The National Health Service (General Medical Services Contracts) Regulations 2015

PART 3 E+W Lists of patients: closure etc.

Application for closure of list of patients E+W

33.—(1) Where a contractor wants to close its list of patients, the contractor must send a written application to that effect (“ the application”) to [F1 NHS England].

(2) The application must include the following information—

(a) the options which the contractor has considered, rejected or implemented in an attempt to alleviate the difficulties which the contractor has encountered in respect of its open list and, if any of the options were implemented, the level of success in reducing or extinguishing such difficulties;

(b) details of any discussions between the contractor and its patients and a summary of those discussions including whether or not, in the opinion of those patients, the list of patients should be closed;

(c) details of any discussions between the contractor and the other contractors in the contractor's practice area and a summary of the opinion of the other contractors as to whether or not the list of patients should be closed;

(d) the period of time, being a period of not less than three months and not more than 12 months, during which the contractor wants its list of patients to be closed;

(e) any reasonable support from [F1 NHS England] which the contractor considers would enable its list of patients to remain open or would enable the period of the proposed closure to be minimised;

(f) any plans which the contractor may have to alleviate the difficulties mentioned in the application during the period of the proposed closure in order for that list to re-open at the end of that period without the existence of those difficulties; and

(g) any other information which the contractor considers ought to be drawn to the attention of [F1 NHS England].

(3) [F1 NHS England] must acknowledge receipt of the application before the end of the period of seven days beginning with the date on which [F1 NHS England] received the application.

(4) [F1 NHS England] must consider the application and may request such other information from the contractor as [F1 NHS England] requires in order to enable it to determine the application.

(5) [F1 NHS England] must enter into discussions with the contractor concerning—

(a) the support which [F1 NHS England] may give to the contractor; or

(b) any changes which [F1 NHS England] or the contractor may make,

which would enable the contractor to keep its list of patients open.

(6) [F1 NHS England] and the contractor must, throughout the period of the discussions referred to in sub-paragraph (5), use reasonable endeavours to achieve the aim of keeping the contractor's list of patients open.

(7) [F1 NHS England] or the contractor may, at any stage during the discussions, invite the Local Medical Committee (if any) for the area in which the contractor provides services under the contract to attend any meetings arranged between [F1 NHS England] and the contractor to discuss the application.

(8) [F1 NHS England] may consult such persons as it appears to [F1 NHS England] may be affected by the closure of the contractor's list of patients and, if [F1 NHS England] does so, it must provide to the contractor a summary of the views expressed by those persons consulted in respect of the application.

(9) [F1 NHS England] must enable the contractor to consider and comment on all the information before [F1 NHS England] makes a decision in respect of the application.

(10) A contractor may withdraw the application at any time before [F1 NHS England] makes a decision in respect of that application.

(11) [F1 NHS England] must, before the end of the period of 21 days beginning with the date on which the application was received by [F1 NHS England] (or within such longer period as the parties may agree), make a decision to—

(a) approve the application and determine the date from which the closure of the contractor's list is to take effect; or

(b) reject the application.

(12) [F1 NHS England] must give notice in writing to the contractor of its decision to—

(a) approve the application in accordance with paragraph 34; or

(b) reject the application in accordance with paragraph 35.

(13) A contractor may not submit more than one application to close its list of patients in any period of 12 months beginning with the date on which [F1 NHS England] makes its decision on the application unless—

(a) paragraph 36 applies; or

(b) there has been a change in the circumstances of the contractor which affects its ability to deliver services under the contract.

Textual Amendments

F1 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1

Approval of an application to close a list of patients E+W

34.—(1) Where [F1 NHS England] approves an application to close a contractor's list of patients, [F1 NHS England] must—

(a) give notice in writing to the contractor of its decision as soon as possible and the notice (“the closure notice”) must include the details specified in sub-paragraph (2); and

(b) at the same time as [F1 NHS England] gives notice to the contractor, send a copy of the closure notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the contract, and

(ii) any person who [F1 NHS England] consulted in accordance with paragraph 33(8).

(2) The closure notice must include—

(a) the period of time for which the contractor's list of patients is to be closed which must be—

(i) the period specified in the application, or

(ii) where [F1 NHS England] and the contractor have agreed in writing to a different period, that different period,

and, in either case, the period must not be less than three months and not more than 12 months;

(b) the date on which the closure of the list of patients is to take effect (“the closure date”); and

(c) the date on which the list of patients is to re-open.

(3) Subject to paragraph 37, a contractor must close its list of patients with effect from the closure date and the list of patients must remain closed for the duration of the closure period as specified in the closure notice.

Textual Amendments

F1 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1

Rejection of an application to close a list of patients E+W

35.—(1) Where [F1 NHS England] rejects an application to close a contractor's list of patients it must—

(a) give notice in writing to the contractor of its decision as soon as possible, including [F1 NHS England's] reasons for rejecting the application; and

(b) at the same time as it gives notice to the contractor, send a copy of the notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the contract, and

(ii) any person who [F1 NHS England] consulted in accordance with paragraph 33(8).

(2) Subject to sub-paragraph (3), if [F1 NHS England] rejects an application from a contractor to close its list of patients, the contractor must not make a further application to close its list of patients until whichever is the later of—

(a) the end of the period of three months beginning with the date on which [F1 NHS England's] decision to reject the application was made; or

(b) in a case where a dispute arising from [F1 NHS England's] decision to reject the application has been referred to the NHS dispute resolution procedure, the end of the period of three months beginning with the date on which a final determination to reject the application was made in accordance with that procedure (or any court proceedings).

(3) A contractor may make a further application to close its list of patients where there has been a change in the circumstances of the contractor which affects the contractor's ability to deliver services under the contract.

Textual Amendments

F1 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1

Application for an extension of a closure period E+W

36.—(1) A contractor may apply to extend the closure period by sending a written application (“ the application”) to that effect to [F1 NHS England] no later than eight weeks before the date on which the closure period is due to expire.

(2) The application must include the following information—

(a) details of the options which the contractor has considered, rejected or implemented in an attempt to alleviate the difficulties which have been encountered during the closure period or which may be encountered when the closure period expires;

(b) the period of time during which the contractor wants its list of patients to remain closed (which may not be longer than 12 months);

(c) details of any reasonable support from [F1 NHS England] which the contractor considers would enable the contractor's list of patients to re-open or would enable the proposed extension to the closure period to be minimised;

(d) details of any plans which the contractor may have to alleviate the difficulties mentioned in the application to extend the closure period in order for the list of patients to re-open at the end of the proposed extension of that period without the existence of those difficulties; and

(e) any other information which the contractor considers ought to be drawn to the attention of [F1 NHS England].

(3) [F1 NHS England] must acknowledge receipt of the application before the end of the period of seven days beginning with the date on which [F1 NHS England] received the application.

(4) [F1 NHS England] must consider the application and may request such other information from the contractor as it requires in order to enable it to decide the application.

(5) [F1 NHS England] may enter into discussions with the contractor concerning—

(a) the support which [F1 NHS England] may give to the contractor; or

(b) any changes which [F1 NHS England] or the contractor may make,

which would enable the contractor to re-open its list of patients.

(6) [F1 NHS England] must determine the application before the end of the period of 14 days beginning with the date on which [F1 NHS England] received that application (or before the end of such longer period as the parties may agree).

(7) [F1 NHS England] must give notice in writing to the contractor of its decision to approve or reject the application to extend the closure period as soon as possible after making that decision.

(8) Where [F1 NHS England] approves an application, [F1 NHS England] must—

(a) give notice in writing to the contractor of its decision (“the extended closure notice”) which must include the details referred to in sub-paragraph (9); and

(b) at the same time as it gives notice in writing to the contractor, send a copy of the extended closure notice to—

(i) the Local Medical Committee (if any) for the area in which the contractor provides services under the contract, and

(ii) any person who [F1 NHS England] consulted in accordance with paragraph 33(8).

(9) The extended closure notice must include—

(a) the period of time for which the contractor's list of patients is to remain closed which must be—

(i) the period specified in the application, or

(ii) where [F1 NHS England] and contractor have agreed in writing a different period to the period specified in that application, that agreed period,

and, in either case, the period (“the extended closure period”) must not be less than three months and not more than 12 months beginning with the date on which the extended closure period is to take effect;

(b) the date on which the extended closure period is to take effect; and

(c) the date on which the contractor's list of patients is to re-open.

(10) Where [F1 NHS England] rejects an application, it must—

(a) give notice in writing to the contractor of its decision including its reasons for rejecting the application; and

(b) at the same time as it gives notice to the contractor, send a copy of the notice to the Local Medical Committee (if any) for the area in which the contractor provides services under the contract.

(11) Where an application is made in accordance with sub-paragraphs (1) and (2), the contractor's list of patients is to remain closed pending whichever is the later of—

(a) the determination by [F1 NHS England] of that application; or

(b) in a case where a dispute arising from [F1 NHS England's] decision to reject the application to extend the closure period has been referred to the NHS dispute resolution procedure, the contractor ceasing to pursue that dispute through that procedure (or any court proceedings).

Textual Amendments

F1 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1

Re-opening of list of patients E+W

37.  The contractor may re-open its list of patients before the expiry of the closure period if [F1 NHS England] and the contractor agree that the contractor should do so.

Textual Amendments

F1 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1