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

Regulation 19

SCHEDULE 1 E+W Additional services

Additional services: general E+W

1.  The contractor must provide, in relation to each additional service, such facilities as are necessary to enable the contractor to properly perform that service.

Cervical screening E+W

2.—(1) A contractor whose contract includes the provision of cervical screening must—

(a) provide all the services described in sub-paragraph (2); and

(b) make the records described in sub-paragraph (3).

(2) The services described in this sub-paragraph are—

(a) the provision of necessary information and advice to assist women identified by the Board as recommended nationally for a cervical screening test in making an informed decision as to participation in the NHS Cervical Screening Programme M1 ;

(b) the performance of cervical screening tests on women who have agreed to participate in that Programme; and

(c) ensuring that test results are followed up appropriately.

(3) The records described in this sub-paragraph are an accurate record of the carrying out of a cervical screening test, the result of the test and any clinical follow up requirements.

Marginal Citations

M1 The NHS Cervical Screening Programme is a programme intended to reduce the number of women who develop cervical cancer and the number of women who die from that condition. All women aged between 25 and 64 are invited for cervical screening. Further information about the Programme is available at http://www.nhs.uk/conditions/Cervical-screening-test/Pages/Introduction.aspx or in hard copy form from Department of Health, Richmond House, 79 Whitehall, London SW1A 2NS.

Contraceptive services E+W

F1 3.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F1 Sch. 1 para. 3 omitted (1.10.2019) by virtue of The National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) (Amendment) Regulations 2019 (S.I. 2019/1137), regs. 1(2), 12

Vaccines and immunisations E+W

4.—(1) This paragraph applies to a contractor whose contract includes the provision of vaccines and immunisations but does not apply to the provision of—

(a) childhood immunisations; and

(b) the combined Haemophilus influenza type B and Meningitis C booster vaccine.

(2) The contractor must—

(a) offer to provide to patients all vaccines and immunisations (other than those mentioned in sub-paragraph (1)) of the type, and in the circumstances, specified in the GMS Statement of Financial Entitlements;

(b) taking into account the individual circumstances of the patient, consider whether immunisation ought to be administered by the contractor or by another health care professional or whether a prescription form ought to be provided for the purpose of self-administration by the patient of the immunisation;

(c) provide appropriate information and advice to patients about such vaccines and immunisations;

(d) record, in the patient's record, any refusal of the offer referred to in paragraph (a);

(e) where the offer is accepted and immunisation is to be administered by the contractor or by another health care professional, include in the patient's record—

(i) the patient's consent to immunisation or the name of the person who gave consent to immunisation and that person's relationship to the patient,

(ii) the batch numbers, expiry date and title of the vaccine,

(iii) the date of administration,

(iv) in the case where two vaccines are administered by injections, in close succession, the route of the administration and the injection site of each vaccine,

(v) any contraindications to the vaccine, and

(vi) any adverse reactions to the vaccine; and

(f) where the offer is accepted and the immunisation is not to be administered by the contractor or another health care professional, issue a prescription form for the purpose of self-administration by the patient.

(3) The contractor must ensure that all staff involved in the administration of vaccinations and immunisations are trained in the recognition and initial treatment of anaphylaxis.

(4) In this paragraph, “patient's record” means the record which is kept in accordance with regulation 67.

Childhood vaccines and immunisations E+W

5.—(1) A contractor whose contract includes the provision of childhood immunisations must comply with the requirements in sub-paragraphs (2) and (3).

(2) The contractor must—

(a) offer to provide to children all vaccines and immunisations of the type specified, and in the circumstances which are set out, in the GMS Statement of Financial Entitlements;

(b) provide appropriate information and advice to patients and, where appropriate, to the parents of patients, about such vaccines and immunisations;

(c) record in the patient's record any refusal of the offer referred to in paragraph (a);

(d) where the offer is accepted, administer the immunisations and include in the patient's record—

(i) the name of the person who gave consent to the immunisations and that person's relationship to the patient,

(ii) the batch number and expiry date of the vaccine,

(iii) the date of administration,

(iv) in a case where two vaccines are administered by injections in close succession, the route of administration and the injection site of each vaccine,

(v) any contraindications to the vaccine, and

(vi) any adverse reactions to the vaccine.

(3) The contractor must ensure that all staff involved in administering vaccines and immunisations are trained in the recognition and initial treatment of anaphylaxis.

(4) In this paragraph, “patient's record” has the same meaning as in paragraph 4.

Child health surveillance E+W

6.—(1) A contractor whose contract includes the provision of child health surveillance services must, in respect of any child under the age of five years for whom it has responsibility under the contract—

(a) provide all the services described in sub-paragraph (2), other than an examination described in that sub-paragraph which the parent refuses to allow the child to undergo, until the date upon which the child attains the age of five years; and

(b) maintain the records specified in sub-paragraph (3).

(2) The services described in this sub-paragraph are—

(a) monitoring the health, well-being and physical, mental and social development (“development”) of the child while under the age of five years with a view to detecting any deviations from normal development—

(i) by the consideration of information concerning the child received by or on behalf of the contractor, and

(ii) on any occasion when the child is examined or observed by or on behalf of the contractor (whether by virtue of paragraph (b) or otherwise); and

(b) examination of the child at the frequency that has been agreed with the Board in accordance with the nationally agreed evidence based programme set out in the fourth edition of “Health for all Children”M2 .

(3) The records specified in this sub-paragraph are an accurate record of—

(a) the development of the child while under the age of five years, compiled as soon as is reasonably practicable following the first examination of that child and, where appropriate, amended following each subsequent examination; and

(b) the responses (if any) to offers made to the child's parent for the child to undergo an examination referred to in sub-paragraph (2)(b).

Marginal Citations

M2 Health for All Children, Revised 4th Edition by David M B Hall and David Elliman was published by Oxford University Press on 7th September 2006.

Maternity medical services E+W

7.—(1) A contractor whose contract includes the provision of maternity medical services must—

(a) provide to female patients who have been diagnosed as pregnant all necessary maternity medical services throughout the antenatal period;

(b) provide to female patients and their babies all necessary maternity medical services throughout the postnatal period other than neonatal checks;

(c) subject to sub-paragraph (2), provide all necessary maternity medical services to female patients whose pregnancy has terminated as a result of miscarriage or abortion.

(2) Where the contractor has a conscientious objection to the termination of pregnancy by abortion, the contractor must promptly refer the patient to another provider of primary medical services who does not have such an objection.

(3) In this paragraph—

“antenatal period” means the period beginning with the start of the pregnancy and ending with the onset of labour;

“maternity medical services” means—

(a)

in relation to female patients (other than babies) all primary medical services relating to pregnancy, excluding intra partum care; and

(b)

in relation to babies, any primary medical services necessary in their first fourteen days of life; and

“postnatal period” means the period beginning with the conclusion of the delivery of the baby or the patient's discharge from secondary care services (whichever is the later) and ending on the fourteenth day after the birth.

Minor surgery E+W

8.—(1) A contractor whose contract includes the provision of minor surgery must comply with the requirements in sub-paragraphs (2) and (3).

(2) The contractor must make available to patients where appropriate—

(a) curettage;

(b) cautery; and

(c) cryocautery of warts, verrucae and other skin lesions.

(3) The contractor must record in the patient's record—

(a) details of the minor surgery provided to the patient; and

(b) the consent of the patient to that surgery.

(4) In this paragraph, “patient's record” has the same meaning as in paragraph 4.