4.—(1) After regulation 26 (other contractual terms) of the GMS Contracts Regulations, insert—
26A.—(1) This regulation applies where the contractor and the Primary Care Trust enter into arrangements under the Patient Choice Scheme.
(2) The terms of the contract—
(a)which have the same effect as the provisions specified in paragraph (3) must be varied in accordance with paragraph (4); and
(b)must be varied to include terms which have the same effect as the provisions specified in paragraphs (5) to (7),
but only to the extent that such variations relate to the provision of primary medical services to patients who wish to receive such services under arrangements made in accordance with the Patient Choice Scheme with effect from the start of the day on which such arrangements commence and for the period ending at the end of the day which is the date of the termination of those arrangements, which must be no later than 31st March 2013.
(3) The terms of the contract specified in this paragraph are—
(a)regulation 15 (essential services);
(b)regulation 20 (arrangements to access services throughout core hours);
(c)the provisions which provide for the contractor to provide out of hours services; and
(d)in Schedule 6 (other contractual terms)—
(i)paragraph 2(1) (attendance at practice premises);
(ii)paragraph 3(2)(a) (attendance outside practice premises); and
(iii)paragraph 17(2) (refusal of applications for inclusion in the list of patients).
(4) The contract must include terms which have the effect of temporarily releasing the contractor and the Primary Care Trust from all obligations, payments, rights and liabilities relating to those terms (and only those terms) which have the same effect as the provisions specified in paragraph (3)—
(a)including any right to enforce those terms only in respect of the provision of primary medical services to patients who wish to receive such services under arrangements made in accordance with the Patient Choice Scheme; and
(b)only where, in the opinion of the contractor, it is not clinically appropriate or practical to provide the services or access to such services in accordance with those terms or to comply with those terms, under arrangements made under the Patient Choice Scheme.
(5) The contract must also include a term which has the effect of requiring the contractor to notify a person in writing that where the contractor is minded to accept that person onto its list of patients in accordance with the Patient Choice Scheme the contractor is under no obligation to provide—
(a)essential services, in a case where at the time treatment is required, it is not clinically appropriate or practical to provide primary medical services given the particular circumstances of the patient;
(b)out of hours services, in a case where at the time treatment is required, it is not clinically appropriate or practical to provide such services given the particular circumstances of the patient; or
(c)additional services (within the meaning of regulation 2) to the patient if it is not clinically appropriate or practical to provide such services given the particular circumstances of the patient.
(6) The contract must also include terms to have the effect of providing that immediately after the date of the termination of the arrangements under the Patient Choice Scheme, the variations made as a consequence of paragraph (2) must terminate save to the extent necessary in respect of enforcing any obligation, condition, payment, right and liability arising from those terms prior to the date of termination.
(7) In a case where primary medical services are provided to a patient under arrangements made in accordance with the Patient Choice Scheme but that patient is not on the contractor’s list of patients, the contract must contain a term which has the effect of requiring payment to be made under the contract and such payment must be made in accordance with the provisions in regulation 22(2) and (3) (finance) and the GMS Statement of Financial Entitlements.”.