The National Health Service (Personal Medical Services Agreements) Regulations 2004

6.  As if paragraphs 18 to 20 were substituted as follows—

“Removal from the list at the request of the patient

18.— (1) Where the Primary Care Trust receives in writing a request from a registered patient for his removal from its list of patients, it shall remove that person from its list of patients.

(2) A removal under sub-paragraph (1) shall take effect—

(a) on the date on which the Primary Care Trust receives notification of the registration of the person with another provider of essential services (or their equivalent); or

(b) 14 days after the date on which the request made under sub-paragraph (1) is received by the Primary Care Trust,

whichever is the sooner.

(3) The Primary Care Trust shall, as soon as practicable, notify in writing, subject to sub-paragraph (4), the patient that his name will be, or has been, removed from its list of patients on the date referred to in sub-paragraph (2).

(4) In this paragraph and in paragraphs 19(2), 20(3), 22(2), 25(2)(b) and 27(3), a reference to a request received from or advice, information or notification required to be given to a patient shall include a request received from or advice, information or notification required to be given to—

(a) in the case of a patient who is a child, a parent or other person referred to in paragraph 14(4)(a); or

(b) in the case of an adult patient who is incapable of making the relevant request or receiving the relevant advice, information or notification, a relative or the primary carer of the patient.

Removals from the list at the behest of the Primary Care Trust

19.— (1) Subject to paragraph 20, a Primary Care Trust may remove a patient from its list of patients if it has reasonable grounds for wishing to remove the patient which do not relate to the applicant’s race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

(2) The Primary Care Trust shall notify the patient of its specific reasons for removing him from its list of patients and the date on which the patient’s name is or will be removed from its list of patients.

(3) Except in the circumstances specified in sub-paragraph (4), a Primary Care Trust may only remove a patient under sub-paragraph (1), if, within the period of 12 months prior to the date of the removal, it has warned the patient that he is at risk of removal.

(4) The circumstances referred to in sub-paragraph (3) are that—

(a) the reason for removal relates to a change in address;

(b) the Primary Care Trust has reasonable grounds for believing that the issue of such a warning would—

(i) be harmful to the physical or mental health of the patient, or

(ii) put at risk the safety of the Primary Care Trust’s staff or any other person; or

(c) it is, in the opinion of the Primary Care Trust, not reasonable or practical for it to do so.

(5) The Primary Care Trust shall record in writing—

(a) the date of any warning given in accordance with sub-paragraph (3) and the reasons for giving such a warning as explained to the patient; or

(b) the reason why no such warning was given.

(6) The Primary Care Trust shall keep a written record of removals under this paragraph which shall include—

(a) the reason for removal given to the patient; and

(b) the circumstances of the removal,

and shall make this record available to the Strategic Health Authority on request.

(7) A removal in accordance with sub-paragraph (1) shall, subject to sub-paragraph (8), take effect from—

(a) the date on which the Primary Care Trust receives notification of the registration of the person with another provider of essential services (or their equivalent); or

(b) the eighth day after the decision of the Primary Care Trust to remove the patient under sub-paragraph (1),

whichever is the sooner.

(8) Where, on the date on which the removal would take effect under sub-paragraph (7), the Primary Care Trust is treating the patient at intervals of less than seven days, the removal shall take effect—

(a) on the eighth day after the person no longer needs such treatment; or

(b) on the date on which the Primary Care Trust receives notification of the registration of the person with another provider of essential services (or their equivalent),

whichever is the sooner.

Removals from the list of patients who are violent

20.— (1) The Primary Care Trust may remove a patient from its list of patients with immediate effect on the grounds that the patient has committed an act of violence against any of the persons specified in sub-paragraph (2) or behaved in such a way that any such person has feared for his safety provided that it has reported the incident to the police.

(2) The persons referred to in sub-paragraph (1) are—

(a) any member of the Primary Care Trust’s staff; or

(b) any other person present—

(i) on the contractor’s premises, or

(ii) in the place where services were provided to the patient by the Primary Care Trust under the agreement.

(3) Where the Primary Care Trust has removed a patient from its list of patients in accordance with sub-paragraph (1) it shall give written notice of the removal to the patient.

(4) Where a patient is removed from the Primary Care Trust’s list of patients in accordance with this paragraph, the Primary Care Trust shall record in the patient’s medical records that the patient has been removed under this paragraph and the circumstances leading to his removal.”.