PART 5CONTRACTS: REQUIRED TERMS
Essential services15
1
For the purposes of section 28R(1) of the Act (requirement to provide certain primary medical services), the services which must be provided under a general medical services contract (“essential services”) are the services described in paragraphs (3), (5), (6) and (8).
2
Subject to regulation 20, a contractor must provide the services described in paragraphs (3) and (5) throughout the core hours.
3
The services described in this paragraph are services required for the management of its 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,
delivered in the manner determined by the practice in discussion with the patient.
4
For the purposes of paragraph (3) —
“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 M1; and
“management” includes —
- a
offering consultation and, where appropriate, physical examination for the purpose of identifying the need, if any, for treatment or further investigation; and
- b
the making available of 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.
- a
5
The services described in this paragraph are the provision of appropriate ongoing treatment and care to all registered patients and temporary residents taking account of their specific needs including —
a
the provision of advice in connection with the patient’s health, including relevant health promotion advice; and
b
the referral of the patient for other services under the Act.
6
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 its practice area.
7
In paragraph (6), “emergency” includes any medical emergency whether or not related to services provided under the contract.
8
A contractor must provide primary medical services required in core hours for the immediately necessary treatment of any person falling within paragraph (9) who requests such treatment, for the period specified in paragraph (10).
9
A person falls within paragraph (8) if he or she is a person —
a
whose application for inclusion in the contractor’s list of patients has been refused in accordance with paragraph 17 of Schedule 6 and who is not registered with another provider of essential services (or their equivalent) in the area of the Local Health Board;
b
whose application for acceptance as a temporary resident has been rejected under paragraph 17 of Schedule 6; or
c
who is present in the contractor’s practice area for less than 24 hours.
10
The period referred to in paragraph (8) is —
a
in the case of paragraph (9)(a), 14 days beginning with the date on which that person’s application was refused or until that person has been subsequently registered elsewhere for the provision of essential services (or their equivalent), whichever occurs first;
b
in the case of paragraph (9)(b), 14 days beginning with the date on which that person’s application was rejected or until that person has been subsequently accepted elsewhere as a temporary resident, whichever occurs first; and
c
in the case of paragraph (9)(c), 24 hours or such shorter period as the person is present in the contractor’s practice area.