The National Health Service (General Ophthalmic Services Supplementary List) and (General Ophthalmic Services Amendment and Consequential Amendment) Regulations 2005

Amendment of Schedule 1

39.—(1) Schedule 1 to the Ophthalmic Regulations (terms of service)(1) shall be amended in accordance with the following provisions of this regulation.

(2) For paragraphs 3 (premises at which general ophthalmic services are to be provided) and 3A (visits) there shall be substituted—

“Premises at which general ophthalmic services are to be provided

3.   Subject to paragraph 3A, a contractor shall provide general ophthalmic services only at an address which is included in relation to him in the ophthalmic list.

Provision of mobile services

3A.— (1) A contractor, who has made arrangements with the Primary Care Trust to provide mobile services, may provide them only in accordance with sub-paragraph (2), after giving notice in accordance with sub-paragraph (3).

(2) The contractor may only provide mobile services if—

(a) the patient has requested the contractor to provide those services to him, or, where the patient is incapable of making such a request, a relative of his, a primary carer of that patient or a duly authorised person has made such a request; and

(b) subject to sub-paragraphs (5), (6) and (7), he has notified the Trust in accordance with sub-paragraphs (3) and, if applicable, (4) and the Trust has not informed the contractor that it is not content with those changes.

(3) The contractor shall notify the Primary Care Trust of his intention to provide mobile services—

(a) where they are to be provided to three or more persons at a day centre or residential centre, at least three weeks in advance; or

(b) in any other case, as far in advance as is reasonably possible, but not less than 48 hours (except that no part of a Saturday, Sunday or bank holiday shall count towards that period) before that provision,

of that provision, identifying the persons to whom the services are to be provided and specifying the date and approximate time when he will provide them.

(4) If the contractor wishes to change any of the matters of which he has notified the Primary Care Trust under sub-paragraph (3), he shall so notify the Trust at least 48 hours (except that no part of a Saturday, Sunday or bank holiday shall count towards that period) before —

(a) if he wishes to provide mobile services to further or different persons, that provision;

(b) if he wishes to change the date or time of the provision of those services, both—

(i) the previously notified date of that provision, and

(ii) if the notification is to change the date, the date so notified.

(5) If the contractor is unable attend the place at which he has notified the Primary Care Trust that he would be attending, he may instead, on that day and at that approximate time, provide mobile services at another location (“the substitution”), provided that the Trust notifies him that it agrees to the substitution.

(6) In a case to which paragraph (5) applies the contractor may attend and provide mobile services at the originally notified place at such time as the Trust shall agree.

(7) In a case where circumstances have arisen whereby it was not possible to notify in accordance with sub-paragraph (4)(a), the contractor may provide mobile services to up to 3 other persons at the previously notified time and place.”.

(3) In paragraph 4 (premises and equipment)—

(a) in sub-paragraph (1), for “sub-paragraph (1A)”, there shall be substituted “, sub-paragraphs (1A) to (1D)”;

(b) for sub-paragraph (1A) there shall be substituted—

“(1A) A contractor, who has made arrangements with the Primary Care Trust to provide mobile services, shall provide suitable equipment for the provision of such services.

(1B) A contractor, who was included on the ophthalmic list of a Primary Care Trust on 31st March 2005, and who—

(a) does not provide or no longer provides accommodation and equipment, as required under sub-paragraph (1), or equipment as required under sub-paragraph (1A); and

(b) is not employed, in relation to the general ophthalmic services which he has undertaken to provide in the area of that Trust, by another contractor,

may, instead of providing the accommodation and equipment, as required under sub-paragraph (1), or equipment as required by sub-paragraph (1A), enter into arrangements of the kind described in sub-paragraph (1C), provided the conditions set out in sub-paragraph (1D) are met.

(1C) The arrangements referred to in sub-paragraph (1B) are legally enforceable arrangements under which—

(a) requisite, proper and sufficient consulting and waiting room accommodation and suitable equipment; or

(b) in the case of the provision of mobile services, suitable equipment;

are available to him for the provision of the general ophthalmic services which he has undertaken to provide, which permit inspection as required under paragraph 4(2) or (2A).

(1D) The conditions referred to in sub-paragraph (1B) are that the contractor has satisfied the Primary Care Trust that—

(a) the arrangements are legally enforceable and permit inspection as required under paragraph 4(2) or (2A);

(b) the accommodation and equipment or, in the case of the provision of mobile services, equipment, provided under the arrangements are adequate and suitable.”;

(c) in sub-paragraph (2) for “sub-paragraph (2A)” there shall be substituted “sub-paragraphs (2A) and (3)”

(d) in sub-paragraph (2A), for “In the case of a mobile practice, the contractor”, there shall be substituted, “A contractor, who has made arrangements with the Primary Care Trust to provide mobile services,”; and

(c) at the end, there shall be added sub-paragraph (3)—

“(3) In addition to the right to inspect under sub-paragraph (2A), a contractor, who has made arrangements with the Primary Care Trust to provide mobile services, shall allow an authorised officer of the Secretary of State or that Trust to inspect the facilities and equipment that he uses when providing those services at a location of which he notified the Trust under paragraph 3A(3).”.

(4) Paragraph 5 (notices) shall be renumbered as sub-paragraph (1) of paragraph 5, and—

(a) at the beginning there shall be inserted “Subject to sub-paragraph (2),”; and

(b) at the end there shall be added sub-paragraph (2)—

“(2) Where mobile services are being provided, a notice shall be displayed only in so far as it is reasonably practicable to do so.”.

(5) In paragraph 6 (records)—

(a) at the beginning of sub-paragraph (1) there shall be inserted “Subject to paragraph 6ZA”; and

(b) in sub-paragraph (2), for “paragraph 8(5)”, there shall be substituted “paragraphs 6ZA and 8(5)”.

(6) After paragraph 6 there shall be inserted paragraph 6ZA—

“6ZA.— (1) A contractor, who was included on the list of a Primary Care Trust on 31st March 2005 and who—

(a) does not keep or no longer keeps records as required under paragraph 6; and

(b) is not employed, in relation to the general ophthalmic services he provides in the area of that Trust, by another contractor,

may, instead of keeping those records, comply with the conditions set out in sub-paragraph (2).

(2) The conditions referred to in sub-paragraph (1) are that that contractor has—

(a) made legally enforceable arrangements that a proper record in respect of each patient to whom he provides general ophthalmic services, giving appropriate details of sight testing, is kept and that all such records are kept for a period of seven years and during that period shall be produced when and as required under paragraph 6(2);

(b) satisfied the Primary Care Trust as to the keeping of the records and that the arrangements are legally enforceable and require such production; and

(c) access to those records at all reasonable times.”.

(7) In paragraph 6A (declarations of convictions)—

(a) at the end of sub-paragraph (3) there shall be added “and, for the purposes of this sub-paragraph, “employer” includes any partnership of which the ophthalmic medical practitioner or optician is or was a member”;

(b) in sub-paragraph (4)—

(i) for “Having supplied the information referred to in paragraph (1), the contractor shall inform”, there shall be substituted “The contractor shall notify”,

(ii) there shall be inserted after paragraph (c) the following paragraphs—

“(cc) has accepted a conditional offer under section 302 of the Criminal Procedure (Scotland) Act 1995(2) (fixed penalty: conditional offer by procurator fiscal) or agreed to pay a penalty under section 115A of the Social Security Administration Act 1992 (penalty as alternative to prosecution)(3);

(cd) has, in proceedings in Scotland for an offence, been the subject of an order under section 246(2) or (3) of the Criminal Procedure (Scotland) Act 1995 discharging him absolutely;”, and

(iii) in paragraph (d), from “, or is subject” to the end shall be omitted;

(iv) for paragraph (i) there shall be substituted—

“(i) becomes to his knowledge the subject of any investigation by the NHS Counter Fraud and Security Management Service in relation to fraud, or is notified of the outcome of such an investigation, where it is adverse;”;

(c) in sub-paragraph (5)—

(i) for “Having supplied the information referred to in paragraph (1), the contractor shall inform”, there shall be substituted “The contractor shall notify”,

(ii) for paragraph (f), there shall be substituted—

“(f) becomes to his knowledge the subject of any investigation in relation to fraud, or is notified of the outcome of such an investigation if adverse;”; and

(iii) in paragraph (b), from “, or is subject” to the end shall be omitted;

(d) After sub-paragraph (5), there shall be inserted as sub-paragraph (5A)—

“(5A) If the contractor is a corporate optician, it shall notify the Primary Care Trust within 7 days if one of its directors or a person who was in the preceding six months or was at the time of the originating events one of its directors—

(a) is convicted of any criminal offence in the United Kingdom;

(b) is bound over following any criminal conviction in the United Kingdom;

(c) accepts a police caution in the United Kingdom;

(d) has accepted a conditional offer under section 302 of the Criminal Procedure (Scotland) Act 1995(4) (fixed penalty: conditional offer by procurator fiscal) or agreed to pay a penalty under section 115A of the Social Security Administration Act 1992 (penalty as alternative to prosecution)(5);

(e) has, in proceedings in Scotland for an offence, been the subject of an order under section 246(2) or (3) of the Criminal Procedure (Scotland) Act 1995 discharging him absolutely;

(f) is convicted elsewhere of an offence, or what would constitute a criminal offence if committed in England and Wales;

(g) is charged in the United Kingdom with a criminal offence, or is charged elsewhere with an offence which, if committed in England and Wales, would constitute a criminal offence;

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

(i) becomes the subject of any investigation into his professional conduct by any licensing, regulatory or other body;

(j) becomes subject to any investigation into his professional conduct in respect of any current or previous employment, or is notified at the outcome of any such investigation and any finding against him;

(k) becomes to his knowledge the subject of any investigation by the NHS Counter Fraud and Security Management Service in relation to fraud, or is notified of the outcome of such an investigation, where it is adverse;

(l) becomes the subject of any investigation by another Primary Care Trust or equivalent body, which might lead to his removal from any list or equivalent list;

(m) is removed, contingently removed or suspended from, refused admission to or conditionally included in any list or equivalent list,

and, if so, give the name and address of that director or ex-director and details, including approximate dates, of where any investigation or proceedings were or are to be brought, the nature of that investigation or proceedings, and any outcome;”;

(e) at the end there shall be added sub-paragraph (7)—

“(7) An ophthalmic medical practitioner or optician, who is included in the ophthalmic list of a Primary Care Trust, shall supply that Trust with an enhanced criminal record certificate under section 115 of the Police Act 1997(6) in relation to himself, if the Primary Care Trust at any time, for reasonable cause, gives him notice to provide such a certificate.”.

(8) In paragraph 6B (applications to other lists), “and” at the end of sub-paragraph (a) shall be deleted and, at the end of sub-paragraph (b), there shall be added—

“and

(c) in the case of a corporate optician, if any of its directors applies to be included in any list held by another Primary Care Trust or equivalent body and of the outcome of any such application.”.

(9) In paragraph 7 (deputies)—

(a) for sub-paragraph (1) there shall be substituted—

“(1) Subject to regulation 21 of the Supplementary List Regulations (transitional provisions), a contractor may arrange for sight to be tested on his behalf by an ophthalmic medical practitioner or optician, but no such arrangements shall be made unless the name of that ophthalmic medical practitioner or optician is included in an ophthalmic list or a supplementary list.”; and

(b) sub-paragraph (2)(b) and “and” preceding it shall be deleted.

(10) In paragraph 8 (employees)—

(a) for sub-paragraphs (1), (2) and (3) there shall be substituted—

“(1) Subject to regulation 21 of the Supplementary List Regulations (transitional provisions), a contractor may employ to test sight—

(a) an ophthalmic medical practitioner or optician, whose name is included in an ophthalmic list or a supplementary list; or

(b) a person, who is authorised to test sight by rules made under section 24(3) of the Opticians Act 1989(7) (testing of sight), acting under the continuous personal supervision of an ophthalmic medical practitioner or optician, whose name is included in an ophthalmic list or a supplementary list.”; and

(b) sub-paragraph (4)(b) and “and” preceding it shall be deleted.

(11) In paragraph 9 (payments)—

(a) for sub-paragraph (2), there shall be substituted the following—

“(2) Any such claim shall be—

(a) signed by the optician or ophthalmic medical practitioner, whose name is included in an ophthalmic list or a supplementary list and who performed the general ophthalmic services in respect of which the claim is made (“the practitioner”); and

(b) in a case where the practitioner is not on the ophthalmic list of that Primary Care Trust, counter-signed on behalf of the contractor by a person (who may be the practitioner), duly authorised by the contractor to counter-sign, whom the contractor has previously notified the Primary Care Trust as being so authorised;

(2A) In the case of a claim signed under sub-paragraph (2)(a), the practitioner shall supply, with his signature, his professional registration number with the prefix and suffix given to that number in the ophthalmic list or supplementary list in which the practitioner’s name is included; and

(2B) In the case of a claim counter-signed under sub-paragraph (2)(b), the person authorised to counter-sign shall supply, with his counter-signature, the professional registration number of the contractor.”; and

(b) in sub-paragraph (3), after “signatory”, there shall be inserted “or counter-signatory”.

(12) In paragraph 10(2) (testing of sight)—

(a) after “a contractor” there shall be inserted “or an ophthalmic medical practitioner or optician assisting him in the provision of general ophthalmic services”; and

(b) for “inform the patient’s doctor of his opinion”, there shall be substituted—

“(i) refer the patient to an ophthalmic hospital,

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

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

(1)

Relevant amendments are S.I. 1989/1175, 1996/705, 2001/414, 3793, 2002/601 and 2469.

(2)

1995 c. 46.

(3)

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

(4)

1995 c. 46.

(5)

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

(6)

1997 c. 50; relevant amendments are the 2001 Act s. 19(1), (2) and (3) and the 2002 Act s. 2(5) and Schedule 2, paragraph 64.

(7)

c. 44.