this Part;

Part 2 (persons for whom a CCG has responsibility);

Part 5 (standing rules: commissioning contract terms); and

in respect of a CCG, a person for whom it is responsible under or by virtue of section 3 of the 2006 Act (duties of clinical commissioning groups as to commissioning certain health services) M13, in relation only to the provision of services which it has a duty to arrange for, or in respect of, that person; and

in respect of the Board, a person for or in respect of whom it is required to arrange the provision of services for under or by virtue of regulations under section 3B of the 2006 Act (Secretary of State's power to require Board to commission services), in respect only of services which the Board is required to arrange for, or in respect of, that person.

an immigration removal centre;

a secure training centre; or

a young offender institution.

a person who is a serving member of the armed forces; and

that person's family.

community services;

secondary care services; and

the services specified in Schedule 4.

where a person referred to in paragraph (1)(a) has been injured in service and is in receipt of compensation for infertility under the Armed Forces Compensation Scheme, include funding the cost of sperm storage facilities from the date on which the injury was sustained (where clinically necessary and where provision for such storage has previously been made); and

where, and to the extent that, the Board is satisfied that this is clinically appropriate in the circumstances of any case, include the provision of up to three cycles of in vitro fertilisation treatments or other means of assisted conception.

A is the spouse or civil partner of B; or

have regard to any evidence which A considers demonstrates that the relationship is substantial; and

in particular, have regard to the examples of evidence specified in paragraph (8) which could, either alone or together, indicate that the relationship is substantial.

evidence of regular financial support of A by B;

evidence indicating that A and B have purchased or are purchasing accommodation together as joint owners or evidence of joint ownership of other valuable property, such as a car or land;

evidence of a joint savings plan or joint investments of a substantial nature;

evidence that A and B operate a joint account for which they are co-signatories;

evidence of joint financial arrangements such as joint repayment of a loan or payment of each other's debts;

evidence that either A or B has given the other the power of attorney;

evidence that the names of both A and B appear on a lease or, if they live in rental accommodation, rental agreement; and

evidence of the length of the relationship.

has been severely injured in service; and

after specialist sperm retrieval, wishes to receive infertility treatment and is eligible for, and has been accepted for, such treatment.

in any case, include funding the cost of sperm storage facilities;

where, and to the extent that, the Board is satisfied that it is clinically appropriate in the circumstances of any particular case, include up to three cycles of in vitro fertilisation treatments or other means of assisted conception;

be provided at the same facility at which the specialist sperm retrieval took place and the extracted sperm of that person is stored.

has died or has become mentally incapacitated; and

in any case, include funding the cost of sperm storage facilities from the date on which the person died or, as the case may be, became mentally incapacitated; and

where, and to the extent that, the Board is satisfied that it is clinically appropriate in the circumstances of any particular case, include up to three cycles of in vitro fertilisation treatments and other means of assisted conception.

community services (including mandatory dental services and sedation services);

secondary care services; and

the services specified in Schedule 4.

a court;

a secure children's home F10...;

a secure training centre specified in the first column of Table 1 in Schedule 3 from the date specified in the corresponding entry in the second column of that Table;

an immigration removal centre specified in the first column of Table 2 in Schedule 3 from the date specified in the corresponding entry in the second column of that Table; and

a young offender institution F11....

a “relevant contract” is a contract having effect as between the Board and another person for the provision as part of the health service of transferring services where that contract has effect immediately before the transfer date;

the agreement made on 20thJuly 2005 and ending on 27th July 2013 between the Secretary of State for Health, Nations Healthcare (Nottingham) Limited, Nottinghamshire County Teaching Primary Care Trust, Nottingham City Primary Care Trust, Derby City Primary Care Trust, Derbyshire County Primary Care Trust, Lincolnshire Teaching Primary Care Trust, Leicestershire County and Rutland Primary Care Trust, Bassetlaw Primary Care Trust and Nottinghamshire University Hospitals NHS Trust for the provision of elective services and diagnostic services by Nations Healthcare (Nottingham) Limited;

the agreement made on 15th December 2006 and ending on 31st March 2014 between the Secretary of State for Health, InHealth Group Limited and InHealth London Limited for the provision of diagnostic services by InHealth London Limited;

the agreement made on 30th May 2008 and ending on 2nd February 2016 between the Secretary of State for Health, Care UK Clinical Services Limited and Care UK Limited for the provision of assessment and minor elective care services and diagnostic services by Care UK Clinical Services Limited;

the agreement made on 30th May 2008 and ending on 27th October 2015 between the Secretary of State for Health, PHG (Hampshire) Limited and Care UK plc for the provision of elective services and diagnostic services by PHG (Hampshire) Limited;

the agreement made on 31st July 2008 and ending on 31st October 2015 between the Secretary of State for Health, UKSH South West Limited and UK Specialist Hospitals Limited for the provision of elective services and diagnostic services by UKSH South West Limited; and

the agreement made on 26th September 2011 and ending on 16th October 2016 between the Secretary of State for Health, Clinicenta (Hertfordshire) Limited and Carillion plc for the provision of elective services and assessment and minor elective care services by Clinicenta (Hertfordshire) Limited.

the provision of funding for mental health staff to provide the services referred to in paragraph (1); and

such provision for partnership working with other persons or health services as is considered necessary to facilitate the effective delivery of those services.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

regulation 4 of, and sub-paragraph (c), (g), (h), (i) or (j) of paragraph 2 of Schedule 1 to these Regulations.

the health service provider is a registered person; or

the health service provider is carrying on a regulated activity.

provides the LETB in question with such information as it may request.

for “Registered persons” in paragraph (1), substitute “Health service providers”;

for “registered person”, in each place it appears, substitute “health service provider”;

in paragraph (1), omit “in carrying on a regulated activity”; and

in paragraphs (8) and (9) for “a regulated activity”, substitute “health care services”;

terms and conditions making provision for the matters specified in regulation 16; and

such other terms and conditions as the Board considers are, or might be, appropriate for inclusion in commissioning contracts entered into by a relevant body.

before exercising its functions under regulation 17(1) and (2) for the first time; and

the Care Quality Commission M17;

CCGs;

Healthwatch England M18;

Monitor M19;

the Secretary of State; and

such other persons as the Board considers it is appropriate to consult.

in the case of the Board, by virtue of regulation 7 (secondary care services and community services: serving members of the armed forces and their families) or regulation 10 (services for prisoners and other detainees).

there may be a need for such care; or

an individual who is receiving NHS Continuing Healthcare may no longer be eligible for such care.

any assessment pursuant to regulation 28(1) (persons who enter relevant premises or who develop a need for nursing care) is carried out in relation to that person; and

any notice is given to a social services authority pursuant to F30paragraph 1(1) of Schedule 3 to the Care Act 2014 (cases where hospital patient is likely to have care and support needs after discharge) in relation to that person.

complete and use the NHS Continuing Healthcare Checklist issued by the Secretary of State and dated F311st March 2018 to inform that decision;

inform that person (or someone lawfully acting on that person's behalf) in writing of the decision as to whether to carry out an assessment of that person's eligibility for NHS Continuing Healthcare; and

make a record of that decision.

the relevant body makes a decision as to whether that person has a primary health need in accordance with paragraph (7), using the completed Decision Support Tool to inform that decision.

where that person is, or is to be, accommodated in relevant premises, more than incidental or ancillary to the provision of accommodation which a social services authority is, or would be but for a person's means, under a duty to provide; or

of a nature beyond which a social services authority whose primary responsibility is to provide social services could be expected to provide,

an individual has a primary health need arising from a rapidly deteriorating condition; and

the condition may be entering a terminal phase,

the Fast Track Pathway Tool completed in accordance with paragraph (8); or

the recommendation of an NHS trust under direction 2(9) of the Delayed Discharges Directions that a person is eligible for NHS Continuing Healthcare, based on the Fast Track Pathway Tool completed in accordance with direction 2(8) of those Directions.

notify the person (or someone lawfully acting on that person’s behalf), in writing, of the decision made about their eligibility for NHS Continuing Healthcare, the reasons for that decision and, where applicable, the matters referred to in paragraph (11); and

make a record of that decision.

the procedure followed by the relevant body in reaching that decision; or

the primary health need decision made in accordance with paragraph (5)(b).

consult with the relevant social services authority before making a decision about a person's eligibility for NHS Continuing Healthcare, including any decision that a person receiving NHS Continuing Healthcare is no longer eligible to do so; and

co-operate with the relevant social services authority in arranging for persons to participate in a multi-disciplinary team for the purpose of fulfilling its duty under regulation 21(5).

a decision as to eligibility for NHS Continuing Healthcare; or

where a person is not eligible for NHS Continuing Healthcare, the contribution of a relevant body or social services authority to a joint package of care for that person,

are receiving community care services under F42Part 1 of the Care Act 2014 (care and support) or section 117 of the Mental Health Act 1983 (after-care) on the date on which they are found to be eligible to receive NHS Continuing Healthcare;

have been in receipt of NHS Continuing Healthcare but are determined to be no longer eligible for NHS Continuing Healthcare; or

are otherwise determined to be ineligible for NHS Continuing Healthcare.

appoint such number of persons to act as chairs of the panels referred to in paragraph (4) (“chairs”) as the Board considers reasonable to ensure that applications for a review under paragraph (3) can be considered by such a panel within a reasonable time; and

appoints under paragraph (1)(a); or

includes in a list pursuant to paragraph (1)(b),

a chair;

one CCG member drawn from the list established under paragraph (1)(b) who has been appointed in respect of a CCG, other than a CCG whose procedure or decision is the subject of the review; and

one social services authority member drawn from that list who has been appointed in respect of a social services authority other than one in whose area is situated all or part of the area of a CCG whose procedure or decision is the subject of the review.

when requested to do so by the Board, provide its nomination pursuant to paragraph (1) as soon as is reasonably practicable; and

ensure that CCG members are, so far as reasonably practicable, available to participate in review panels.

the chair, a member (other than a member of an NHS foundation trust), a director, a governor or an employee of an NHS body;

the chair or a member of the governing body of a CCG; or

an elected member or employee of a social services authority in England and Wales or of an equivalent body in Scotland or Northern Ireland.

the chair, the chief executive, a non-executive director or a non-officer member of an NHS body (other than a member of an NHS foundation trust);

the chair or a member of the governing body of a CCG; or

an elected member of a social services authority in England and Wales or of an equivalent body in Scotland or Northern Ireland.

that person may, after the second anniversary of the day on which they were dismissed, apply in writing to the Board to remove the disqualification for appointment as a chair, CCG member or social services authority member; and

the Board may decide that the disqualification is removed.

that person has become disqualified for appointment under regulation 25, the Board must notify that person in writing of such disqualification; or

at the time of that person's appointment they were so disqualified, the Board must declare that the person in question was not duly appointed and notify that person in writing to that effect.

is resident in relevant premises or may need to become resident in such premises; and

may be in need of nursing care,

the relevant body has carried out an assessment pursuant to regulation 21(2); but

paragraph (3) does not apply because a decision has been made that the person is not eligible for NHS Continuing Healthcare,

the relevant body determines that a person has a need for nursing care pursuant to this regulation; and

the person has agreed with that body that that person does want to be provided with such nursing care,

has their need for nursing care assessed and it is determined that that person no longer has any need for nursing care;

is no longer resident in the relevant premises;

becomes eligible for NHS Continuing Healthcare pursuant to this Part; or

dies.

£100 per week, where nursing care is provided in accommodation in Northern Ireland, or

£78 per week, where nursing care is provided in accommodation in Scotland,

has their need for nursing care assessed and it is determined that that person no longer has any need for nursing care;

is no longer resident in that accommodation;

becomes eligible for NHS Continuing Healthcare pursuant to this Part; or

dies.

has their need for nursing care assessed on or after the relevant date and it is determined that that person no longer has any need for nursing care;

is no longer resident in the relevant premises;

becomes eligible for NHS Continuing Healthcare pursuant to this Part; or

dies.

has their need for nursing care assessed on or after the relevant date and it is determined that that person no longer has any need for nursing care;

is no longer resident in the relevant premises;

becomes eligible for NHS Continuing Healthcare pursuant to this Part; or

dies,

has their need for nursing care assessed on or after the relevant date; and

following that assessment it is determined that that person's need for nursing care has diminished to the extent that if the old Guidance were applied, that person would be eligible only for a medium band payment or low band payment,

the person in respect of whom the high band payment was being made (and where appropriate that person's representative); and

the registered person,

regulation 21(2)(b) applies;

an assessment of eligibility for NHS Continuing Healthcare is undertaken pursuant to regulation 21; and

that body determines that the person is no longer eligible for NHS Continuing Healthcare.

started to assess a person's eligibility for NHS Continuing Healthcare under paragraphs (5) to (7) of direction 2 of the Responsibilities Directions or the Delayed Discharges Directions, the relevant body with responsibility for that person must complete the assessment as if it had commenced under regulation 21.

a Strategic Health Authority has before the relevant date, received an application for a review of procedure or a decision pursuant to direction 4(2) of the Responsibilities Directions in respect of which a decision has not been made before the relevant date; or

on or after the relevant date the Board receives an application for a review of procedure or a decision which would have been a valid application under direction 4(2) of the Responsibilities Directions if made before the relevant date.

such a person must be treated as if they had been appointed by the Board under regulation 24; and

in the case of a PCT member, as if that person were appointed as a CCG member in respect of each CCG whose area falls wholly or partly within the area of the PCT in relation to which they were a PCT member.

the National Health Service (Nursing Care in Residential Accommodation) (England) Directions 2007 M31 which came into force on 1st October 2007;

the National Health Service (Nursing Care in Residential Accommodation) (Amendment) (England) Directions 2009 which came into force on 1st October 2009 M32;

the NHS Continuing Healthcare (Responsibilities) Directions 2009 M33 which came into force on 1st October 2009; and

the Delayed Discharges (Continuing Care) Directions 2009 which came into force on 28thSeptember 2009 M34.

the making of a direct payment;

the application of the personal health budget by the relevant body in accordance with the outcome of discussions with the eligible person or that person’s representative as to how best to secure the provision of the relevant health service to the person; or

the transfer of the personal health budget by a relevant body to a person who applies the money in accordance with the outcome of discussions with the eligible person or that person’s representative as to how best, with the agreement of the relevant body, to secure the provision of the relevant health service to the eligible person.

publicise and promote the availability of personal health budgets to eligible persons and their representatives; and

provide information, advice and other support to eligible persons and their representatives to assist them in deciding whether to request a personal health budget in respect of a relevant health service.

a decision under paragraph (4A); or

written reasons in accordance with paragraph (7),

ensure that the relevant body complies with relevant NICE recommendations; and

include arrangements for the determination of any request for the funding of a health care intervention for a person, where there is no relevant NICE recommendation and the relevant body's general policy is not to fund that intervention.

publish on its website a written statement of its reasons for any general policy it has on whether a particular healthcare intervention is to be made available for persons for whom it has responsibility; or

where it has not published such a statement, provide a written statement of the reasons for any such policy when any person makes a written request for such a statement.

makes a decision to refuse a request for the funding of a health care intervention for a person; and

its general policy is not to fund that intervention,

a person has made a request for a written statement of the reasons for a Primary Care Trust's general policy on whether a particular health care intervention is to be funded pursuant to direction 3(1) of the Directions to Primary Care Trusts and NHS trusts concerning decisions about drugs and other treatments 2009 which came into force on 1st April 2009 (“the Decisions Directions”) M37; and

a written statement of reasons has not been provided by the Primary Care Trust to whom that request was made before the relevant date in accordance with that direction,

has made a decision to refuse a request for the funding of a health care intervention in respect of a person where the Primary Care Trust's general policy is not to fund that intervention; but

has not provided that person with a written statement of reasons for that decision pursuant to direction 3(3) of the Decisions Directions,

has made a decision to fund a health care intervention for a person where the Primary Care Trust's general policy is not to fund that intervention; but

has not notified that person of that decision,

decide whether or not to fund that intervention; and

if the decision is to refuse to fund that intervention, provide a written statement of reasons to that person as soon as reasonably practicable as if regulation 35(2) applied.

who requires an elective referral; and

for whom that body has responsibility,

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

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

cancer services which are subject to the 2 week maximum waiting time by virtue of regulation 52; F60or

maternity services; F61...

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

publicising details, and promoting awareness, of where that information may be found.

a person requires an elective referral;

that person has not yet seen a clinically appropriate secondary care provider as a result of the referral; and

that person had not been offered the choice of any clinically appropriate secondary care provider in relation to that referral,

the Choice Directions continued in force on and after the relevant date in respect of that person;

references to “Primary Care Trust” in those directions, and any relevant guidance referred to in those directions, were a reference to the relevant body that has responsibility for that person; and

references to “secondary care provider” were references to “health service provider” within the meaning of these Regulations.

a person makes a complaint to a relevant body on or after the relevant date in respect of failure before that date to ensure that choice is offered pursuant to direction 2 of the Choice Directions, or failure to publicise or promote such choice in accordance with direction 6 of those Directions,

the relevant body has responsibility for that person;

there has been a start date in respect of that person; and

the person's waiting time period, as specified in regulation 46, has not come to an end.

it is more appropriate for that person to receive treatment from a primary care service;

a clinical decision is made to start a period of monitoring of that person prior to any decision being made as to what, if any, treatment should be provided;

a clinical decision is made that no treatment should be provided to that person;

an eligible referrer; or

themselves, with the prior approval of an eligible referrer.

a consultant;

a member of a consultant's team; or

persons providing interface services where a person who has been referred may be referred on from those services to a consultant or consultant-led team.

has not commenced appropriate treatment; or

will not have commenced appropriate treatment,

in the case of the relevant health service provider or a CCG, the person referred or a person lawfully acting on their behalf; or

in the case of the Board, a CCG which has been notified by the person referred or a person lawfully acting on their behalf.

the date for the appointment was reasonable;

that person had been made aware of the consequences of not attending appointments; and

that person had not requested in advance that the date for that appointment be re-arranged.

that person had re-arranged the date of the appointment;

the original date for the appointment had been reasonable; and

that person had been made aware of the consequences of not attending appointments.

that patient had been offered a reasonable appointment date falling within that period; or

they decided that they did not want to be offered any appointment dates within that period.

has been offered a reasonable appointment date falling within that period; or

was unable to make themselves available for any appointment dates within that period.

that it is in the best clinical interests of that patient to commence treatment after the end of the period of 18 weeks beginning with the start date;

that the person does not need treatment; or

to refer the patient back to primary care services prior to any treatment commencing.

for whom the relevant body has responsibility; and

the person referred did not attend an appointment made by a health service provider in response to the urgent referral; and

that person had not requested in advance of the appointment that the date for that appointment be rearranged,

begins with the start date; and

ends on the date on which the health service provider receives notification from the person who has been urgently referred that they are available again for an appointment for treatment for suspected cancer.

a person has been referred urgently for treatment for suspected cancer to a health service provider (“the relevant provider”);

the referral is for an appointment with a specialist with a view to diagnosis or treatment of cancer;

the referred person, or a person lawfully acting on their behalf, notifies the relevant provider or the relevant body which has responsibility for the person referred, that they have not had an appointment, or will not have an appointment, within two weeks beginning with the date on which the person's referral request is received by the relevant provider (“the relevant period”); and

the relevant provider or the relevant body is satisfied that the person referred has not or will not have an appointment within the relevant period.

was made aware of the consequences of not attending appointments and did not attend an appointment made by the relevant provider in response to the referral; or

chose not to attend an appointment within the relevant period.

publish the name and contact details of the service; and

take reasonable steps to communicate the name and contact details of that service to any relevant persons for which it has responsibility.

establishes a service for the purpose of providing advice and assistance to relevant persons referred to the provider;

publishes the name and contact details of that service; and

takes reasonable steps to communicate the name and contact details of that service to any relevant persons referred to the provider for whom the relevant body is responsible.

a Primary Care Trust or Strategic Health Authority is responsible for a person pursuant to direction 1(4) or (5) of the Waiting Times Directions;

that person falls within direction 3(2) and (3) of the Waiting Times Directions, having been referred before the relevant date,

the Waiting Times Directions continued in force on and after the relevant date;

references to “Primary Care Trust” or “Strategic Health Authority” in those directions, and any relevant guidance referred to in those directions, were a reference to the relevant body that has responsibility for that person on and after the relevant date; and

the relevant body had had responsibility for that person from the date on which that person was referred for the purpose of calculating any periods of time referred to in those directions or that guidance.

a Primary Care Trust or Strategic Health Authority is responsible for a person pursuant to direction 1(4) or (5) of the Waiting Times Directions; and

that person falls within direction 9(1)(a), (b) and (c) of the Waiting Times Directions, having been referred before the relevant date,

the Waiting Times Directions continued in force on and after the relevant date;

references to “Primary Care Trust” or “Strategic Health Authority” in those directions, and any relevant guidance referred to in those directions, were a reference to the relevant body that has responsibility for that person on and after the relevant date; and

the relevant body had had responsibility for that person from the date on which that person was referred for the purpose of calculating any periods of time referred to in those directions or that guidance.

a scheme product is supplied or administered in accordance with the scheme to a scheme patient,

a scheme product continues to be supplied or administered in accordance with the scheme to a scheme patient where such a patient was receiving such a course of treatment immediately before the relevant date unless the patient's consultant has determined, in consultation with the scheme patient, that the scheme product is no longer clinically appropriate;

the payment of remuneration, national insurance, pensions, allowances or gratuities to the persons listed in paragraph (2), insofar as the payment is attributable to any of the activities referred to in paragraph (1)(d) or (e);

the provision of education and training for the persons listed in paragraph (2), where the education or training relates to any of the activities referred to in paragraph (1)(d) or (e);

employees of a relevant body;

non-executive members of the Board;

members of a CCG governing body;

members of committees of the Board, a CCG or a CCG governing body and members of sub-committees of those committees;

members of a CCG who are individuals; and

individuals authorised to act on behalf of a member of a CCG in dealings between the member and the CCG.

payments made to persons providing services as part of the health service under arrangements made by a relevant body, in respect of the provision of such services pursuant to those arrangements; and

payments made by a relevant body under or by virtue of section 12A of the 2006 Act.