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PART 5E+WContracts: required terms

Essential servicesE+W

17.—(1) Subject to paragraph (2), for the purposes of section 85(1) of the Act (requirement to provide certain medical services), the services which must be provided under a contract (“essential services”) are the services described in paragraphs (4), (6), (7) [F1and (9)].

(2) Essential services are not required to be provided by the contractor during any period in respect of which the Care Quality Commission has suspended the contractor as a service provider under section 18 of the Health and Social Care Act 2008 M1 (suspension of registration).

(3) Subject to regulation 20(2)(b) and (c), a contractor must provide the services described in paragraphs (4) and (6) throughout the core hours.

(4) The services described in this paragraph are services required for the management of a contractor's registered patients and temporary residents who are, or believe themselves to be—

(a)ill, with conditions from which recovery is generally expected;

(b)terminally ill; or

(c)suffering from chronic disease,

which are delivered in the manner determined by the contractor's practice in discussion with the patient.

(5) For the purposes of paragraph (4)—

“disease” means a disease included in the list of three-character categories contained in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems M2; and

“management” includes—

(a)

offering consultation and, where appropriate, physical examination for the purposes of identifying the need, if any, for treatment or further investigation; and

(b)

making available such treatment or further investigation as is necessary and appropriate, including the referral of the patient for other services under the Act and liaison with other health care professionals involved in the patient's treatment and care.

[F2(6) The services described in this paragraph are the provision of appropriate ongoing treatment and care to all of the contractor’s registered patients and temporary residents taking into account their specific needs including—

(a)advice in connection with the patient’s health and relevant health promotion advice; and

(b)the referral of a patient for services under the Act,

together with the provision of [F3the services specified in paragraph (6A)].]

[F4(6A) The services mentioned in paragraph (6) are—

(a)cervical screening services;

(b)child health surveillance services;

(c)contraceptive services;

(d)maternity medical services; and

(e)vaccine and immunisation services.]

(7) A contractor must provide primary medical services required in core hours for the immediately necessary treatment of any person to whom the contractor has been requested to provide treatment owing to an accident or emergency at any place in the contractor's practice area.

(8) In paragraph (7), “emergency” includes any medical emergency whether or not related to services provided under the contract.

(9) A contractor must provide primary medical services required in core hours for the immediately necessary treatment of any person to whom paragraph (10) applies who requests such treatment for the period specified in paragraph (11).

(10) This paragraph applies to a person if—

(a)that person's application for inclusion in the contractor's list of patients has been refused in accordance with [F5paragraph 21, 32D or 32F] of Schedule 3, and that person is not registered with another provider of essential services (or their equivalent);

(b)that person's application for acceptance as a temporary resident has been refused under [F6paragraph 21, 32E or 32G] of Schedule 3; or

(c)that person is present in the contractor's practice area for a period of less than 24 hours.

(11) The period specified in this paragraph is, in the case of a person to whom—

(a)paragraph (10)(a) applies, 14 days beginning with the [F7relevant date] or until that person has been subsequently registered elsewhere for the provision of essential services (or their equivalent), whichever occurs first;

(b)paragraph (10)(b) applies, 14 days beginning with the [F8relevant date] or until that person has been subsequently accepted elsewhere as a temporary resident, whichever occurs first; or

(c)paragraph (10)(c) applies, 24 hours or such shorter period as the person is present in the contractor's practice area.

[F9(11A) For the purposes of paragraph (11) “relevant date”—

(a)if the person’s application is refused in accordance with paragraph 32D, 32E, 32F or 32G of Schedule 3, means the later of—

(i)the date on which the application is refused, and

(ii)the date on which the person returns to the United Kingdom;

(b)if the person’s application is refused in accordance with paragraph 21 of Schedule 3, means the date on which the application is refused.]

F10(12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F10(13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F10(14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F10(15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

Marginal Citations

M2The tenth revision of the International Statistical Classification of Diseases and Related Health Problems is available from the World Health Organisation at http://www.who.int/classifications/icd/en. Hard copies are available from the WHO bookshop which is able take orders online at http://bookorders.who.int/bookorders/index.htm and can provide a list of distributors in the UK.