15 of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
shall have effect subject to the following modifications—
</p>
</intro>
<level class="para1" eId="regulation-21-3-a">
<num>(a)</num>
<content>
<p>in subsection (1), for the words “Regional Health Authority” in both places where they occur, there shall be substituted the words “Family Health Services Authority”, and after the word “determined” there shall be inserted the words “by the relevant Regional Health Authority”; and</p>
</content>
</level>
<level class="para1" eId="regulation-21-3-b">
<num>(b)</num>
<intro>
<p>in subsection (4)—</p>
</intro>
<level class="para2" eId="regulation-21-3-b-i">
<num>(i)</num>
<content>
<p>in paragraph (a), for the words “Regional Health Authority” there shall be substituted the words “Family Health Services Authority which has a locality in England”,</p>
</content>
</level>
<level class="para2" eId="regulation-21-3-b-ii">
<num>(ii)</num>
<content>
<p>in paragraph (b), for the words “another Regional Health Authority” there shall be substituted the words “a Regional Health Authority which is not the relevant Regional Health Authority in respect of the members of the practice”, and</p>
</content>
</level>
<level class="para2" eId="regulation-21-3-b-iii">
<num>(iii)</num>
<content>
<p>for the words “other Authority” there shall be substituted the words “Regional Health Authority”.</p>
</content>
</level>
</level>
</paragraph>
</hcontainer>
<hcontainer name="regulation" eId="regulation-22">
<heading>Transfer of functions in Wales</heading>
<num>22.</num>
<paragraph eId="regulation-22-1">
<num>(1)</num>
<content>
<p>With effect from 1st April 1991, the function of the Secretary of State under section 15(2) of being liable to pay a sum to the members of each fund-holding practice whose relevant Family Health Services Authority has a locality in Wales shall become the function of a Family Health Services Authority.</p>
</content>
</paragraph>
<paragraph eId="regulation-22-2">
<num>(2)</num>
<content>
<p>The Family Health Services Authority which is to exercise the function referred to in paragraph (1) in relation to the members of any existing fund-holding practice is the relevant Family Health Services Authority.</p>
</content>
</paragraph>
<paragraph eId="regulation-22-3">
<num>(3)</num>
<intro>
<p>
Section 15 of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
shall have effect subject to the following modifications—
</p>
</intro>
<level class="para1" eId="regulation-22-3-a">
<num>(a)</num>
<intro>
<p>in subsection (2)—</p>
</intro>
<level class="para2" eId="regulation-22-3-a-i">
<num>(i)</num>
<content>
<p>for the words “the Secretary of State” in the first place where they occur there shall be substituted the words “every Family Health Services Authority which has a locality in Wales”,</p>
</content>
</level>
<level class="para2" eId="regulation-22-3-a-ii">
<num>(ii)</num>
<content>
<p>for the words “whose relevant Family Health Services Authority has a locality in Wales” there shall be substituted the words “in respect of whom it is the relevant Family Health Services Authority”, and</p>
</content>
</level>
<level class="para2" eId="regulation-22-3-a-iii">
<num>(iii)</num>
<content>
<p>after the word “determined” there shall be inserted the words “by the Secretary of State”, and</p>
</content>
</level>
<level class="para2" eId="regulation-22-3-a-iv">
<num>(iv)</num>
<content>
<p>for the words “the Secretary of State” in the second place where they occur there shall be substituted the word “he”; and</p>
</content>
</level>
</level>
<level class="para1" eId="regulation-22-3-b">
<num>(b)</num>
<intro>
<p>in subsection (5)—</p>
</intro>
<level class="para2" eId="regulation-22-3-b-i">
<num>(i)</num>
<content>
<p>for the words “the Secretary of State” in the first place where they occur there shall be substituted the words “a Family Health Services Authority which has a locality in Wales”,</p>
</content>
</level>
<level class="para2" eId="regulation-22-3-b-ii">
<num>(ii)</num>
<content>
<p>for the words “the Secretary of State” in the second place where they occur there shall be substituted the words “the Authority making the payment”, and</p>
</content>
</level>
<level class="para2" eId="regulation-22-3-b-iii">
<num>(iii)</num>
<content>
<p>for the words “that Authority” there shall be substituted the words “that Regional Health Authority”.</p>
</content>
</level>
</level>
</paragraph>
</hcontainer>
</part>
<part eId="part-VII">
<num>PART VII</num>
<heading>Amendment of Regulations</heading>
<hcontainer name="regulation" eId="regulation-23">
<heading>Amendment of regulations</heading>
<num>23.</num>
<content>
<p>
<mod>
In regulation 3 of the
<abbr title="National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 (S.I. 1990/1753)">Application Regulations</abbr>
(applications for recognition as a fund-holding practice), for paragraph (5) there is substituted the following paragraph—
<quotedStructure startQuote="" endQuote="" uk:context="body" uk:docName="uksi" ukl:TargetClass="secondary" ukl:TargetSubClass="regulation" ukl:Context="main" ukl:Format="default">
<paragraph>
<num>(5)</num>
<content>
<p>
Where at least one of the members of a practice wishing to make an application is on the medical list of a Health Board, section 14 of
<abbr title="National Health Service and Community Care Act 1990 c. 19">the Act</abbr>
shall operate subject to the modification that at the end of subsection (1) there shall be added the words “except, if at least one of those practitioners is also providing general medical services in accordance with arrangements under section 19 of the National Health Service (Scotland) Act 1978
<authorialNote class="footnote" eId="f00012" marker="12">
<p>
<ref eId="c00018" href="http://www.legislation.gov.uk/id/ukpga/1978/29">1978 c. 29</ref>
.
</p>
</authorialNote>
, where more patients on the lists of members of the practice reside in Scotland than in England”.
</p>
</content>
</paragraph>
</quotedStructure>
</mod>
</p>
</content>
</hcontainer>
</part>
<hcontainer name="signatures">
<hcontainer name="signatureBlock">
<content>
<block name="signature">
<signature refersTo="#">William Waldegrave</signature>
</block>
<block name="role">
<role refersTo="#">Secretary of State for Health</role>
</block>
<block name="date">
<date date="1991-03-08">8th March 1991</date>
</block>
</content>
</hcontainer>
<hcontainer name="signatureBlock">
<content>
<block name="signature">
<signature refersTo="#">David Hunt</signature>
</block>
<block name="role">
<role refersTo="#">Secretary of State for Wales</role>
</block>
<block name="date">
<date date="1991-03-08">8th March 1991</date>
</block>
</content>
</hcontainer>
</hcontainer>
</body>
<conclusions>
<blockContainer class="explanatoryNote">
<subheading>(This note is not part of the Reglulations</subheading>
<blockContainer ukl:Name="P">
<p>These Regulations contain provisions relating to the operation of recognised fund-holding practices.</p>
</blockContainer>
<blockContainer ukl:Name="P">
<p>
A recognised fund-holding practice is a practice comprising one or more medical practitioners who are providing general medical services in accordance with arrangements under section 29 of the National Health Service Act 1977 which has been recognised by a Regional Health Authority under section 14 of the National Health Service and Community Care Act 1990 is a recognised fund-holding practice and which in consequence of recognition is entitled to be paid an allotted sum in accordance with section 15(1) of the
<abbr title="National Health Service and Community Care Act 1990 c. 19">1990 Act</abbr>
. An allotted sum may only be applied for purposes specified in these Regulations.
</p>
</blockContainer>
<blockContainer ukl:Name="P">
<p>The Regulations include provision about—</p>
<blockContainer ukl:Name="P2" class="prov2">
<num>(1)</num>
<p>the interpretation of the Regulations and their application in Wales (Part I),</p>
</blockContainer>
<blockContainer ukl:Name="P2" class="prov2">
<num>(2)</num>
<p>the conditions for continuing to be entitled to recognition as a recognised fund-holding practice and additions to and withdrawals from a recognised fund-holding practice (Part II),</p>
</blockContainer>
<blockContainer ukl:Name="P2" class="prov2">
<num>(3)</num>
<p>renunciation of recognition including the procedure for renunciation and its consequences (Part III),</p>
</blockContainer>
<blockContainer ukl:Name="P2" class="prov2">
<num>(4)</num>
<p>removal of recognition as a recognised fund-holding practice, including specifying the grounds for removal, the procedure for removal, appeals against removal and the consequences of removal (Part IV),</p>
</blockContainer>
<blockContainer ukl:Name="P2" class="prov2">
<num>(5)</num>
<p>the purposes for which allotted sums may be applied (Part V),</p>
</blockContainer>
<blockContainer ukl:Name="P2" class="prov2">
<num>(6)</num>
<p>the transfer of some of the functions of Regional Health Authorities in England and similar functions of the Secretary of State in Wales to Family Health Services Authorities (Part VI).</p>
</blockContainer>
</blockContainer>
<blockContainer ukl:Name="P">
<p>They also amend the National Health Service (Fund-holding Practices) (Applications and Recognition) Regulations 1990 in relation to applications from medival practitioners who have patients in England and Scotland.</p>
</blockContainer>
</blockContainer>
</conclusions>
</act>
</akomaNtoso>