The National Health Service (General Medical Services Contracts) Regulations 2004

1. Introductory Text

2. PART 1 GENERAL

   1. 1. Citation, commencement and application

   2. 2. Interpretation

3. PART 2 CONTRACTORS

   1. 3. Conditions: general

   2. 4. Conditions relating solely to medical practitioners

   3. 5. General condition relating to all contracts

   4. 6. Reasons

   5. 7. Appeal

   6. 8. Prescribed period under section 28D(1)(bc) of the Act

4. PART 3 PRE-CONTRACT DISPUTE RESOLUTION

   1. 9. Pre-contract disputes

5. PART 4 HEALTH SERVICE BODY STATUS

   1. 10. Health service body status

6. PART 5 CONTRACTS: REQUIRED TERMS

   1. 11. Parties to the contract

   2. 12. Health service contract

   3. 13. Contracts with individuals practising in partnership

   4. 14. Duration

   5. 15. Essential services

   6. 16. Additional services

   7. 17. Opt outs of additional and out of hours services

   8. 18. Services generally

   9. 19. (1) Except in the case of the services referred to...

   10. 20. A contract must contain a term which requires the contractor...

   11. 21. Certificates

   12. 22. Finance

   13. 23. The contract must contain a term to the effect that...

   14. 24. Fees and charges

   15. 25. Arrangements on termination

   16. 26. Other contractual terms

7. PART 6 FUNCTIONS OF LOCAL MEDICAL COMMITTEES

   1. 27. (1) The functions of a Local Medical Committee which are...

8. PART 7 TRANSITIONAL PROVISIONS

   1. 28. Commencement

   2. 29. Additional services

   3. 30. Out of hours services

   4. 31. (1) Where the contract is with— (a) an individual medical...

   5. 32. A contract which includes the provision of out of hours...

9. Signature

10. 1. SCHEDULE 1

       REPEAT DISPENSING FORMS

       1. PART 1 REPEATABLE PRESCRIPTION

       2. PART 2 BATCH ISSUE

    2. SCHEDULE 2

       ADDITIONAL SERVICES

       1. 1. Additional services generally

       2. 2. Cervical screening

       3. 3. Contraceptive services

       4. 4. Vaccinations and immunisations

       5. 5. Childhood vaccinations and immunisations

       6. 6. Child health surveillance

       7. 7. Maternity medical services

       8. 8. Minor surgery

    3. SCHEDULE 3

       OPT OUTS OF ADDITIONAL AND OUT OF HOURS SERVICES

       1. 1. Opt outs of additional services: general

       2. 2. Temporary opt outs and permanent opt outs following temporary opt outs

       3. 3. Permanent opt outs

       4. 4. Out of hours opt outs where the opt out notice is served after 30th September 2004

       5. 5. Out of hours opt outs where the opt out notice is served before 1st October 2004

       6. 6. Informing patients of opt outs

    4. SCHEDULE 4

       LIST OF PRESCRIBED MEDICAL CERTIFICATES

    5. SCHEDULE 5

       FEES AND CHARGES

       1. 1. The contractor may demand or accept a fee or other...

    6. SCHEDULE 6

       OTHER CONTRACTUAL TERMS

       1. PART 1 PROVISION OF SERVICES

          1. 1. Premises

          2. 2. Attendance at practice premises

          3. 3. Attendance outside practice premises

          4. 4. Newly registered patients

          5. 5. Patients not seen within three years

          6. 6. Patients aged 75 years and over

          7. 7. Clinical reports

          8. 8. Storage of vaccines

          9. 9. Infection control

          10. 10. Criteria for out of hours services

          11. 11. Standards for out of hours services

          12. 12. Duty of co-operation in relation to additional, enhanced and out of hours services

          13. 13. Where a contractor is to cease to be required to...

       2. PART 2 PATIENTS

          1. 14. List of patients

          2. 15. Application for inclusion in a list of patients

          3. 16. Temporary residents

          4. 17. Refusal of applications for inclusion in the list of patients or for acceptance as a temporary resident

          5. 18. Patient preference of practitioner

          6. 19. Removal from the list at the request of the patient

          7. 20. Removal from the list at the request of the contractor

          8. 21. Removals from the list of patients who are violent

          9. 22. Removals from the list of patients registered elsewhere

          10. 23. Removals from the list of patients who have moved

          11. 24. Where the address of a patient who is on the...

          12. 25. Removals from the list of patients absent from the United Kingdom etc.

          13. 26. Removals from the list of patients accepted elsewhere as temporary residents

          14. 27. Removals from the list of pupils etc. of a school

          15. 28. Termination of responsibility for patients not registered with the contractor

          16. 29. Closure of lists of patients

          17. 30. Approval of closure notice by the Primary Care Trust

          18. 31. Rejection of closure notice by the Primary Care Trust

          19. 32. Assignment of patients to lists: open lists

          20. 33. Assignment of patients to lists: closed lists

          21. 34. Factors relevant to assignments

          22. 35. Assignments to closed lists: determinations of the assessment panel

          23. 36. Assignments to closed lists: NHS dispute resolution procedure relating to determinations of the assessment panel

          24. 37. Assignments to closed lists: assignments of patients by a Primary Care Trust

       3. PART 3 PRESCRIBING AND DISPENSING

          1. 38. Prescribing

          2. 39. (1) Subject to paragraphs 42 and 43, a prescriber shall...

          3. 40. Repeatable prescribing services

          4. 41. Repeatable prescriptions

          5. 42. Restrictions on prescribing by medical practitioners

          6. 43. Restrictions on prescribing by supplementary prescribers

          7. 44. Bulk prescribing

          8. 45. Interpretation of paragraphs 38, 39 and 41 to 44

          9. 46. Excessive prescribing

          10. 47. Provision of dispensing services

          11. 48. Consent to dispense

          12. 49. Contractors who previously provided dispensing services under pilot schemes or section 28C arrangements

          13. 50. Terms relating to the provision of dispensing services

          14. 51. Dispensing contractor list

          15. 52. Provision of drugs, medicines and appliances for immediate treatment or personal administration

       4. PART 4 PERSONS WHO PERFORM SERVICES

          1. 53. Qualifications of performers

          2. 54. No health care professional other than one to whom paragraph...

          3. 55. Where the registration of a health care professional or, in...

          4. 56. No health care professional shall perform any clinical services unless...

          5. 57. Conditions for employment and engagement

          6. 58. (1) A contractor shall not employ or engage—

          7. 59. (1) The contractor shall not employ or engage a health...

          8. 60. (1) Before employing or engaging any person to assist it...

          9. 61. Training

          10. 62. The contractor shall afford to each employee reasonable opportunities to...

          11. 63. Terms and conditions

          12. 64. Arrangements for GP Registrars

          13. 65. Independent nurse prescribers and supplementary prescribers

          14. 66. Signing of documents

          15. 67. Level of skill

          16. 68. Appraisal and assessment

          17. 69. Sub-contracting of clinical matters

          18. 70. Sub-contracting of out of hours services

          19. 71. Withdrawal and variation of approval under paragraph 70

          20. 72. (1) Without prejudice to any other remedies which it may...

       5. PART 5 RECORDS, INFORMATION, NOTIFICATIONS AND RIGHTS OF ENTRY

          1. 73. Patient records

          2. 74. Access to records for the purpose of the Quality Information Preparation Scheme

          3. 75. Confidentiality of personal data

          4. 76. Practice leaflet

          5. 77. Provision of information

          6. 78. Requests for information from Patients' Forums

          7. 79. Inquiries about prescriptions and referrals

          8. 80. Reports to a medical officer

          9. 81. Annual return and review

          10. 82. Notifications to the Primary Care Trust

          11. 83. The contractor shall, unless it is impracticable for it to...

          12. 84. The contractor shall notify the Primary Care Trust in writing...

          13. 85. Notice provisions specific to a contract with a company limited by shares

          14. 86. Notice provisions specific to a contract with two or more individuals practising in partnership

          15. 87. Notification of deaths

          16. 88. Notifications to patients following variation of the contract

          17. 89. Entry and inspection by the Primary Care Trust

          18. 90. Entry and inspection by members of Patients' Forums

          19. 91. Entry and inspection by the Commission for Healthcare Audit and Inspection

       6. PART 6 COMPLAINTS

          1. 92. Complaints procedure

          2. 93. Making of complaints

          3. 94. Where a patient has died a complaint may be made...

          4. 95. Period for making complaints

          5. 96. Further requirements for complaints procedures

          6. 97. Co-operation with investigations

          7. 98. Provision of information about complaints

       7. PART 7 DISPUTE RESOLUTION

          1. 99. Local resolution of contract disputes

          2. 100. Dispute resolution: non-NHS contracts

          3. 101. NHS dispute resolution procedure

          4. 102. Determination of dispute

          5. 103. Interpretation of Part 7

       8. PART 8 VARIATION AND TERMINATION OF CONTRACTS

          1. 104. Variation of a contract: general

          2. 105. Variation provisions specific to a contract with an individual medical practitioner

          3. 106. Variation provisions specific to a contract with two or more individuals practising in partnership

          4. 107. Termination by agreement

          5. 108. Termination by the contractor

          6. 109. Late payment notices

          7. 110. Termination by the Primary Care Trust: general

          8. 111. Termination by the Primary Care Trust for breach of conditions in regulation 4

          9. 112. Termination by the Primary Care Trust for the provision of untrue etc. information

          10. 113. Other grounds for termination by the Primary Care Trust

          11. 114. The Primary Care Trust may serve notice in writing on...

          12. 115. Termination by the Primary Care Trust: remedial notices and breach notices

          13. 116. Termination by the Primary Care Trust: additional provisions specific to contracts with two or more individuals practising in partnership and companies limited by shares

          14. 117. Contract sanctions

          15. 118. Contract sanctions and the NHS dispute resolution procedure

          16. 119. Termination and the NHS dispute resolution procedure

          17. 120. Consultation with the Local Medical Committee

       9. PART 9 MISCELLANEOUS

          1. 121. Clinical governance

          2. 122. Insurance

          3. 123. The contractor shall at all times hold adequate public liability...

          4. 124. Gifts

          5. 125. Compliance with legislation and guidance

          6. 126. Third party rights

    7. SCHEDULE 7

       OUT OF HOURS SERVICES

       1. 1. Temporary arrangements for transfer of obligations and liabilities in relation to certain out of hours services

       2. 2. Application for approval of an out of hours arrangement

       3. 3. Effect of approval of an arrangement with a transferee doctor

       4. 4. Review of approval

       5. 5. Suspension of approval

       6. 6. Immediate withdrawal of approval other than following review

       7. 7. Suspension or termination of an out of hours arrangement

    8. SCHEDULE 8

       CLOSURE NOTICE

    9. SCHEDULE 9

       PRIMARY CARE TRUSTS SPECIFIED

       1. FOR THE PURPOSES OF REPEATABLE PRESCRIBING

    10. SCHEDULE 10

        INFORMATION TO BE INCLUDED IN PRACTICE LEAFLETS

11. Explanatory Note