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The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012

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Duty to ensure persons are offered a choice of health service providerE+W

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39.—(1) A relevant body must make arrangements to ensure that a person—

(a)who requires an elective referral; and

(b)for whom that body has responsibility,

is given the choices specified in paragraph (2).

[F1(2) Subject to regulations 40 and 41, the choices specified for the purposes of this paragraph are the choice—

(a)in respect of a first outpatient appointment with a consultant or a member of a consultant’s team [F2, inclusive of any subsequent treatment required as a result of that elective referral], of—

(i)any clinically appropriate health service provider with whom any [F3commissioning body] has a [F4qualifying contract], and

(ii)any clinically appropriate team led by a named consultant who is employed or engaged by that health service provider; and

(b)in relation to an elective referral for mental health services in respect of which the patient’s first outpatient appointment is not with a consultant or a member of a consultant’s team [F5, inclusive of any subsequent treatment required as a result of that elective referral], of—

(i)any clinically appropriate health service provider with whom any [F6commissioning body] has a [F7qualifying contract], and

(ii)any clinically appropriate team led by a named health care professional who is employed or engaged by that health service provider.]

F8(3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F8(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(5) The arrangements referred to in [F9paragraph (1)] must include such arrangements as are necessary to ensure that a person may make the choices specified in [F10that paragraph] where that person—

(a)has not been offered that choice by the person making the initial referral; and

(b)notifies the relevant body who has responsibility for that person that that choice was not offered.

(6) For the purposes of this Part, a health service provider, or a team led by a consultant or a health care professional, is clinically appropriate if, in the opinion of the person making the referral, they offer services that are clinically appropriate for that person in respect of the condition for which that person is referred.

[F11(7) Where—

(a)a person makes a choice pursuant to the arrangements required by paragraph (1), and

(b)the relevant body which is responsible for that person does not have in place a commissioning contract for the service required as a result of the referral,

the terms of the qualifying contract referred to in paragraph (2) under which the service is to be provided apply to the provision of the service required in respect of the person’s referral.

[F12(8) In paragraph (2)—

commissioning body” means—

(a)

a relevant body, or

(b)

an NHS trust or NHS foundation trust when exercising commissioning functions of a relevant body that have been delegated by virtue of arrangements made under section 65Z5(1) of the 2006 Act;

qualifying contract” means an NHS Standard Contract which—

(a)

is signed and in effect before the date on which the referral is made,

(b)

is a commissioning contract for the service required as a result of the referral,

(c)

requires that service to be provided from the location specified in that contract or sets out the criteria to determine how that service will be accessible to patients, and

(d)

is not a contract put in place solely to provide that service to a specified individual.]

[F13(9) For the purposes of the definition of “qualifying contract” in paragraph (8), “commissioning contract” means a contract, other than a primary care contract, entered into by—

(a)a relevant body when exercising its commissioning functions, or

(b)an NHS trust or NHS foundation trust in the exercise of the commissioning functions of a relevant body that have been delegated by virtue of arrangements made under section 65Z5(1) of the 2006 Act.]]

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