2002 No. 111

NATIONAL HEALTH SERVICE

The National Health Service (General Medical Services and Pharmaceutical Services) (Scotland) Amendment Regulations 2002

Made

Laid before the Scottish Parliament

Coming into force

The Scottish Ministers, in exercise of the powers conferred by sections 2(5), 19, 27(2), 28(1), 28A, 105(7), 106(a) and 108(1) of and Schedule 1, paragraph 11(c) to the National Health Service (Scotland) Act 19781 and of all other powers enabling them in that behalf, hereby make the following Regulations:

Citation, commencement and interpretation1

These Regulations may be cited as the National Health Service (General Medical Services and Pharmaceutical Services) (Scotland) Amendment Regulations 2002 and shall come into force on 1st April 2002.

Amendment of the National Health Service (Pharmaceutical Services) Regulations 19952

1

The National Health Service (Pharmaceutical Services) Regulations 19952 are amended in accordance with the following paragraphs.

2

In regulation 2(1) (interpretation and application)–

a

the definition of “Charges Regulations” is omitted;

b

in the definition of “nurse prescriber”, for “nurse or health visitor” there is substituted “nurse, midwife or health visitor”;

c

the definition of “Remission of Charges Regulations” is omitted;

d

after the definition of “relevant service” there is inserted–

  • “restricted availability appliance” means an appliance which is approved for particular categories of persons or for particular purposes only;

e

the definition of “supplemental services” is omitted.

3

For regulation 2(1A) (interpretation) there is substituted–

1A

The specified description of nurse, midwife or health visitor mentioned in the definition of “nurse prescriber” in paragraph (1) is–

a

a person who is either–

i

registered in Part 1 or 12 of the register maintained by the Nursing and Midwifery Council3 pursuant to paragraph 10 of Schedule 2 to the Nursing and Midwifery Order 20014 (referred to below in this definition as the “professional register”), and has a district nursing qualification additionally recorded in the professional register under rule 11 of the Nurses, Midwives and Health Visitors Rules 19835, or

ii

registered in Part 11 of the professional register as a health visitor,

and against whose name (in each case) is recorded in the professional register an annotation signifying that he is qualified to order drugs, medicines and appliances for patients; or

b

a person who is registered in Parts 1, 3, 5, 8, 10, 11, 12, 13, 14 or 15 of the professional register and against whose name is recorded in the professional register an annotation signifying that he is qualified to order drugs, medicines and appliances from the Nurse Prescribers' Extended Formulary Appendix in the British National Formulary6.

4

Regulation 3(4) (pharmaceutical services) is omitted.

5

Regulation 3(7)(b) (pharmaceutical services) is omitted.

6

In regulation 9(1)(c) (payments to pharmacists) “supplemental services and” is omitted.

7

In regulation 9(1)(f) (payments to pharmacists) for “and the specifications for such appliances;” there is substituted “, the specifications for such appliances and, in the case of a restricted availability appliance, the categories of persons for whom or the purposes for which the appliance is approved;”.

8

In Schedule 1, (interpretation) paragraph 1(a) is omitted.

9

In Schedule 1, paragraph 3(1) (provision of pharmaceutical services)–

a

in paragraph (a), after “appliances” there is inserted “, not being restricted availability appliances”;

b

after paragraph (b) there is inserted–

ba

an order for a restricted availability appliance, signed by and endorsed on its face with the reference “SLS”, by a doctor;

c

at the end of paragraph (c) “or” is omitted;

d

in paragraph (d), after “appliances” there is inserted “, not being restricted availability appliances”; and

e

after paragraph (d) there is inserted–

or

e

an order for a restricted availability appliance, signed by and endorsed on its face with the reference “SLS” by a nurse prescriber.

10

In Schedule 1, paragraph 3(11) (provision of pharmaceutical services), after paragraph (b) there is inserted–

ba

that appliance is not a restricted availability appliance; and

11

In Schedule 1, paragraph 11 (records) is omitted.

Amendment of the National Health Service (General Medical Services) Regulations 19953

1

The National Health Service (General Medical Services) Regulations 19957 are amended in accordance with the following paragraphs.

2

In regulation 2(1) (interpretation), in the definition of “nurse prescriber”, for “nurse or health visitor” there is substituted “nurse, midwife or health visitor”.

3

For regulation 2(1A) (interpretation) there is substituted–

1A

The specified description of nurse, midwife or health visitor mentioned in the definition of “nurse prescriber” in paragraph (1) is–

a

a person who is either–

i

registered in Part 1 or 12 of the register maintained by the Nursing and Midwifery Council8 pursuant to paragraph 10 of Schedule 2 to the Nursing and Midwifery Order 20019 (referred to below in this definition as the “professional register”), and has a district nursing qualification additionally recorded in the professional register under rule 11 of the Nurses, Midwives and Health Visitors Rules 198310, or

ii

registered in Part 11 of the professional register as a health visitor,

and against whose name (in each case) is recorded in the professional register an annotation signifying that he is qualified to order drugs, medicines and appliances for patients; or

b

a person who is registered in Parts 1, 3, 5, 8, 10, 11, 12, 13, 14 or 15 of the professional register and against whose name is recorded in the professional register an annotation signifying that he is qualified to order drugs, medicines and appliances from the Nurse Prescribers' Extended Formulary Appendix in the British National Formulary.

4

In regulation 35(1) (payments) after subparagraph (d) there is inserted–

da

fees and allowances for the grant of pre-payment certificates in accordance with regulation 8 of the National Health Service (Charges for Drugs and Appliances) (Scotland) Regulations 200111

5

In Schedule 1–

a

in paragraph 1 (interpretation), after the definition of “prescription form” there is inserted–

  • “restricted availability appliance” means an appliance which is approved for particular categories of persons or particular purposes only;

b

in paragraph 29(1) (prescribing and dispensing), before “A doctor” there is inserted “Subject to sub-paragraph (1A),”;

c

after paragraph 29(1) there is added–

1A

A doctor shall supply a restricted availability appliance only if it is for a patient in a category of person or a purpose specified in the Drug Tariff.

d

in paragraph 29(2)(b) (prescribing and dispensing), after sub-paragraph (ii) there is added–

iii

shall supply under regulation 34 for that patient a restricted availability appliance only if it is for a patient in a category of person or a purpose specified in the Drug Tariff;

e

in paragraph 30(3) (prescribing and dispensing) “, or an appliance,” is omitted; and

f

after paragraph 30(3) there is added–

4

In the case of urgency a doctor may request a chemist to dispense an appliance before a prescription form is issued only if–

a

that appliance does not contain a scheduled drug or a controlled drug within the meaning of the Misuse of Drugs Act 197112 other than a drug which is for the time being specified in Schedule 5 to the Misuse of Drugs Regulations 198513;

b

in the case of a restricted availability appliance, the appliance is for a patient in a category of person or a purpose specified in the Drug Tariff; and

c

in either case, the doctor undertakes to furnish the chemist, within 72 hours, with a prescription form completed in accordance with sub paragraphs (1) and (2).

6

In Schedule 11 (drugs to be supplied by general medical practitioners or prescribed for supply under pharmaceutical services only in certain circumstances) after the entry “Alprostadil (Caverject), (MUSE), (Viridal)” in each of columns 1 and 2 there is inserted “Apomorphine Hydrochloride (sublingual tablets) (Uprima)”.

MALCOLM CHISHOLMA member of the Scottish ExecutiveSt. Andrew’s House,Edinburgh

(This note is not part of the Regulations)

These Regulations amend the National Health Service (Pharmaceutical Services) (Scotland) Regulations 1995 (“the Pharmaceutical Services Regulations”) which govern the arrangements to be made by Health Boards for the provision in their area of pharmaceutical services under the National Health Service (Scotland) Act 1978 (“the 1978 Act”). They also amend the National Health Service (General Medical Services) (Scotland) Regulations 1995 (“the General Medical Services Regulations”) which regulate the terms on which doctors provide general medical services under the 1978 Act.

Regulation 2 amends the Pharmaceutical Services Regulations.

Definitions of “Charges Regulations” and “Remission of Charges Regulations” contained in regulation 2(1) and which are not relevant are removed (regulation 2(2)(a) and (c)). The definition of “prescription form” in Schedule 1, paragraph 1 is removed as this term is defined in regulation 2(1) (regulation 2(8)). References to “supplemental services” which were not removed by S.S.I. 2001/70, which removed supplemental services from the arrangements for the provision of pharmaceutical services which must be made by a Health Board, are removed by this regulation (regulation 2(2)(e), (4), (5), (6) and (11)).

The definition of “nurse prescriber” is amended by regulation 2(2)(b) and (3) in order to extend the categories of nurse, midwife or health visitor who may prescribe under the National Health Service in Scotland.

A new category of appliance to be known as a restricted availability appliance is introduced. A definition of this term is included in regulation 2(1) (regulation 2(2)(d)). This appliance is an appliance that will only be available on prescription to patients falling within limited categories and for certain limited purposes to be set out in the Drug Tariff.

Regulation 2 then makes various amendments to the Pharmaceutical Services Regulations to enable such appliances to be added to the Drug Tariff (regulation 2(7)) and to restrict the circumstances in which such appliances may be supplied on prescription (regulation 2(9) and (10)).

Regulation 3 amends the General Medical Services Regulations.

The definition of “nurse prescriber” is amended by regulation 3(2) and (3) in order to extend the categories of nurse, midwife or health visitor who may prescribe under the National Health Service in Scotland.

Regulation 3(4) amends regulation 35 in order to enable fees and allowances to be paid to doctors who grant pre-payment certificates in accordance with regulation 8 of the National Health Service (Charges for Drugs and Appliances) (Scotland) Regulations 2001.

Regulation 3(5) makes various amendments to Schedule 1 of the General Medical Services Regulations in order to take into account the new restricted availability appliances referred to above. The amendments prevent a doctor from supplying restricted availability appliances except to patients who fall into limited categories and for limited purposes specified in the Drug Tariff and, in the case of urgency, prevents a doctor requesting a pharmacist, without a prescription, to supply a restricted availability appliance containing scheduled or controlled drugs.

Regulation 3(6) amends Schedule 11 which lists drugs to be supplied by general medical practitioners or prescribed for supply under pharmaceutical services only in certain circumstances. It amends the list in Schedule 11, so as to include the tablet form of the drug Apomorphine Hydrochloride (Uprima) used for the treatment of erectile dysfunction.

The British National Formulary is available from the British Medical Association of Tavistock Square, London WC1H 9JP, the Royal Pharmaceutical Society of Great Britain of 1 Lambeth High Street, London SE1 7JN, Pharaceutical Press, PO Box 151 Wallingford, Oxon OX10 8QU or BMJ Books, PO Box 295, London WC1H 9TE.