The National Health Service (General Medical Services Contracts) Regulations 2015

PART 7 E+W Persons who perform services

Qualifications of performers: medical practitioners E+W

[F1 40.   A medical practitioner may only perform a clinical service under the contract where that medical practitioner is not—

(a) prohibited from performing any such service by regulation 24 of the National Health Service (Performers Lists) (England) Regulations 2013;

(b) suspended from the medical performers list or from the Medical Register; and

(c) subject to interim suspension under section 41A of the Medical Act 1983.]

Textual Amendments

F1 Reg. 40 substituted (27.5.2024) by The National Health Service (Primary Medical Services and Performers Lists) (Amendment) Regulations 2024 (S.I. 2024/575), reg. 1(2)(a), Sch. 1 para. 2(1)

Qualifications of performers: health care professionals E+W

41.  A health care professional (other than one to whom regulation 40 applies) may not perform clinical services under the contract unless—

(a) that person is registered with the professional body relevant to that person's profession; and

(b) that registration is not subject to a period of suspension.

Conditional registration or inclusion in primary care list E+W

42.  Where the registration of a health care professional or, in the case of a medical practitioner, the inclusion of that practitioner's name in a primary care list, is subject to conditions, the contractor must ensure compliance with those conditions in so far as they are relevant to the contract.

Clinical experience E+W

43.  A health care professional may not perform any clinical services under the contract unless that person has such clinical experience and training as are necessary to enable the person to properly perform such services.

Conditions for employment and engagement: medical practitioners E+W

44.— [F2 (1) Subject to paragraph (2), a contractor may not employ or engage a medical practitioner unless the contractor has checked that the practitioner meets the requirements of—

(a) regulation 40; and

(b) regulation 43.]

(2) Where—

(a) the employment or engagement of a medical practitioner is urgently needed; and

(b) it is not possible for the contractor to check the matters referred to in regulation 43 in accordance with paragraph (1)(b) before employing or engaging the practitioner,

the contractor may employ or engage the practitioner on a temporary basis for a single period of up to seven days while such checks are undertaken.

F3 (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F2 Reg. 44(1) substituted (27.5.2024) by The National Health Service (Primary Medical Services and Performers Lists) (Amendment) Regulations 2024 (S.I. 2024/575), reg. 1(2)(a), Sch. 1 para. 2(2)(a)

F3 Reg. 44(3) omitted (27.5.2024) by virtue of The National Health Service (Primary Medical Services and Performers Lists) (Amendment) Regulations 2024 (S.I. 2024/575), reg. 1(2)(a), Sch. 1 para. 2(2)(b)

Conditions for employment or engagement: health care professionals E+W

45.—(1) Subject to paragraph (2), a contractor may not employ or engage a health care professional to perform clinical services under the contract unless—

(a) the contractor has checked that the health care professional meets the requirements of regulation 41; and

(b) the contractor has taken reasonable steps to satisfy itself that the health care professional meets the requirements of regulation 43.

(2) Where—

(a) the employment or engagement of a health care professional is urgently needed; and

(b) it is not possible for the contractor to check that the health care professional meets the requirements referred to in regulation 41 before employing or engaging the health care professional,

the contractor may employ or engage the health care professional on a temporary basis for a single period of up to seven days while such checks are undertaken.

(3) When considering a health care professional's experience and training for the purposes of paragraph (1)(b), the contractor must, in particular, have regard to—

(a) any post-graduate or post-registration qualification held by the health care professional; and

(b) any relevant training undertaken, and any relevant clinical experience gained, by the health care professional.

Clinical references E+W

46.—(1) The contractor may not employ or engage a health care professional to perform clinical services under the contract (other than an exempt medical practitioner to whom regulation 40(3)(d) applies) unless—

(a) that person has provided two clinical references, relating to two recent posts (which may include any current post) as a health care professional which lasted for three months without a significant break or, where this is not possible, a full explanation of why this is the case and details of alternative referees; and

(b) the contractor has checked and is satisfied with the references.

(2) Where—

(a) the employment or engagement of a health care professional is urgently needed; and

(b) it is not possible for the contractor to obtain and check the references in accordance with paragraph (1)(b) before employing or engaging that health care professional,

the contractor may employ or engage the health care professional on a temporary basis for a single period of up to 14 days while the references are checked and considered, and for an additional period of a further seven days if the contractor believes that the person supplying those references is ill, on holiday or otherwise temporarily unavailable.

(3) Where the contractor employs or engages the same person on more than one occasion within a period of three months, the contractor may rely on the references provided on the first occasion, provided that those references are not more than 12 months old.

Verification of qualifications and competence E+W

47.—(1) The contractor must, before employing or engaging any person to assist it in the provision of services under the contract, take reasonable steps to satisfy itself that the person in question is both suitably qualified and competent to discharge the duties for which that person is to be employed or engaged.

(2) The duty imposed on the contractor by paragraph (1) is in addition to the duties imposed by regulations 44 to 46.

(3) When considering the competence and suitability of any person for the purposes of paragraph (1), the contractor must, in particular, have regard to that person's—

(a) academic and vocational qualifications;

(b) education and training; and

(c) previous employment or work experience.

Training E+W

48.—(1) The contractor must ensure that for any health care professional who is—

(a) performing clinical services under the contract, or

(b) employed or engaged to assist in the performance of such services,

there are in place arrangements for the purpose of maintaining and updating the skills and knowledge of that health care professional in relation to the services which that health care professional is performing or assisting in the performance of.

(2) The contractor must afford to each employee reasonable opportunities to undertake appropriate training with a view to maintaining that employee's competence.

Terms and conditions E+W

49.  The contractor may only offer employment to a general medical practitioner on terms which are no less favourable than those contained in the document entitled “Model terms and conditions of service for a salaried general practitioner employed by a GMS practice” published by the British Medical Association and the NHS Confederation as item 1.2 of the supplementary documents to the GMS contract 2003 M1 .

Marginal Citations

M1 This document is available at: http://bma.org.uk/sessionalgps. Hard copies may be requested from The British Medical Association, BMA House, Tavistock Square, London WC1H 9JP.

Arrangements for GP Specialty Registrars E+W

50.—(1) The contractor may only employ a GP Specialty Registrar subject to the conditions specified in paragraph (2).

(2) The conditions specified in this paragraph are that the contractor must not, by reason only of having employed a GP Specialty Registrar, reduce the total number of hours for which other medical practitioners perform primary medical services under the contract or for which other staff assist those practitioners in the performance of those services.

(3) Where a contractor employs a GP Specialty Registrar, the contractor must—

(a) offer that GP Specialty Registrar terms of employment in accordance with such rates, and subject to such conditions, as are approved by the Secretary of State concerning the grants, fees, travelling and other allowances payable to GP Specialty Registrars; and

(b) take into account the guidance contained in the document entitled “A Reference Guide For Postgraduate Specialty Training in the UK”M2 .

Marginal Citations

M2 This guidance, last published in May 2014, is available at http://specialtytraining.hee.nhs.uk/files/2013/10/A-Reference-Guide-for-Postgraduate-Specialty-Training-in-the-UK.pdf. Hard copies are available from Health Education England, 1st Floor, Blenheim House, Duncombe Street, Leeds, LS1 4PL.

Notice requirements in respect of relevant prescribers E+W

51.—(1) For the purposes of this regulation, “a relevant prescriber” is—

(a) a chiropodist or podiatrist independent prescriber;

(b) an independent nurse prescriber;

(c) a pharmacist independent prescriber;

(d) a physiotherapist independent prescriber; or

(e) a supplementary prescriber.

(2) The contractor must give notice to [F4 NHS England] where—

(a) a relevant prescriber is employed or engaged by a contractor to perform functions which include prescribing;

(b) a relevant prescriber is a party to the contract whose functions include prescribing; or

(c) the functions of a relevant prescriber whom the contractor already employs or has already engaged are extended to include prescribing.

(3) The notice under paragraph (2) must be given in writing to [F4 NHS England] before the expiry of the period of seven days beginning with the date on which—

(a) the relevant prescriber was employed or engaged by the contractor or, as the case may be, became a party to the contract (unless immediately before becoming such a party, paragraph (2)(a) applied to that relevant prescriber); or

(b) the functions of the relevant prescriber were extended to include prescribing.

(4) The contractor must give notice to [F4 NHS England] where—

(a) the contractor ceases to employ or engage a relevant prescriber in the contractor's practice whose functions include prescribing in the contractor's practice;

(b) a relevant prescriber ceases to be a party to the contract;

(c) the functions of a relevant prescriber employed or engaged by the contractor in the contractor's practice are changed so that they no longer include prescribing in the contractor's practice; or

(d) the contractor becomes aware that a relevant prescriber whom it employs or engages has been removed or suspended from the relevant register.

(5) The notice under paragraph (4) must be given in writing to [F4 NHS England] before the end of the second working day after the day on which an event described in sub-paragraphs (a) to (d) occurred in relation to the relevant prescriber.

(6) The contractor must provide the following information when it gives notice to [F4 NHS England] in accordance with paragraph (2)—

(a) the person's full name;

(b) the person's professional qualifications;

(c) the person's identifying number which appears in the relevant register;

(d) the date on which the person's entry in the relevant register was annotated to the effect that the person was qualified to order drugs, medicines and appliances for patients;

(e) the date on which—

(i) the person was employed or engaged (if applicable),

(ii) the person became a party to the contract (if applicable), or

(iii) the functions of the person were extended to include prescribing in the contractor's practice.

(7) The contractor must provide the following information when it gives notice to [F4 NHS England] in accordance with paragraph (4)—

(a) the person's full name;

(b) the person's professional qualifications;

(c) the person's identifying number which appears in the relevant register;

(d) the date on which—

(i) the person ceased to be employed or engaged in the contractor's practice,

(ii) the person ceased to be a party to the contract,

(iii) the functions of the person were changed so as to no longer include prescribing in the contractor's practice, or

(iv) the person was removed or suspended from the relevant register.

Textual Amendments

F4 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1

Signing of documents E+W

52.—(1) The contractor must ensure—

(a) that the documents specified in paragraph (2) include—

(i) the clinical profession of the health care professional who signed the document, and

(ii) the name of the contractor on whose behalf the document is signed; and

(b) that the documents specified in paragraph (3) include the clinical profession of the health care professional who signed the document.

(2) The documents specified in this paragraph are—

(a) certificates issued in accordance with regulation 22, unless regulations relating to particular certificates provide otherwise; and

(b) any other clinical documents apart from—

(i) home oxygen order forms, and

(ii) the documents specified in paragraph (3).

(3) The documents specified in this paragraph are batch issues, prescription forms and repeatable prescriptions.

(4) This regulation is in addition to any other requirements relating to the documents specified in paragraphs (2) and (3) whether in these Regulations or elsewhere.

Level of skill E+W

53.  The contractor must carry out its obligations under the contract with reasonable care and skill.

Appraisal and assessment E+W

54.—(1) The contractor must ensure that any medical practitioner performing services under the contract—

(a) participates in the appraisal system provided by [F4 NHS England] unless that medical practitioner participates in an appropriate appraisal system provided by another health service body or is an armed forces GP; and

(b) co-operates with [F4 NHS England] in relation to [F4 NHS England’s] patient safety functions.

(2) [F4 NHS England] must provide an appraisal system for the purposes of paragraph (1)(a) after consultation with the Local Medical Committee (if any) for the area in which the practitioner provides services under the contract and such other persons as appear to it to be appropriate.

(3) In paragraph (1), “armed forces GP” means a medical practitioner who is employed on a contract of service by the Ministry of Defence, whether or not as a member of the armed forces of the Crown.

Textual Amendments

F4 Words in Regulations substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1