The National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006

Regulations 2(1) and 18

SCHEDULE 1 TERMS OF SERVICE

Interpretation

1.  In this Schedule–

(a) the expression “the regulations” means the National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006;

(b) any reference to a numbered regulation is a reference to the regulation bearing that number in the regulations;

(c) any reference to a numbered paragraph is a reference to the paragraph bearing that number in this Schedule, and any reference in a paragraph to a numbered sub paragraph is a reference to the sub paragraph bearing that number in that paragraph;

(d) other words and expressions have the same meaning as in the Regulations.

Incorporation of provisions

2.  Any provisions of the following affecting the rights and obligations of contractors and ophthalmic medical practitioners and opticians assisting in the provision of general ophthalmic services shall form part of the terms of service–

(a) the regulations;

(b) the National Health Service (Tribunal) (Scotland) Regulations 2004(1);

(c) so much of the National Health Service (Service Committees and Tribunal) (Scotland) Regulations 1992(2) as relates to–

(i) the investigation of questions arising between ophthalmic medical practitioners or opticians and their patients, other investigations to be made by a discipline committee and the action which may be taken by the Board as a result of such investigations, including the withholding of remuneration where there has been a breach of the terms of service;

(ii) appeal to the Scottish Ministers from decisions of the Board;

(iii) the investigation of the excessive–

(aa) undertaking of eye examinations;

(bb) issuing of optical vouchers;

(cc) prescribing of supplements;

(d) regulation 9 of the National Health Service (Optical Charges and Payments) (Scotland) Regulations 1998(3);

(e) the Statement;

(f) the General Optical Council’s Rules Relating to Injury of the Eye; and

(g) the College of Optometrist’s Code of Ethics and Guidance for Professional Conduct.

Certificate of training

3.—(1) Except in the case of a body corporate, an ophthalmic medical practitioner or optician providing, or assisting in the provision of, general ophthalmic services shall undertake a course of training in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields from a training provider approved by NHS Education for Scotland and shall provide to the Board a certificate from the provider of that training that that person has completed the training satisfactorily

(2) Except in the case of a body corporate, any application for inclusion in the Ophthalmic List must be accompanied by such a certificate.

(3) Except in the case of a body corporate, in the case of any person to whom regulation 26(6) applies, that person shall provide such a certificate to the Board no later than 30 June 2006, or by such later date as the Board considers appropriate in the circumstances of the case if it thinks it is not reasonably practicable for that person to provide such certificate by 30 June 2006

Premises at which general ophthalmic services are to be provided

4.—(1) Subject to sub paragraph (2), a contractor shall provide general ophthalmic services or cause such services to be provided by an ophthalmic medical practitioner or optician who assists in the provision of general ophthalmic services at any address which is included in relation to the contractor in the Ophthalmic List.

(2) An ophthalmic medical practitioner or optician on the Ophthalmic List may, where requested to do so by or on behalf of a patient, who is–

(a) unable to leave home unaccompanied because of physical or mental illness or disability, agree to provide general ophthalmic services or assist in the provision of general ophthalmic services at the place at which the patient normally resides; or

(b) attending a day centre, agree to provide general ophthalmic services or assist in the provision of general ophthalmic services at that day centre.

Visits

5.—(1) In the case of a mobile practice, a contractor shall give the Board notice in accordance with sub paragraph (2) of any visits which the contractor or an ophthalmic medical practitioner or optician who assists that contractor in the provision of general ophthalmic services intends to make to provide general ophthalmic services to at least three persons at day centres or in residential centres in the Board’s area.

(2) The contractor shall notify the Board at least one month in advance of the month in which the contractor or an ophthalmic medical practitioner or optician who assists that contractor in the provision of general ophthalmic services intends to visit any establishment in the Board’s area and of the intervals at which the contractor intends that return visits shall be made.

Premises and equipment

6.—(1) Subject to sub paragraph (2), a contractor shall provide, as may be requisite, proper and sufficient consulting and waiting room accommodation and suitable equipment, including required equipment, for general ophthalmic services.

(2) In the case of a mobile practice, the contractor shall provide suitable equipment, including required equipment, for general ophthalmic services.

(3) Subject to sub paragraph (4), a contractor, on receipt of a written request from the Board, shall admit at all reasonable times for the purposes of inspecting such accommodation or equipment and reviewing procedures an ophthalmic officer or any authorised officer of the Scottish Ministers or the Board or member of the Board.

(4) In the case of a mobile practice, the contractor, on receipt of a written request from the Board to do so, shall arrange for an ophthalmic officer or any authorised officer of the Scottish Ministers or the Board or member of the Board to be allowed to inspect at a reasonable time the facilities and equipment that the contractor or an ophthalmic medical practitioner or opticians who assists the provider in the provision of general ophthalmic services uses.

Notices

7.  A contractor shall secure that at each place at which the contractor provides general ophthalmic services or an ophthalmic medical practitioner or optician assists the contractor in the provision of general ophthalmic services there is prominently displayed a notice and leaflet supplied or approved by the Board, indicating the services available under general ophthalmic services and indicating to which descriptions of the contractor’s patients a payment may be made under the National Health Service (Optical Charges and Payments) (Scotland) Regulations 1998.

Records

8.—(1) A contractor or ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services shall keep proper, complete, accurate and up-to-date records in respect of each patient to whom general ophthalmic services are provided, giving appropriate details of eye examinations carried out.

(2) A contractor or ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services may keep the records referred to in sub paragraph (1) in computerised form.

(3) A contractor shall retain all such records for a period of 7 years.

(4) A contractor shall, when requested to do so by any authorised officer of the Scottish Ministers, the Agency or the Board during the period in which the contractor is required to retain such records–

(a) produce them to such authorised officer of the Scottish Ministers, the Agency or the Board; or

(b) send them to such authorised officer of the Scottish Ministers, the Agency or the Board within such period as may be specified by the authorised officer not being less than 14 days from the date of request.

Deputies

9.—(1) An ophthalmic medical practitioner may arrange for eye examinations to be carried out on his behalf by another ophthalmic medical practitioner, and an optician may arrange for eye examinations to be carried out on his behalf by another optician, provided that such other ophthalmic medical practitioner or optician is included in the Ophthalmic List of the Board for the area in which such eye examinations are to be carried out.

(2) Any contractor who makes an arrangement for the regular provision of services by a deputy in terms of paragraph (1) shall notify the Board of the arrangements.

Employees

10.—(1) An ophthalmic medical practitioner who employs a person to carry out eye examinations shall employ only another ophthalmic medical practitioner on the Ophthalmic List of the Board for the area in which such eye examinations are to be carried out.

(2) An optician who employs a person to carry out eye examinations shall employ only–

(a) another optician on the Ophthalmic List of the Board for the area in which such eye examinations are to be carried out; or

(b) a person acting under his continuous personal supervision who is authorised to carry out eye examinations by rules made under section 24(3) of the Opticians Act 1989.

(3) Any contractor who makes an arrangement for the regular provision of services by an employee in terms of paragraphs (1) or (2) shall notify the Board of the arrangement.

(4) In this paragraph “employee” includes, in the case of a body corporate, a director and “employ” is to be interpreted accordingly.

Complaints

11.—(1) Subject to sub paragraphs (2) and (3), a contractor shall establish and operate in accordance with this paragraph, a procedure (in this paragraph and in paragraphs 11 and 12 referred to as a “complaints procedure”) to deal with any complaints made by or on behalf of the patients and former patients of the contractor or an ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services.

(2) The complaints procedure to be established by a contractor may be such that it also deals with complaints made in relation to one or more other contractors or ophthalmic medical practitioners or opticians who assist the contractor in the provision of general ophthalmic services.

(3) The complaints procedure to be established by a contractor who provides general ophthalmic services or causes general ophthalmic services to be provided from more than one set of premises may be such that it relates to all those premises together.

(4) A complaints procedure shall apply to complaints made in relation to any matter reasonably connected with the provision or assistance in provision of general ophthalmic services and within the responsibility or control of–

(a) the contractor;

(b) where the contractor is a body corporate, any of its directors or former directors;

(c) a former partner of the contractor;

(d) any other person (being an optician, an ophthalmic medical practitioner or a person authorised to test sight by rules made under section 24(3) of the Opticians Act 1989) who is either employed by the contractor or engaged as his deputy;

(e) any employee of the contractor other than one falling within paragraph (d);

(f) when the contractor is a limited liability partnership , a member or former member;

(g) an ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services,

and in this paragraph and paragraph 12, references to complaints are to complaints falling within this sub paragraph.

(5) A complaint may be made on behalf of a patient or former patient with his consent, or–

(a) where the patient is a child under the age of 16 years–

(i) by either parent, or in the absence of both parents, the guardian or other adult person who has care of the child, or

(ii) in the care of an authority within the meaning of section 17(6) of the Children (Scotland) Act 1995, or in the care of a voluntary organisation, by that authority or voluntary organisation; or

(b) where the person is incapable of making a complaint, by a relative or other adult person who has an interest in his welfare.

(6) Where a patient has died, a complaint may be made by a relative or other adult person who had an interest in his welfare or, where the patient was as described in head (a)(ii) of sub paragraph (5), by the authority or voluntary organisation.

(7) A complaints procedure shall comply with the following requirements–

(a) the contractor shall specify a person (who need not be connected with the contractor and who, in the case of an individual, may be specified by his job title) to be responsible for receiving and investigating all complaints;

(b) all complaints shall be–

(i) recorded in writing,

(ii) acknowledged, either orally or in writing, within the period of 3 days (excluding Saturdays, Sundays, Christmas Day, New Year’s Day and other public or local holidays agreed with the Board) beginning with the day on which the complaint was received by the person specified in head (a), or where that is not possible, as soon as reasonably practicable, and

(iii) properly investigated;

(c) within the period of 10 days (excluding Saturdays, Sundays, Christmas Day, New Year’s Day and any other public or local holidays agreed with the Board) beginning on the day on which the complaint was received by the person specified in head (a), or where that is not possible, as soon as reasonably practicable, the complainant shall be given a written summary of the investigation and its conclusions;

(d) where the investigation of the complaint requires consideration of the patient’s eye examination records, the person specified under head (a) shall inform the patient or person acting on his behalf if the investigation will involve disclosure of information contained in those records to a person other than the contractor, or a director, partner, deputy or employee of the contractor; and

(e) the contractor shall keep a record of all complaints and copies of all correspondence relating to complaints, but such records shall be kept separate from patients' eye examination records.

(8) At each of the premises at which the contractor provides general ophthalmic services or causes general ophthalmic services to be provided the contractor shall provide information about the complaints procedure which the contractor operates and give the name (or title) and address of the person specified in sub paragraph (7)(a).

Co-operation with investigations

12.—(1) A contractor or an ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services shall cooperate with any investigation of a complaint by the Board in accordance with the procedures which it operates in accordance with directions given under section 2(5) of the Act, whether the investigation follows one under the contractor’s complaints procedure or not.

(2) The co operation required by sub paragraph (1) includes–

(a) answering questions reasonably put to the contractor by the Board;

(b) providing any information relating to the complaint reasonably required by the Board; and

(c) attending any meeting to consider the complaint (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given), if the contractor’s presence or the presence of an ophthalmic medical practitioner or optician who assists that contractor in the provision of general ophthalmic services at the meeting is reasonably required by the Board.

Payments

13.—(1) Any claim by a contractor for fees in respect of the provision of general ophthalmic services shall be made by completing or securing the completion of an eye examination form and sending it to the Agency within 6 months after the date of completion of such provision of the services.

(2) Any such claim shall be signed–

(a) if the service was provided on behalf of a contractor by a deputy or employee who is also a contractor, by the deputy or employee who shall give the name of the contractor on whose behalf the service was provided;

(b) if the service was provided on the contractor’s behalf by a person whose name is included in the second part of the Ophthalmic List by the person who assisted in the provision of general ophthalmic services who shall also give the name of the contractor on whose behalf the service was provided; and

(c) in other cases by the contractor.

(3) A signatory shall sign any such claim in ink with his or her initials or forename and with his or her surname in his own handwriting and not by means of a stamp.

(4) Where an eye examination is undertaken by an ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services that ophthalmic medical practitioner or optician shall complete a claim for remuneration in respect of that eye examination which–

(a) is separate from any claim form in respect of eye examinations given by the contractor personally; and

(b) identifies the ophthalmic medical practitioner or optician who undertook the eye examination and his or her status as an ophthalmic medical practitioner or optician who assists the contractor in the provision of general ophthalmic services.

(5) Except as provided in the regulations, in the Statement, or in the National Health Service (Charges for Overseas Visitors) (Scotland) Regulations 1989(4), or in sub paragraph (6), a contractor shall not demand or accept or cause to be demanded or accepted from any patient or from other persons the payment of any fee or other remuneration in respect of the provision of general ophthalmic services.

(6) A contractor shall be entitled to demand and recover from a patient or person having charge of a patient a sum in respect of loss of remunerative time resulting from a failure by that patient to keep an appointment.

(7) A contractor shall not demand or accept or cause to be demanded or accepted from the Agency the payment of any fee or other remuneration in respect of any item of service–

(a) which has not been provided under the general ophthalmic services; or

(b) for which a claim has already been submitted to the Agency.

Eye examinations

14.—(1) An ophthalmic medical practitioner or optician who accepts in accordance with these regulations–

(a) an application from a patient for a primary eye examination; or

(b) an application from a patient for a supplementary eye examination,

shall carry out an eye examination.

(2) Where an ophthalmic medical practitioner or optician is of the opinion that it is clinically necessary to carry out a sight test on a patient whose eyes he or she has examined in accordance with sub paragraph (1), he or she shall carry out a sight test.

(3) Where an ophthalmic medical practitioner or optician carries out a sight test, he or she shall fulfil any duty imposed on him or her by, or in regulations made under, the Opticians Act 1989.

(4) Where an ophthalmic medical practitioner or optician is of the opinion that a patient whose eyes he or she has examined in accordance with sub paragraph (1)–

(a) shows signs of injury, disease or abnormality in the eye or elsewhere which may require medical treatment; or

(b) is not likely to attain a satisfactory standard of vision notwithstanding the application of corrective lenses,

he or she shall, if appropriate, and with the consent of the patient–

(i) refer the patient to an ophthalmic hospital;

(ii) inform the patient’s doctor or GP practice that he or she has done so; and

(iii) give the patient a written statement that he or she has done so, with details of the referral.

(5) Where an ophthalmic medical practitioner or optician undertakes an eye examination of a patient diagnosed as suffering from diabetes or glaucoma he or she shall inform the patient’s doctor of the results of the test.

(6) A prescription for glasses issued following an eye examination which includes a sight test shall be completed by the method recommended in Appendix A to British Standard 3521:1962 (Glossary of Terms relating to Ophthalmic Lenses and Spectacle Frames) published by the British Standards Institution, as effective on the date of its publication, and shall comply with any requirements as to its form specified in the Statement for the purposes of payment in respect of the eye examination.

(7) An ophthalmic medical practitioner or optician shall carry out a maximum of 20 eye examinations in any working day.

(8) Following a primary eye examination or a supplementary eye examination the ophthalmic medical practitioner or optician who carried out the examination shall give a statement of the outcome of the examination to the patient.

Use of disqualified name

15.—(1) Subject to sub paragraph (2), a contractor shall not use in any manner whatsoever the name or part of the name, either alone or in combination with any other words or letters, of or used by, any person so long as that person is disqualified from inclusion in any Ophthalmic List.

(2) Nothing in sub paragraph (1) shall prevent a contractor other than a body corporate from using his own name or being a body corporate, from using the name by which it is enrolled in the register maintained pursuant to the provisions of the Opticians Act 1989.

Regulation 7 and 26(1)

SCHEDULE 2

PART A INFORMATION, CERTIFICATES, CONSENTS, DECLARATIONS AND UNDERTAKINGS TO BE INCLUDED IN AN APPLICATION FOR INCLUSION IN THE FIRST PART OF THE OPHTHALMIC LIST

1.  An application shall contain the following information:–

(a) the applicant’s full name, sex, date of birth and private address and telephone number;

(b) a full description of the applicant’s qualifications including the institution which awarded them;

(c) the applicant’s professional registration number and date of first registration;

(d) whether the applicant is an ophthalmic medical practitioner, a registered optometrist or a body corporate;

(e) address of proposed premises and, in the case of any mobile practice, the address to which correspondence may be sent and the addresses of any day centres and residential centres to be visited more than once;

(f) whether the premises may be reached without use of stairs;

(g) whether the premises have wheelchair access;

(h) proposed days and hours of attendance at these premises and, in the case of any mobile practice, the month in which visits are intended to take place and the planned interval between such visits;

(i) the name of each ophthalmic medical practitioner or optician who is regularly engaged as a deputy, director or employee in the provision of general ophthalmic services;

(j) chronological details of the applicant’s professional experience (including the starting and finishing dates of each appointment together with explanation of any gaps between appointments) with any additional supporting particulars, and an explanation of why the applicant was dismissed from any post;

(k) details of any list or equivalent list from which the applicant has ever been disqualified, conditionally disqualified, removed, suspended, contingently removed or suspended or to which admission was refused or conditionally granted together with reasons for such disqualification, conditional disqualification, removal, suspension or refusal;

(l) name and addresses of two referees who are willing to provide clinical references relating to two recent posts as an ophthalmic medical practitioner or optometrist each of which lasted at least 3 months without a significant break and which may include a current post, or, where this is not possible a full explanation and name and address of an alternative referee or referees;

(m) if the applicant is a national of an EEA state, evidence that the applicant has a knowledge of English which, in the interests of the applicant and of patients who may receive general ophthalmic services from the applicant, is necessary for providing general ophthalmic services;

(n) if the applicant is the director or one of the persons with control of a corporate body, the name and registered office of that body;

(o) if the applicant is, or has been where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud;

(p) whether the applicant has–

(i) had sequestration of the applicant’s estate awarded, or been adjudged bankrupt;

(ii) been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986(5);

(iii) made a composition or arrangement with, or granted a trust deed for, the applicant’s creditors;

(q) where the applicant is a body corporate, whether–

(i) an administrator, administrative receiver or receiver has been appointed in respect of it; or

(ii) an administration order has been made in respect of it under Schedule B1 to the Insolvency Act 1986; or

(iii) it has been wound up under Part IV of the Insolvency Act 1986; or

(r) whether the applicant is subject to a disqualification order under the Company Directors Disqualification Act 1986(6), the Companies (Northern Ireland) Order 1986(7) or to an order made under section 429(2)(b) of the Insolvency Act 1986(8) (failure to pay under county court administration order).

2.  An application shall contain the following declarations as to whether or not the applicant:–

(a) has been convicted of a criminal offence in the British Islands or has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(b) is currently the subject of any proceedings anywhere in the world which might lead to a conviction specified in sub-paragraph (a);

(c) has in summary proceedings in respect of an offence, been the subject of an order discharging the applicant absolutely (without proceeding to conviction);

(d) has accepted and agreed to pay either a procurator fiscal fine under section 302 of the Criminal Procedure (Scotland) Act 1995(9) or a penalty under section 115A of the Social Security Administration Act 1992(10);

(e) has accepted a police caution in the British Islands;

(f) has been bound over following a criminal conviction in the British Islands;

(g) has been subject to any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world where the outcome was adverse;

(h) is currently subject to any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world;

(i) is the subject of any investigation or proceedings by another Health Board or equivalent body which might result in the applicant being disqualified, conditionally disqualified, refused entry, granted entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list;

(j) is, or has been, where the outcome was adverse, the subject of any investigation into the applicant’s professional conduct in respect of any previous or current employment;

(k) is, or has in the preceding 6 months been, or was at the time of the events that gave rise to conviction, proceedings or investigation, a director or one of the body of persons with control of a body corporate, or a member of a partnership (including a limited liability partnership) which–

(i) has been convicted of a criminal offence in the British Islands;

(ii) has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(iii) is currently the subject of any proceeding anywhere in the world which might lead to such a conviction;

(iv) has been subject to any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world; or

(v) is, to the applicant’s knowledge, or has been, where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud;

(l) has had sequestration of the applicant’s estate awarded or been adjudged bankrupt;

(m) has been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986;

(n) has made a composition or arrangement with, or granted a trust deed for, the applicant’s creditors;

(o) if a body corporate–

(aa) has had an administrator, administrative receiver or receiver appointed in respect of it; or

(bb) has had an administration order made in respect of it under Schedule B1 to the Insolvency Act 1986;

(cc) has been wound up under Part IV of the Insolvency Act 1986;

(p) is subject to a disqualification order under the Company Directors Disqualification Act 1986, the Companies (Northern Ireland) Order 1986 or to an order made under section 429(2)(b) of the Insolvency Act 1986 (failure to pay under county court administration order).

3.  An applicant must include:

(a) an enhanced criminal record certificate in relation to himself or herself or, where the applicant is a body corporate carrying on business as an optometrist, in relation to each director or person controlling that body corporate, dated not earlier than 28 days before the date of the application, and

(b) except in the case of a body corporate carrying on business as an optometrist, a certificate from a provider of training approved by NHS Education for Scotland that the applicant has satisfactorily completed a course of training in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields.

4.  An application shall include the following undertakings:–

(a) the applicant will participate in appropriate and relevant NHS audit procedures;

(b) that applicant will be bound by the terms of service;

(c) that the applicant will notify the Board in writing within 7 days of its occurrence if the applicant–

(i) is charged in the British Islands with a criminal offence, the sentence for which could be a term of imprisonment or is charged elsewhere with an offence which, if committed in the British Islands would constitute such a criminal offence;

(ii) is convicted of a criminal offence in the British Islands or is convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(iii) has, in summary proceedings, in respect of an offence, been the subject of an order discharging him or her absolutely (without proceeding to conviction);

(iv) has accepted and agreed to pay either a procurator fiscal fine under section 302 of the Criminal Procedure (Scotland) Act 1995 or a penalty under section 115A of the Social Security Administration Act 1992;

(v) has accepted a police caution in the British Islands;

(vi) is bound over following a criminal conviction in the British Islands;

(vii) becomes the subject of any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world;

(viii) is informed by any licensing, regulatory or other body anywhere in the world of the outcome of any investigation into the applicant’s professional conduct, and there is a finding against the applicant;

(ix) becomes, to the applicant’s knowledge, the subject of any investigation by the Agency in relation to fraud, or is informed of the outcome of any such investigation, where it is adverse;

(x) becomes the subject of any investigation or proceedings by another Health Board or equivalent body, which might result in the applicant being disqualified, conditionally disqualified, refused entry, allowed entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list;

(xi) is disqualified, conditionally disqualified, refused entry, allowed entry subject to conditions, removed or suspended from or refused admission or contingently removed from to any list or equivalent list;

(xii) is, was in the preceding 6 months, or was at the time of the events that gave rise to the charge, conviction or investigation , a director or one of the persons with control of a body corporate and that body corporate–

(aa) is charged in the British Islands with a criminal offence, or is charged elsewhere with an offence which, if committed in the British Islands would constitute a criminal offence;

(bb) is convicted of a criminal offence in the British Islands;

(cc) is convicted elsewhere of an offence which, if committed in the British Islands would constitute a criminal offence;

(dd) becomes the subject of any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world;

(ee) is informed by any licensing, regulatory or other body anywhere in the world of the outcome of any investigation into its provision of professional services, and there is a finding against it; or

(ff) becomes, to his or her knowledge, the subject of any investigation by the Agency in relation to fraud, or is informed of the outcome of any such investigation, if adverse,

together with details of the occurrence, including approximate dates, and where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome;

(xiii) has sequestration of the applicant’s estate awarded or is adjudged bankrupt;

(xiv) is made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986;

(xv) makes a composition or arrangement with, or grants a trust deed for, the applicant’s creditors;

(xvi) if a body corporate–

(aa) has an administrator, administrative receiver or receiver appointed in respect of it; or

(bb) has an administration order made in respect of it under Schedule B1 to the Insolvency Act 1986;

(cc) is wound up under Part IV of the Insolvency Act 1986;

(xvii) is made subject to a disqualification order under the Company Directors Disqualification Act 1986), the Companies (Northern Ireland) Order 1986 or to an order made under section 429(2)(b) of the Insolvency Act 1986 (failure to pay under county court administration order);

(d) that the applicant consents to a request being made by the Board to the Agency, any employer or former employer of the applicant, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, into the applicant or a body corporate referred to in this paragraph and, for the purposes of this sub paragraph, “employer” includes any partnership of which the applicant is or was a member;

(e) that the applicant consents to disclosure of information in terms of regulation 14; and

(f) that the fixed or mobile premises from which the applicant will provide general ophthalmic services contains the required equipment.

PART B INFORMATION, CONSENTS, DECLARATIONS, CERTIFICATES AND UNDERTAKINGS TO BE INCLUDED IN AN APPLICATION FOR INCLUSION IN THE SECOND PART OF THE OPHTHALMIC LIST

1.  An application shall contain the following information:–

(a) the applicant’s full name, sex, date of birth and private address and telephone number;

(b) a full description of the applicant’s qualifications including the institution which awarded them;

(c) the applicant’s professional registration number and date of first registration;

(d) an indication of whether the applicant is an ophthalmic medical practitioner, a registered optometrist or a body corporate;

(e) chronological details of the applicant’s professional experience (including the starting and finishing dates of each appointment together with explanation of any gaps between appointments) with any additional supporting particulars, and an explanation of why the applicant was dismissed from any post;

(f) details of any list or equivalent list from which the applicant has ever been disqualified, conditionally disqualified, removed, suspended, contingently removed or suspended or to which admission was refused or granted subject to conditions together with reasons for such disqualification, conditional disqualification, removal, suspension or refusal or imposition of conditions;

(g) name and addresses of two referees who are willing to provide clinical references relating to two recent posts as an ophthalmic medical practitioner or optometrist which lasted at least 3 months without a significant break and which may include a current post, or, where this is not possible a full explanation and name and address of an alternative referee or referees;

(h) if the applicant is a national of an EEA state, evidence that the applicant has a knowledge of English which, in the interests of the applicant and of patients who may receive general ophthalmic services from the applicant, is necessary for providing general ophthalmic services;

(i) if the applicant is the director or one of the persons with control of a corporate body, the name and registered office of that body;

(j) if the applicant is, or has been where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud.

2.  An application shall contain the following declarations as to whether or not the applicant:–

(a) has been convicted of a criminal offence in the British Islands or has been convicted elsewhere of an offence which would constitute a criminal offence if committed in Scotland;

(b) is currently the subject of any proceedings anywhere in the world which might lead to a conviction specified in sub-paragraph (a);

(c) has in summary proceedings in respect of an offence, been the subject of an order discharging the applicant absolutely (without proceeding to conviction);

(d) has accepted and agreed to pay either a procurator fiscal fine under section 302 of the Criminal Procedure (Scotland) Act 1995 or a penalty under section 115A of the Social Security Administration Act 1992;

(e) has accepted a police caution in the British Islands;

(f) has been bound over following a criminal conviction in the British Islands;

(g) has been subject to any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world where the outcome was adverse;

(h) is currently subject to any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world;

(i) is the subject of any investigation or proceedings by another Board or equivalent body which might result in the applicant being disqualified, conditionally disqualified, refused entry, granted entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list;

(j) is, or has been, where the outcome was adverse, the subject of any investigation into applicant’s professional conduct in respect of any previous or current employment;

(k) is, or has in the preceding 6 months been, or was at the time of the events that gave rise to conviction, proceedings or investigation, a director or one of the body of persons with control of a body corporate, which–

(i) has been convicted of a criminal offence in the British Islands;

(ii) has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(iii) is currently the subject of any proceeding anywhere in the world which might lead to such a conviction;

(iv) has been subject to any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world; or

(v) is, to the applicant’s knowledge, or has been, where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud;

3.  An applicant must include with the application–

(a) an enhanced criminal record certificate in relation to himself or herself dated not earlier than 28 days before the date of the application, and

(b) a certificate from a provider of training approved by NHS Education for Scotland that the applicant has satisfactorily completed a course of training in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields

4.  An application shall include the following consent and undertakings:–

(a) that the applicant will participate in appropriate and relevant NHS audit procedures;

(b) that the applicant will be bound by the terms of service;

(c) that the applicant will notify the Health Board in writing within 7 days of its occurrence if he or she–

(i) is charged in the British Islands with a criminal offence, the sentence for which could be a term of imprisonment or is charged elsewhere with an offence which, if committed in Scotland, would constitute such a criminal offence;

(ii) is convicted of a criminal offence in the British Islands or is convicted elsewhere of an offence which would constitute a criminal offence if committed in Scotland;

(iii) has, in summary proceedings, in respect of an offence, been the subject of an order discharging him or her absolutely (without proceeding to conviction);

(iv) has accepted and agreed to pay either a procurator fiscal fine under section 302 of the Criminal Procedure (Scotland) Act 1995 or a penalty under section 115A of the Social Security Administration Act 1992;

(v) has accepted a police caution in the British Islands;

(vi) is bound over following a criminal conviction in the British Islands;

(vii) becomes the subject of any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world;

(viii) is informed by any licensing, regulatory or other body anywhere in the world of the outcome of any investigation into his or her professional conduct, and there is a finding against the applicant;

(ix) becomes, to the applicant’s knowledge, the subject of any investigation by the Agency in relation to fraud, or is informed of the outcome of any such investigation, where it is adverse;

(x) becomes the subject of any investigation or proceedings by another Board or equivalent body, which might result in the applicant being disqualified, conditionally disqualified, refused entry, allowed entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list;

(xi) is disqualified, conditionally disqualified, refused entry, allowed entry subject to conditions, removed or contingently removed or suspended from or refused admission to any list or equivalent list;

(xii) is, was in the preceding 6 months, or was at the time of the events that gave rise to the charge, conviction or investigation , a director or one of the persons with control of a body corporate and that body corporate–

(aa) is charged in the British Islands with a criminal offence, or is charged elsewhere with an offence which, if committed in the British Islands, would constitute a criminal offence;

(bb) is convicted of a criminal offence in the British Islands;

(cc) is convicted elsewhere of an offence which, if committed in the British Islands, would constitute a criminal offence;

(dd) becomes the subject of any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world;

(ee) is informed by any licensing, regulatory or other body anywhere in the world of the outcome of any investigation into its provision of professional services, and there is a finding against it; or

(ff) becomes, to his or her knowledge, the subject of any investigation by the Agency in relation to fraud, or is informed of the outcome of any such investigation, if adverse,

together with details of the occurrence, including approximate dates, and where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome;

(d) that the applicant shall consent to a request being made by the Health Board to the Agency, any employer or former employer, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, into the applicant or a body corporate referred to in this paragraph and, for the purposes of this sub-paragraph, “employer” includes any partnership of which the applicant is or was a member;

(e) that the applicant consents to disclosure of information in terms of regulation 14; and

(f) that the fixed or mobile premises from which the applicant will assist in the provision of general ophthalmic services contains the required equipment.

PART C DECLARATIONS TO BE PROVIDED IN TERMS OF REGULATION 26(6)

1.  A declaration as to whether or not the person who is included in the Ophthalmic List in terms of regulation 26(3)–

(a) has been convicted of a criminal offence in the British Islands or has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(b) is currently the subject of any proceedings anywhere in the world which might lead to a conviction specified in sub-paragraph (a);

(c) has in summary proceedings in respect of an offence, been the subject of an order discharging the applicant absolutely (without proceeding to conviction);

(d) has accepted and agreed to pay either a procurator fiscal fine under section 302 of the Criminal Procedure (Scotland) Act 1995 or a penalty under section 115A of the Social Security Administration Act 1992;

(e) has accepted a police caution in the British Islands;

(f) has been bound over following a criminal conviction in the British Islands;

(g) has been subject to any investigation into that person’s professional conduct by any licensing, regulatory or other body anywhere in the world where the outcome was adverse;

(h) is currently subject to any investigation into that person’s professional conduct by any licensing, regulatory or other body anywhere in the world;

(i) is the subject of any investigation or proceedings by another Health Board or equivalent body which might result in that person being disqualified, conditionally disqualified, refused entry, granted entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list;

(j) is, or has been, where the outcome was adverse, the subject of any investigation into that person’s professional conduct in respect of any previous or current employment;

(k) is, or has in the preceding 6 months been, or was at the time of the events that gave rise to conviction, proceedings or investigation, a director or one of the body of persons with control of a body corporate, or a member of a partnership (including a limited liability partnership) which–

(i) has been convicted of a criminal offence in the British Islands;

(ii) has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(iii) is currently the subject of any proceeding anywhere in the world which might lead to such a conviction;

(iv) has been subject to any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world; or

(v) is, to that person’s knowledge, or has been, where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud.

2.  A declaration that–

(a) that person consents to a request being made by the Health Board to the Agency, any employer or former employer, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, into that person or a body corporate referred to in this paragraph and, for the purposes of this sub paragraph, “employer” includes any partnership of which that person is or was a member;

(b) the fixed or mobile premises from which that person will provide general ophthalmic services contains the required equipment to provide general ophthalmic services;

(c) –

(i) no sequestration of the person’s estate has been awarded and that the person has not been adjudged bankrupt, unless (in either case) the person has been discharged or the bankruptcy order has been annulled;

(ii) the person has not been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986, unless that order has ceased to have effect or has been annulled;

(iii) the person has not made a composition or arrangement with, or granted a trust deed for, the person ’s creditors unless the person has been discharged in respect of it;

(iv) where the person is a body corporate–

(aa) an administrator, administrative receiver or receiver has not been appointed in respect of it;

(bb) an administration order has not been made in respect of it under Schedule B1 to the Insolvency Act 1986;

(cc) it has been not been wound up under Part IV of the Insolvency Act 1986;

(d) the person is not subject to a disqualification order under the Company Directors Disqualification Act 1986, the Companies (Northern Ireland) Order 1986 or to an order made under section 429(2)(b) of the Insolvency Act 1986 (failure to pay under county court administration order); and

(e) the person undertakes to notify the Health Board in writing within 7 days of the occurrence of any event specified in paragraph 1, or sub paragraphs (c) and (d) of this paragraph.

Regulation 2(1)

SCHEDULE 3 PRIMARY EYE EXAMINATION

TABLE A

THE TESTS AND PROCEDURES SPECIFIED FOR THE PURPOSE OF THE DEFINITION OF PRIMARY EYE EXAMINATION IN REGULATION 2(1)

The taking of a detailed history and symptoms, including relevant medical, family, or ocular history

An assessment of current spectacle correction and their appropriateness to the patient’s current needs by focimetry and identification of lens and frame type

A pupillary assessment including testing for Relative Afferent Pupillary Defects

The recording of unaided vision, visual acuity or pinhole vision as appropriate

An examination appropriate to the reason for referral from a medical practitioner or other carer

An eye health assessment appropriate to the patient’s needs and presenting signs and symptoms

An internal eye examination, with mydriasis where appropriate, using direct ophthalmoscope and/or slit lamp biomicroscopy;

The external examination of the eyes using slit lamp biomicroscopy, and appropriate diagnostic agents

A relevant assessment of extra ocular motor function; oculo motor balance and ocular motility

The examination and checking for co-existing ocular disorders

The communication of the clinical findings, results and diagnosis to the patient, their carer (where appropriate), and other appropriate health professionals as agreed by the patient and their carer

TABLE B

THE TESTS AND PROCEDURES SPECIFIED FOR THE PURPOSE OF THE DEFINITION OF PRIMARY EYE EXAMINATION IN REGULATION 2(1)

Column 1	Column 2
Children aged under 16 years	Tests appropriate to the age of a child to determine vision, refractive state, stereopsis, extra ocular motor function (muscle balance motility) and ocular health
Adults aged 40 years and over who have a family history of Glaucoma	Intra ocular pressure measurement, visual field tests, and assessment of the optic nerve head by slit lamp biomicroscopy, should be performed on a screening basis. This will consist of Non contact tonometry, suprathreshold visual fields and slit lamp biomicroscopy
Adults aged 60 years and over	(i) Supra-threshold fields on a screening basis (ii) Amsler Test if the macula is suspect (iii) The consideration of slit lamp biomicroscopy with mydriasis
Adults aged 70 and over	The performance of slit lamp biomicroscopy with mydriasis
Patients referred from an ophthalmic hospital	Postoperative cataract examination, refraction and report
Refractive Abnormality	(i) Refraction, muscle balance, and other tests as required (ii) Spectacle dispensing advice
Patient’s presenting with sudden onset ‘flashes and floaters’ or sudden vision loss	Vitreous examination and fundus assessment by dilated slit lamp biomicroscopy
Patients with suspect glaucoma or ocular hypertensives	Intra ocular pressure measurement , visual field tests, and assessment of the optic nerve head by slit lamp biomicroscopy, should be performed on a screening basis. This will consist of Non contact tonometry, suprathreshold visual fields and slit lamp biomicroscopy
Patients with macular disorders	(i) Internal Eye examination must be with mydriasis, using slit lamp biomicroscopy (ii) Amsler chart test
Patients with cataract	Internal Eye examination must be with mydriasis when a clear view of the fundus cannot be obtained without mydriasis, using slit lamp biomicroscopy or head mounted indirect ophthalmoscopy
Patients with diabetes	Internal Eye examination must be with mydriasis using slit lamp biomicroscopy or head mounted indirect ophthalmoscopy
Depending on the patient’s presenting signs and symptoms	(a) Standard tests such as binocular function and stereopsis, amplitude of accommodation, colour vision, confrontation fields and other appropriate tests (b) Advice regarding the dispensing of the prescription, and discussion of an appropriate dispensing solution to the current needs of the patient (c) Issue advice and instruction to patients prior to referral into a care pathway, shared care scheme or a level 2 optometric examination (d) Direct referral to an ophthalmic hospital (e) Completing a clinical report for another health care professional or referral letter if required.

Regulation 2(1)

SCHEDULE 4 SUPPLEMENTARY EYE EXAMINATION

TABLE

THE TESTS AND PROCEDURES SPECIFIED FOR THE PURPOSE OF THE DEFINITION OF SUPPLEMENTARY EYE EXAMINATION IN REGULATION 2(1)

Column 1	Column 2
Following routine refraction;	Cycloplegic refraction
Paediatric follow up within six months of the previous examination include:	A refraction; Oculo motor balance; and Stereopsis
Referral refinement	To include, as required: Repeat of visual field assessment by full threshold visual fields; Repeat tonometry using applanation tonometry; and Slit lamp biomicroscopy which may include mydriasis
Suspect glaucoma, unusual optic disc appearance and where abnormalities have been detected during the primary examination	To include, as required: Repeat of visual field assessment by full threshold visual fields; Repeat tonometry using applanation tonometry; and Slit lamp biomicroscopy which may include mydriasis
Diabetes, vitreo retinal disorders, tumour risk	Dilated slit lamp biomicroscopy
Minor disorders such as, corneal abrasion, foreign body	Minor disorders repeat external eye assessment using slit lamp and diagnostic agents
Children aged under 16 years on referral by an ophthalmic hospital	Cycloplegic refraction

Regulation 2(1)

SCHEDULE 5 RECORDS

1.  An ophthalmic medical practitioner or optician shall keep the following data in records (this data is a record of patient details, symptoms, tests performed and results thereof):–

Personal Patient Data	Name, title, address, telephone number, Date of Birth, General Practitioner’s details, occupation, driver Yes/No, hobbies
Symptoms & History	Presenting signs & symptoms, past ocular history, past medical history, family ocular and patient’s own medical history, medication, reason for referral to or from the ophthalmic medical practitioner or optician, Smoker Yes/No
External Examination	A record of all relevant findings
Internal Examination	A record of whether this was with or without mydriasis, the apparatus and diagnostic agents used, and a description of the ocular media, fundus, blood vessels, optic disc and macula
Pupil Assessment	Relative afferent pupillary defect, direct, consensual and near responses, pupil size and shape
Extra Ocular Motor Function	Cover test, convergence, muscle balance, motility, stereopsis, amplitude of accommodation results
Visual Fields	Record relative findings, apparatus, confrontation
Intra Ocular Pressure	Intra ocular pressure measurement, contact or non-contact
Refraction	Objective/subjective findings, unaided vision, pinhole acuity, visual acuity, back vertex distance, prescription issued, spectacle, dispensing details
Colour Vision	Record findings and test procedure
Imaging	Record reference to any electronic images taken
Supplementary Additional Procedures	Note the reason for any supplementary or additional procedures
Diagnosis / Findings	Make a record of all findings and any diagnosis
Communication	Note any advice, statements, reports or referrals issued to the patient or made on behalf of the patient.

Regulation 26

SCHEDULE 6 REGULATIONS REVOKED

Orders and Regulations revoked	References	Extent of revocation
The National Health Service (General Ophthalmic Services) (Scotland) Regulations 1986	S.I. 1986/965	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 1988	S.I. 1988/543	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 1989	S.I. 1989/387	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment (No. 2) Regulations 1989	S.I. 1989/1177	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 1990	S.I. 1990/1048	The whole Regulations
The National Health Service (Optical Charges and Payments) (Miscellaneous Amendments (Scotland) Regulations 1991	S.I. 1991/534	Regulation 19
The National Health Service (Optical Charges and Payments) (Miscellaneous Amendments (Scotland) Regulations 1992	S.I. 1992/531	Regulation 5
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 1995	S.I. 1995/704	The whole regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 1996	S.I. 1995/843	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment (No) Regulations 1996	S.I. 1996/2353	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 1999	S.I. 1999/725	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment (No. 2) Regulations 1999	S.S.I. 1999/55	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2001	S.S.I. 2001/62	The whole Regulations
The National Health Service (Optical Charges and Payments) and (General Ophthalmic Services (Scotland) Amendment Regulations 2002	S.S.I. 2002/86	Regulation 4
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2003	S.S.I. 2003/201	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment (No) Regulations 2003	S.S.I. 2003/432	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2004	S.S.I. 2004/36	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment (No) Regulations 2004	S.S.I. 2004/98	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment (No) Regulations 2004	S.S.I. 2004/169	The whole Regulations
The Primary Medical Services (Consequential and Ancillary Amendments) (Scotland) Order 2004	S.S.I. 2004/212	Schedule 1, paragraph 2
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2005	S.S.I. 2005/128	The whole Regulations
The National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2006	S.S.I. 2006/42	The whole Regulations

(1)

S.S.I. 2004/38 as amended by S.S.I. 2004/122 and 271, 2005/335 and 2006/122.

(2)

S.I. 1992/434 as amended by S.I. 1994/3038, 1995/3201, 1996/938, 1998/657, 1998/1424 and S.S.I. 1999/53, 2004/38, 2005/118 and 334 and 2006/139.

(3)

S.I. 1998/642. Regulation 9 was amended by S.I. 1999/748.

(4)

S.I. 1989/364, amended by S.I. 1992/411, 1994/1770, 1998/251, S.S.I. 2004/369, and S.S.I. 2006/141 with effect from 1st April 2006.

(5)

1986 c. 45.

(6)

1986 c. 46 as amended by the Insolvency Act 2000 (2000 c. 39).

(7)

S.I. 1986/1032 (N.1.6).

(8)

1986 c. 45.

(9)

1995 c. 46.

(10)

1992 c. 5;. section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).