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2004 No. 1020 (W.117)

NATIONAL HEALTH SERVICE, WALES

The National Health Service (Performers Lists) (Wales) Regulations 2004

  Made 30th March 2004 
  Coming into force 1st April 2004 

The National Assembly for Wales, in exercise of the powers conferred upon it by sections 28X, and 126(4) of the National Health Service Act 1977[1], hereby makes the following Regulations:



PART 1

GENERAL

Citation, commencement and application
     1.  - (1) These Regulations may be cited as the National Health Service (Performers Lists) (Wales) Regulations 2004 and shall come into force on 1st April 2004.

    (2) These Regulations apply to Wales only.



PART 2

PROVISIONS AS TO PERFORMERS LISTS

Interpretation and modification
    
2.  - (1) In these Regulations unless the context otherwise requires  - 

and shall be treated as including a case where a person is treated as suspended by a Local Health Board or, prior to 1st April 2003, a Health Authority by virtue of regulation 6(2) of the Abolition of the Tribunal (Wales) Regulations, or in England by a Primary Care Trust or, prior to 1st October 2002, by a Health Authority by virtue of regulation 6(2) of the Abolition of the Tribunal Regulations, and "suspends" and "suspension" shall be construed accordingly;

all references to sections are to sections of the National Health Service Act 1977, except where specified otherwise.

    (2) The provisions of this Part shall have effect in relation to each description of performer as prescribed in the relevant Part, subject to any modification or further provision in that relevant Part.

Performers Lists
     3.  - (1) A Local Health Board shall prepare and publish a medical performers list in accordance with this Part, as modified or supplemented by Part 2.

    (2) Performers lists shall be available for public inspection.

Application for inclusion in a performers list
    
4.  - (1) An application by a performer for the inclusion of the performer's name in a performers list shall be made by sending the Local Health Board an application in writing, which shall include the information mentioned in paragraph (2), the undertakings, certificate, authority and consents required by paragraphs (3), and (6) any declaration required under paragraph (4) or (5) and any further information, undertakings, consents or documentation required under paragraph (7) or the relevant Part.

    (2) The performer shall provide the following information - 

    (3) The performer shall provide the following undertakings, certificate and consent  - 

    (4) The performer shall send with the application a declaration as to whether the performer - 

and, if so, the performer shall give details of any investigation or proceedings which were or are to be brought, including the nature of the investigation or proceedings, where and approximately when that investigation or those proceedings took place or are to take place, and any outcome.

    (5) If the performer is, has in the preceding six months been, or was at the time of the originating events a director of a body corporate, the performer shall in addition make a declaration to the Local Health Board as to whether the body corporate - 

and, if so, give the name and registered office of the body corporate and details of any investigation or proceedings which were or are to be brought, including the nature of the investigation or proceedings, where and approximately when that investigation or those proceedings took place or are to take place, and any outcome.

    (6) The performer shall provide all necessary authority to enable a request to be made by the Local Health Board to any employer or former employer, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, into the performer or a body corporate referred to in paragraphs (2) and (5) and for the purpose of this paragraph, "employer" includes any partnership of which the performer is or was a member.

    (7) If in the case of any application, the Local Health Board finds that the information, references or documentation supplied by the performer are not sufficient for it to decide the performer's application, it shall seek from that performer such further information, references or documentation as it may reasonably require in order to make a decision and that performer shall supply the material so sought to the Local Health Board.

Readmission
     5.  - (1) Where a performer has been removed from its performers list by a Local Health Board on the grounds that the performer had been convicted of a criminal offence, and that conviction is overturned on appeal, that Local Health Board may agree to include the performer in its performers list without a full application if it - 

    (2) In a case to which paragraph (1) applies, if the conviction is reinstated on a further appeal, the previous determination of the Local Health Board to remove that performer from its performers list shall once again have effect.

Decisions and grounds for refusal
    
6.  - (1) The grounds on which a Local Health Board may refuse to include a performer in its performers list are, in addition to any prescribed in the relevant Part, that - 

    (2) The grounds on which a Local Health Board must refuse to include a performer in its performers list are, in addition to any prescribed in the relevant Part, that  - 

    (3) Before making a decision on the performer's application, the Local Health Board shall - 

    (4) Where the Local Health Board is considering a refusal of the performer's application under paragraph (1) or (2) it shall consider all facts which appear to it to be relevant, and shall in particular take into consideration, in relation to paragraph (1)(a), (c) or (d)  - 

    (5) When the Local Health Board takes into consideration any of the matters set out in paragraph (4), it shall consider the overall effect of all the matters being considered.

    (6) When the Local Health Board has decided whether or not to include a performer in its performers list, the Local Health Board shall notify the performer within 7 days of that decision of  - 

Deferment of decision on application
     7.  - (1) A Local Health Board may defer a decision on a performer's application to be included in a performers list, where - 

    (2) A Local Health Board may only defer a decision under paragraph (1) above until the outcome of the relevant event mentioned in any of sub-paragraphs (a), (b), (c),(f), (g), (h), (i), (j) is known or whilst the performer or the body corporate is suspended under sub-paragraph (d) or (e) above.

    (3) The Local Health Board must notify the performer that it has deferred a decision on the application and the reasons for it.

    (4) Once the outcome of the relevant event mentioned in paragraph (1)(a), (b), (c), (f), (g), (h), (i), (j) is known or the suspension referred to in paragraph (1)(d) or (e) has come to an end, the Local Health Board shall notify the performer that the performer must within 28 days of the date of the notification (or such longer period as the Local Health Board may agree) - 

    (5) Provided any additional information has been received within the 28 days or the time agreed, the Local Health Board shall notify the performer as soon as possible that  - 

Conditional inclusion
    
8.  - (1) A Local Health Board may determine that, if a performer is to be included in a performers list, the performer is to be subject, while the performer remains included in that performers list, to the imposition of conditions, having regard to the requirements of section 28X(6) (preventing fraud or prejudice to the efficiency of the service).

    (2) If a performer fails to comply with a condition, which has been imposed by the Local Health Board, it may remove the performer from its performers list.

    (3) Where the Local Health Board is considering the removal of a performer from its performers list for breach of a condition, it shall  - 

    (4) If there are no representations within the period specified in paragraph (3)(c), the Local Health Board shall decide the matter and, within 7 days of making that decision, notify the performer of  - 

    (5) If there are representations, the Local Health Board must take them into account before reaching its decision, and shall then, within 7 days of making that decision, notify the performer of  - 

    (6) If the performer requests an oral hearing, this must take place before the Local Health Board reaches its decision and the Local Health Board must then, within 7 days of making that decision, notify the performer of  - 

    (7) When the Local Health Board notifies the performer of any decision, it shall inform the performer that, if the performer wishes to exercise a right of appeal, the performer must do so within the period of 28 days beginning with the date on which the Local Health Board gave the performer the notice informing the performer of its decision and shall tell the performer how to exercise any such right.

    (8) The Local Health Board shall also notify the performer of the performer's right to have the decision reviewed in accordance with regulation 14.

    (9) Where the Local Health Board determines that a performer  - 

the name of the performer may be included (or continue to be included) in its performers list during the period for bringing the appeal to the FHSAA pursuant to regulation 15, or if an appeal is brought, until such time as that appeal has been decided, provided the performer agrees in writing to be bound by the conditions imposed until the time for appeal has expired or the appeal is decided.

Requirements with which a performer in a performers list must comply
    
9.  - (1) A performer, who is included in a performers list of a Local Health Board, shall make a declaration to that Local Health Board in writing within 7 days of its occurrence if the performer  - 

and, if so, the performer shall give details of any investigation or proceedings which were or are to be brought, including the nature of the investigation or proceedings, where and approximately that investigation or those proceedings were or are to take place, and any outcome.

    (2) A performer, who is included in a performers list of a Local Health Board, and is, was in the preceding six months, or was at the time of the originating events, a director of a body corporate, shall make a declaration to that Local Health Board in writing within 7 days of its occurrence if that body corporate  - 

and, if so, the performer shall give the name and registered address of the body corporate and details of any investigation or proceedings which were or are to be brought, including the nature of that investigation or those proceedings, where and approximately when the investigation or those proceedings took place or are to take place, and any outcome.

    (3) A performer, who is included in a performers list of a Local Health Board, shall provide all necessary authority to enable a request to be made by that Local Health Board to any employer or former employer, licensing, regulatory or other body in the United Kingdom or elsewhere, for information relating to a current investigation, or an investigation where the outcome was adverse, by that employer or body into the performer or a body corporate referred to in paragraph (1) and (2) for the purposes of this paragraph, "employed" includes any partnership of which the performer is or was a member.

    (4) A performer, who is included in a performers list of a Local Health Board, shall supply that Local Health Board with an enhanced criminal record certificate under section 115 of the Police Act 1997[27] in relation to the performer, if the Local Health Board at any time, for reasonable cause, requests the performer to provide such a certificate.

    (5) Subject to paragraph (6) a performer, who is included in a performers list of a Local Health Board, shall comply with any undertaking the performer gave on admission to that list or to any previous list from which the performer has transferred pursuant to Schedule 1.

    (6) A performer, who is included in a relevant performers list of a Local Health board shall act in accordance with the undertakings that a performer is required to provide when applying for inclusion in that relevant performers list.

    (7) A performer, who is included in a performers list of a Local Health Board, shall, except where the relevant Part provides to the contrary, participate in the appraisal system provided on behalf of that Local Health Board, and send the Local Health Board a copy of the statement summarising that appraisal.

Removal from performers list
     10.  - (1) The Local Health Board must remove the performer from its performers list where it becomes aware that the performer  - 

    (2) Where a Local Health Board is notified by the FHSAA that it has considered an appeal by a performer against  - 

the Local Health Board shall remove the performer from its performers list and shall notify the performer immediately that it has done so.

    (3) The Local Health Board may remove a performer from its performers list where any of the conditions set out in paragraph (4) is satisfied.

    (4) The conditions mentioned in paragraph (3) are that the  - 

    (5) For the purposes of this regulation, in addition to the services covered by the definition of "health scheme" in section 49F(8), the following shall also be health schemes - 

    (6) Where the performer cannot demonstrate that the performer has performed the services, which those included in the relevant performers list perform, within the area of the Local Health Board during the preceding twelve months, the Local Health Board may remove the performer from its performers list.

    (7) Subject to any provision in the relevant Part, in calculating the period of twelve months referred to in paragraph (6), the Local Health Board shall disregard any period during which  - 

    (8) Where a Local Health Board is considering removing a performer from its performers list under paragraphs (3) to (6) or regulations 8(2), 12(3)(c) or 15(6)(b) or contingently removing a performer under regulation 12(1), it shall give the performer  - 

    (9) If there are no representations within the period specified in paragraph (8)(c), the Local Health Board shall decide whether or not to remove the performer and then, within 7 days of making that decision, notify the performer of  - 

    (10) If there are representations, the Local Health Board must take them into account before reaching its decision, and shall then, within 7 days of making that decision, notify the performer of - 

    (11) If the performer requests an oral hearing, this must take place before the Local Health Board reaches its decision, and the Local Health Board shall decide whether or not to remove the performer and then, within 7 days of making that decision, notify the performer of  - 

    (12) When the Local Health Board notifies the performer of any decision, it shall inform the performer that, if the performer wishes to exercise a right of appeal, the performer must do so within the period of 28 days beginning with the date on which the Local Health Board informed the performer of its decision and shall tell the performer how to exercise any such right.

    (13) The Local Health Board shall also notify the performer of the performer's right to have the decision reviewed in accordance with regulation 14.

    (14) Where the Local Health Board decides to remove a performer under paragraph (6), the performer shall not be removed from its performers list until  - 

whichever is the later.

Criteria for a decision on removal
     11.  - (1) Where a Local Health Board is considering whether to remove a performer from its performers list under regulation 10(3) and (4)(c) (an unsuitability case), it shall  - 

    (2) The matters referred to in paragraph (1) are  - 

    (3) Where a Local Health Board is considering removal of a performer from its performers list under regulation 10(3) and (4)(b) it shall consider  - 

    (4) The matters referred to in paragraph (3)(c) are  - 

    (5) Where a Local Health Board is considering removal of a performer from its performers list under regulation 10(3) and (4)(a) ("an efficiency case"), it shall  - 

    (6) The matters referred to in paragraph (5)(c) are  - 

    (7) In making any decision under regulation 10, the Local Health Board shall take into account the overall effect of any relevant incidents and offences relating to the performer of which it is aware, whichever condition it relies on.

    (8) When making a decision on any condition in regulation 10(4), the Local Health Board shall state in its decision on which condition it relies.

Contingent removal
     12.  - (1) In an efficiency case or a fraud case the Local Health Board may, instead of deciding to remove a performer from its performers list, decide to remove the performer contingently.

    (2) If it so decides, it must impose such conditions as it may decide on the inclusion of the performer in its performers list with a view to  - 

    (3) If the Local Health Board determine that the performer has failed to comply with a condition, it may decide to  - 

Suspension
    
13.  - (1) If a Local Health Board is satisfied that it is necessary to do so for the protection of members of the public or is otherwise in the public interest, it may suspend a performer from its performers list in accordance with the provisions of this regulation  - 

    (2) Subject to paragraph (8), in a case falling within paragraph (1)(a), the Local Health Board must specify a period, not exceeding six months, as the period of suspension.

    (3) Subject to paragraph (8), in a case falling within paragraph (1)(b), the Local Health Board may specify that the performer remains suspended after the decision referred to in that paragraph has been made for an additional period, not exceeding six months.

    (4) The period of suspension under paragraph (1)(a) or (b) may extend beyond six months if - 

    (5) If the FHSAA does so order, it shall specify  - 

    (6) The FHSAA may, on the application of the Local Health Board, make a further order (complying with paragraph (5)) at any time while the period of suspension pursuant to the earlier order is still continuing.

    (7) If the Local Health Board suspends a performer in a case falling within paragraph (1)(c) or (d), the suspension has effect from the date the Local Health Board informed the performer of the suspension until  - 

    (8) The Local Health Board may extend the period of suspension under paragraph (2) or impose a further period of suspension under paragraph (3), so long as the aggregate does not exceed six months.

    (9) The effect of a suspension is that while a performer is suspended under these Regulations the performer is to be treated as not being included in the Local Health Board's performers list, even though the performer's name appears in it.

    (10) The Local Health Board may at any time revoke the suspension and inform the performer of its decision.

    (11) Where a Local Health Board is considering suspending a performer or varying the period of suspension under this regulation, it shall give the performer  - 

    (12) If the performer does not wish to have an oral hearing or does not attend the oral hearing, the Local Health Board may suspend the performer with immediate effect.

    (13) If an oral hearing does take place, the Local Health Board shall take into account any representations made before it reaches its decision.

    (14) The Local Health Board may suspend the performer with immediate effect following the hearing.

    (15) The Local Health Board shall notify the performer of its decision and the reasons for it (including any facts relied upon) within 7 days of making that decision.

    (16) The Local Health Board shall notify the performer of any right of review under regulation 14.

    (17) During a period of suspension payments may be made to or in respect of the performer in accordance with a determination by the Assembly.

    (18) If a payment is made pursuant to a determination under paragraph (17), but the payee was not entitled to receive all or any part thereof, if the amount to which he or she was not entitled has not been recovered by other means, it may be recovered as a civil debt.

    (19) If a performer is dissatisfied with a decision of a Local Health Board ("the original decision") - 

the performer may ask the Local Health Board to review the original decision and, if the performer does so, it shall reconsider that decision, and once it has done so, it must notify the performer in writing of the decision that is the outcome of its reconsideration of its original decision ("the reconsidered decision"), and give the performer notice of the reasons for its reconsidered decision.

    (20) If the performer remains dissatisfied (whether on the same or different grounds), he or she may appeal to the Assembly by giving the performer a notice of appeal within a period of 28 days beginning on the day that the Local Health Board notified the performer of the reconsidered decision.

    (21) A notice of appeal under paragraph (20) shall include - 

    (22) The Assembly shall thereafter send a written request to the parties to make, in writing and within a specified period, any representations they may wish to make about the matter (and the request to the Local Health Board shall include a copy of the performer's brief statement of the grounds for appeal).

    (23) Once the period specified pursuant to paragraph (22) has elapsed, the Assembly shall - 

    (24) Once the period specified pursuant to paragraph (23)(b) has elapsed, the Assembly shall, as soon as is reasonably practicable, having taken into account any such representations or observations as referred to in paragraphs (22) and (23) (if submitted within the specified periods) and such other evidence as it sees fit to consider - 

Reviews
    
14.  - (1) A Local Health Board may, and if requested in writing to do so by the performer must, review its decision to  - 

    (2) A performer may not request a review of a Local Health Board's decision until the expiry of a three month period beginning with the date of the Local Health Board's decision or, in the case of a conditional inclusion under regulation 8, beginning with the date the Local Health Board includes the performer's name in a performers list.

    (3) After a review has taken place, the performer cannot request a further review before the expiry of six months from the date of the decision on the last review.

    (4) If a Local Health Board decides to review its decision under this regulation to conditionally include, contingently remove or suspend a performer, it shall give the performer  - 

    (5) If there are no representations within the period specified in paragraph (4)(c), the Local Health Board shall notify the performer of its decision, the reasons for it (including any facts relied upon) and of any right of appeal under regulation 15.

    (6) If there are representations, the Local Health Board must take them into account before reaching its decision.

    (7) The Local Health Board shall, within 7 days of making its decision, notify the performer of  - 

    (8) If a Local Health Board decides to review its decision to impose conditions under regulation 8, the Local Health Board may vary the conditions, impose different conditions, remove the conditions or remove the performer from its performers list.

    (9) If a Local Health Board decides to review its decision to impose a contingent removal under regulation 12, the Local Health Board may vary the conditions, impose different conditions, or remove the performer from its performers list.

    (10) If a Local Health Board decides to review its decision to suspend a performer under regulation 13(1)(a) or (b), the Local Health Board may decide to impose conditions or remove the performer from its performers list.

    (11) A Local Health Board may not review its decision to suspend a performer under regulation 13(1)(c) or (d).

Appeals
    
15.  - (1) A performer may appeal (by way of redetermination) to the FHSAA against a decision of a Local Health Board mentioned in paragraph (2) by giving notice to the FHSAA.

    (2) The Local Health Board decisions in question are decisions  - 

    (3) On appeal the FHSAA may make any decision which the Local Health Board could have made.

    (4) Where the decision of the FHSAA on appeal is that the appellant's inclusion in a performers list is to be subject to conditions, whether or not those conditions are identical with the conditions imposed by the Local Health Board, the Local Health Board shall ask the performer to notify it within 28 days of the decision (or such longer period as the Local Health Board may agree) whether the performer wishes to be included on its performers list subject to those conditions.

    (5) If the performer notifies the Local Health Board that the performer does wish to be included in a performers list subject to the conditions, the Local Health Board shall so include the performer.

    (6) Where the FHSAA on appeal decides to impose a contingent removal  - 

Notification
    
16.  - (1) Where a Local Health Board decides to  - 

it shall notify the persons or bodies specified in paragraph (2), and shall additionally notify those specified in paragraph (3), if requested to do so by those persons or bodies in writing (including electronically), of the matters set out in paragraph (4).

    (2) Where paragraph (1) applies, a Local Health Board shall notify within 7 days of that decision  - 

    (3) The persons or bodies to be additionally notified in accordance with paragraph (1) are  - 

    (4) The matters referred to in paragraph (1) are  - 

    (5) The Local Health Board shall send to the performer concerned a copy of any information about the performer provided to the persons or bodies listed in paragraph (2) or (3), and any correspondence with that person or body relating to that information.

    (6) Where the Local Health Board has notified any of the persons or bodies specified in paragraph (2) or (3) of the matters set out in paragraph (4), it may, in addition, if requested by that person or body, notify that person or body of any evidence that was considered, including any representations from the performer.

    (7) Where a Local Health Board is notified by the FHSAA that it has imposed a national disqualification on a performer who was, or had applied to be included, in its performers list, it shall notify the persons or bodies listed in paragraph (2)(b), (g) and (h) and paragraph (3).

    (8) Where a decision is changed on review or appeal, or a suspension lapses, the Local Health Board shall notify the persons or bodies that were notified of the original decision of the later decision or the fact that that suspension has lapsed.

Amendment of or withdrawal from performers list
    
17.  - (1) A performer shall, unless it is impracticable for the performer to do so, give notice to the Local Health Board within 28 days of any occurrence requiring a change in the information recorded about the performer in its performers list and of any change of the performer's private address.

    (2) Where a performer intends to withdraw from a performers list, unless it is impracticable for the performer to do so, the performer shall so notify to the Local Health Board at least three months in advance of that date.

    (3) A performer shall so notify the Local Health Board that the performer intends to withdraw from its relevant performers list if the performer is accepted on to any relevant performers list of another Local Health Board.

    (4) The Local Health Board shall on receiving notice from any performer - 

    (5) A performer may withdraw a notice given pursuant to paragraph (1) or (2) at any time before the Local Health Board removes the performer's name from its performers list.

    (6) A notice given pursuant to paragraph (3) may not be withdrawn once the performer has been accepted on that other list..

Restrictions on withdrawal from performers list
    
18.  - (1) Where a Local Health Board is investigating a performer - 

the performer may not withdraw from any list kept by any Local Health Board in which the performer is included, except where the Assembly has given its consent, until the matter has been finally determined by the Local Health Board.

    (2) Where a Local Health Board has decided to remove a performer from its performers list under regulation 10(3) to (6) or to contingently remove the performer from it under regulation 12, but has not yet given effect to its decision, the performer may not withdraw from any list kept by any Local Health Board in which the performer is included, except where the Assembly has given its consent.

    (3) Where a Local Health Board has suspended a performer under regulation 13(1)(b), the performer may not withdraw from any list kept by any Local Health Board in which the performer is included, except where the Assembly has given its consent, until the decision of the relevant court or body is known and the matter has been considered and finally determined by the Local Health Board.

Review periods on national disqualification
    
19.  - (1) If on making a decision to impose a national disqualification, the FHSAA states that it is of the opinion that the criminal or professional conduct of the performer is such that there is no realistic prospect of a further review being successful if held within the period specified in section 49N(8)(a)[31], the reference to "two years" in that provision shall be a reference to five years;

    (2) If on the last review by the FHSAA of a national disqualification the performer was unsuccessful and the FHSAA states that it is of the opinion that there is no realistic prospect of a further review being successful if held within a period of three years beginning with the date of its decision on that review the reference to "one year" in section 49N(8)(b) shall be a reference to three years;

    (3) If the FHSAA states that it is of the opinion that, because a criminal conviction considered by the FHSAA in reaching the decision that has effect has been quashed or the penalty reduced on appeal, there is a need for an immediate review the reference to "two years" or "one year" in section 49N(8) shall be a reference to the period that has already elapsed;

    (4) If the FHSAA is of the opinion that because the decision of a licensing, regulatory or other body has been quashed or the penalty reduced on appeal, there is a need for an immediate review the reference to "two years" or "one year" in section 49N(8) shall be a reference to the period that has already elapsed.

Disclosure of Information
     20.  - (1) The Local Health Board may disclose information about a performer supplied to it or acquired by it pursuant to these Regulations to any of the following  - 

    (2) The LHB shall disclose to the Assembly information supplied to or acquired by the LHB pursuant to these Regulations as the Assembly may from time to time request.



PART 3

MEDICAL PERFORMERS LIST

Interpretation
    
21.  - (1) For the purposes of this Part the prescribed description of performer is medical practitioner and the relevant body is the General Medical Council. (2) In this Part  - 

after the coming into force of article 10 of the 2003 Order, is entered on the GP Register.

Medical performers list
     22.  - (1) Subject to paragraphs (2) and (3) a medical practitioner may not perform any primary medical service, unless that medial practitioner is a general medical practitioner and his or her name is included in a medical performers list.

    (2) A medical practitioner who is provisionally registered under section 15, 15A or 21 of the Medical Act[
42], may perform primary medical service when the medical practitioner's name is not included in a medical performers list, but only whilst acting in the course of employment in a resident medical capacity in an approved medical practice (within the meaning of section 11(4) of that Act[43]).

    (3) A GP Registrar, who has applied in accordance with these Regulations to a Local Health Board for inclusion in its medical performers list may perform primary medical services, despite not being included in that performers list, until the first of the following events arises - 

    (4) In respect of any medical practitioner whose name is included in a medical performers list, the performers list shall include  - 

Application for inclusion in a medical performers list
     23.  - (1) In addition to the information required by regulation 4(2), the general medical practitioner when making an application for inclusion of the general medical practitioner's name in a medical performers list shall give the following information  - 

    (2) In addition to the undertakings required by regulation 4(3) the general medical practitioner shall give the following further undertakings  - 

    (3) The events to which this paragraph applies are - - 

    (4) If the medical practitioner is an armed forces GP, the medical practitioner shall not be required to give an undertaking pursuant to regulation 4(3)(e) (undertaking to participate in appraisal system).

Additional grounds for refusal
     24.  - (1) In addition to the grounds in regulation 6(1), a Local Health Board may also refuse to admit a medical practitioner to its medical performers list if  - 

    (2) In addition to the grounds in regulation 6(2), a Local Health Board shall also refuse to admit a medical practitioner to its medical performers list if  - 

    (3) For the purposes of regulation 6(2)(d), the day prescribed in this Part is 3rd November 2003 or, if that medical practitioner had been included in a medical list or a supplementary performers list, 26th August 2002.

    (4) Regulation 6(2)(a) (intention to work in the Local Health Board's area) shall not apply in the case of an armed forces GP.

    (5) In addition to checking the information provided by the doctor, as required by regulation 6(3)(a), the Local Health Board shall also check the information the doctor provided under regulation 23.

Requirements with which a doctor in a medical performers list must comply
     25. Regulation 9(6) (requirement to participate in appraisal system) shall not apply in the case of an armed forces GP, but in such a case the medical practitioner shall provide the Local Health Board with a copy of the annual appraisal undertaken by the Ministry of Defence or the armed forces, as the case may be.

Grounds for removal from a medical performers list
    
26.  - (1) Subject to paragraph (2) and in addition to the grounds in regulation 10(1), the Local Health Board must remove a medical practitioner from its performers list where it becomes aware that the medical practitioner is  - 

    (2) Paragraph (1)(c) shall not apply where a direction that a medical practitioner's registration is suspended is made in a health case.

    (3) For the purposes of regulation 10(1)(b), the day prescribed in this Part is 3rd November 2003 or, if that medical practitioner had been included in a medical performers list or a supplementary performers list, 26th August 2002.

    (4) Regulation 10(6) (power to remove for non-practice in the area) shall not apply in the case of an armed forces GP.

    (5) In calculating the period of 12 months under regulation 10(7) (periods to be disregarded), the Local Health Board shall disregard any period during which the doctor's registration or the doctor's entitlement to practise as such was suspended  - 

Additional decision that may be appealed
     27. A general medical practitioner may also appeal, under regulation 15, against a decision of the Local Health Board to refuse to include the general practitioner's name in its medical performers list under regulation 24(1).



Signed on behalf of the National Assembly for Wales under section 66(1) of the Government of Wales Act 1998[
56]


D. Elis-Thomas
The Presiding Officer of the National Assembly

30th March 2004



SCHEDULE 1

TRANSITIONAL AND CONSEQUENTIAL PROVISIONS


Interpretation
     1. In this Schedule  - 

and terms used in this Schedule shall bear the same meaning that they have in Part 2.

Allocation of medical practitioners on previous lists
     2. Subject to paragraph 7, in the case of a general medical practitioner, whose name, immediately before 1st April 2004, was included in a Local Health Board's  - 

the general medical practitioner's name shall, on that day, be included in its medical performers list.

     3. Subject to paragraphs 6 and 8, in the case of a general medical practitioner, whose name, immediately before 1st April 2004 was included in the medical list of more than one Local Health Board, his or her name shall, on that day, be included in the medical performers list of the Local Health Board in whose area the greatest number of the patients on the list of that medical practitioner resided immediately before that day.

     4. In a case to which paragraph 3 applies, if there is a doubt as to in which area the largest number of the patients on the list of that medical practitioner reside, the Local Health Boards involved shall agree between themselves, after considering any representations from the medical practitioner, as to in which medical performers list the medical practitioner shall be included.

     5. In any case where the Local Health Boards are unable to agree between themselves, in accordance with paragraphs 4 or 6, as to in which Local Health Board's medical performers list that medical practitioner shall be included the Assembly shall determine the matter, after considering any representations the medical practitioner made to any of those Local Health Boards.

     6. Subject to paragraph 8, in the case of a general medical practitioner, whose name, immediately before 1st April 2004 was included in the medical list of more than one Local Health Board, and on that day will be a party to a scheme to provide primary medical service to more than one of those Local Health Boards, the medical practitioner shall choose in which list the name of the medical practitioner shall be included.

Applications not decided on 1st April 2004
     7. Subject to paragraph 8, in any case where there was any application, including an application which the Local Health Board has deferred, by a medical practitioner to a Local Health Board for the medical practitioner's name to be included in its medical list, service list or supplementary list and that application has not been decided before 1st April 2004, it shall be deemed to be an application to have the medical practitioner's name included in the medical performers list of that Local Health Board.

     8. In a case where  - 

that application shall be void and the Local Health Board shall so notify the medical practitioner, informing the medical practitioner of the reason for that.

Matters relating to the medical practitioner
     9. Subject to paragraphs 7 and 8, in a case falling within paragraph 2, any matter, question or proceeding relating to any medical practitioner under the Medical Regulations, the Services List Regulations or the Supplementary List Regulations, that had not been finally decided before 1st April 2004, shall be treated as though it had arisen in relation to the medical performers list in which that medical practitioner has been included or, but for that matter, would have been included and shall continue to be dealt with by the Local Health Board.

     10. In a case where the services list, supplementary list or any medical list, on which the medical practitioner's name was included immediately before 1st April 2004, contained, in relation to the medical practitioner, any condition or contingent removal, or if the medical practitioner was then suspended from that list, that condition, contingent removal or suspension, as the case may be, shall equally apply to the medical performers list in which the medical practitioner's name is included and any national disqualification shall apply to the medical performers list on and after 1st April 2004 as it did, in relation to any other list, before that date.

     11. Subject to paragraph 12, in any case where there is any continuing matter and that matter had not been finally decided before 1st April 2004, it shall be treated as though it had arisen in relation to the medical performers list in which that medical practitioner has been included or, but for that matter, would have been included.

     12. In any case where there is a continuing matter and the medical performers list in which that medical practitioner's name is included is not that of the Initial Local Health Board, that matter shall proceed as though that name were included in the Initial Local Health Board's medical performers list.

Enhanced criminal record certificates
     13.  - (1) Where a medical practitioner's name has been included in a medical performers list of a Local Health Board pursuant to this Schedule, and  - 

the medical practitioner shall, within 3 months of the Local Health Board notifying the medical practitioner of that requirement, provide that certificate to it.

    (2) When sub-paragraph (1)(b) applies, the Local Health Board shall write to each such medical practitioner informing the medical practitioner that the medical practitioner is now under a duty to  - 

and, subject to sub-paragraph (3), if the medical practitioner has not provided it with such a certificate within that time, it shall remove the medical practitioner from its medical performers list.

    (3) Local Health Board  - 

Appeals to the FHSAA under Part II of the 2001 Rules
     14. Where  - 

that Local Health Board shall continue to be the respondent, even if the medical practitioner's name is from 1st April 2004, included in the medical performer's list of a different Local Health Board.

     15. Where  - 

that Local Health Board shall continue to be the respondent, even if the medical practitioner's name is, from 1st April 2004, included in the medical performer's list of a different local Health Board.

Applications to the FHSAA under Part III of the 2001 Rules
     16. Where the FHSAA  - 

the parties to that application shall, from the 1st April 2004, continue to be the medical practitioner who was a party immediately before the 1st April 2004 and the Initial Local Health Board.

General matters relating to cases under Part IV of the 2001 Rules
     17. Where a panel has  - 

in relation to any appeal falling within paragraph 17, those directions or varied directions shall continue to apply to the Initial Local Health Board, even if the medical practitioner's name is, on and after 1st April 2004, included in the medical performer's list of a different Local Health Board.

     18. Where a panel has, pursuant to rule 42 or 43 of the 2001 Rules, given a decision  - 

     19. Where the FHSAA has taken a decision before the 1st April 2004 which, by virtue of rule 46 of the 2001 Rules, it would, at the time it took that decision have been obliged to publish, that obligation shall continue on or after the 1st April 2004 if it has not published the decision immediately



SCHEDULE 2

REVOCATIONS


The following Regulations are hereby revoked  - 

The National Health Service (General Medical Services Supplementary List) (Wales) Regulations 2002[
59].



EXPLANATORY NOTE

(This note is not part of the Regulations)


These Regulations provide for lists for performing primary medical care to be kept by Local Health Boards in accordance with the provisions of section 28X of the National Health Service Act 1977.

Part I lays down general provisions relating to lists and regulation 2 provides some definitions for the Regulations.

Regulation 3 provides that each Local Health Board must prepare and publish lists.

Regulation 4 sets out how to apply to be included in the list and requires certain information to be given.

Regulation 5 provides for a performer to be readmitted to the list on a successful appeal against conviction.

Regulation 6 sets out the grounds on which the Local Health Board may or must refuse to admit a performer to the list, and the matters to which it must have regard.

Regulation 7 sets out the circumstances in which a Local Health Board may defer consideration of an application to include a performer in its list and the procedure to be followed.

Regulation 8 allows Local Health Boards to enter a performer's name in its list subject to condition. It also allows a performer's name to be included in that list, until any appeal has been decided, provided the performer agrees to be bound by the condition until the appeal is determined.

Regulation 9 provides for a requirement that a performer notify the Local Health Board in writing, within 7 days, if the performer, or a company of which the performer is a director, incurs any criminal convictions or other specified matters occur.

Regulation 10 provides for the mandatory removal from its list by a Local Health Board of any performer on certain specified grounds, and for the discretionary removal on other specified grounds.

Regulation 11 sets out the criteria for decisions on discretionary removals from the list.

Regulation 12 provides for a Local Health Board to impose conditions on a performer who is in the list and for the medical practitioner to be removed if the medical practitioner fails to comply with those conditions.

Regulation 13 provides for a Local Health Board to suspend a performer from its list, if certain conditions are met, for the procedure to be then followed and provides for payment to suspended performers.

Regulation 14 provides for review and the procedure to be followed by Local Health Boards where the Local Health Board decides to conditionally include, contingently remove, or suspend a performer from its list.

Regulation 15 provides for appeals from specified decisions to be heard by the FHSAA.

Regulation 16 provides for a Local Health Board to notify specified persons of specified information relating to decisions to refuse to admit, impose conditions, remove (or contingently remove) or suspend a performer from the list.

Regulation 17 provides for amendment of the list and withdrawal from the list and regulation 18 provides for the circumstances in which a performer may not withdraw from the list.

Regulation 19 amends the statutory period for review set out in section 49N of the National Health Service Act 1977 in specified circumstances.

Regulation 20 provides for the disclosure of information to specified persons.

Part II (regulations 21 to 27) modifies the general provisions in Part I to make provisions specific to general medical practitioners and regulation 21 provides some definitions for Part II.

Regulation 22 provides, subject to specified exceptions, that no general medical practitioner may perform any primary medical service unless included in such a list, what information is to be included in the list and that the list shall be published.

Regulation 23 supplements regulation 4 by providing for certain specific information to be provided by general medical practitioners.

Regulation 24 provides further grounds on which the Local Health Board may or must refuse to admit a general medical practitioner to its list, and matters to which it must have regard.

Regulation 25 provides an exception, subject to a further requirement, to the requirement to participate in an appraisal scheme provided by or on behalf of a Local Health Board.

Regulation 26 provides additional grounds for the mandatory removal from its list by a Local Health Board of a general medical practitioner, and modifies certain provisions for removal from a list in regulation 10.

Regulation 27 provides an additional ground of appeal for a general medical practitioner from those in regulation 15.

Schedule 1 makes transitional and consequential provisions.

Schedule 2 makes various revocations.


Notes:

[1] 1977 c.49; see section 128(1) as amended by the National Health Service and Community Care Act 1990 (c.19) ("the 1990 Act"), section 26(2)(g) and (i), for the definitions of "prescribed" and "regulations". Section 28X was inserted by the Health and Community Care (Community Health and Standards) Act 2003 (c.43 ) ("the 2003 Act"), s.179. Section 126(4) was amended by the 1990 Act, Schedule 4, paragraph 37(6) and by the 2001 Act, Schedule 5, paragraph 5(13)(b). As regards Wales, the functions of the Secretary of State under section 29 and 126(4) of the 1977 Act are transferred to the National Assembly for Wales under article 2 of, and Schedule 1 to, the National Assembly for Wales (Transfer of Functions) Order 1999, S.I. 1999/672; section 68 of the 2001 Act and section 197 of the 2003 Act provide that Schedule 1 shall be construed so as to include the amendments made by these Acts to the 1977 Act.back

[2] S.I. 2001/ 3744.back

[3] S.I. 2002/1920.back

[4] Section 49S was inserted by the 2001 Act, section 27(1) and amended by the 2002 Act, Schedule 2; provision corresponding to it may be made by virtue of the 2003 Act, section 28X(4).back

[5] Section 49H was inserted by the 2001 Act, section 25; section 49F was amended by the 2002 Act, Schedule 2, paragraph 21.back

[6] Section 49N was inserted by the 2001 Act, section 25 and amended by the 2002 Act, Schedule 2 paragraph 25. Corresponding provision may be made by virtue of the 1002 Act, section 28X(4).back

[7] S.I. 1992/635back

[8] The NCAA was established by S.I. 2000/2961; section 11 was amended by the 1995 Act, Schedule 1, paragraphs 1 and 2 and by the 1999 Act, section 65 and Schedule 4, paragraphs 4 and 6.back

[9] S.I. 2002/3039.back

[10] 1997 c.46.back

[11] 2002 c.17.back

[12] No Regulations have been made by the Assembly; the relevant Regulations for England are the National Health Service (Personal Medical Services)(Services Lists) and (General Medical Services) and (General Medical Services Supplementary List) Amendment Regulations 2003 SI2003/2644.back

[13] S.I. 2002/1882 (W.191) amended by S.I. 2002/2802(W.270).back

[14] Secton 49I was inserted by the 2001 Act, section 25 and amended by the 2002 Act, Schedule 2; provision corresponding to it may be made by virtue of the 2003 Act, section 18X(4).back

[15] Section 49J was inserted by the 2001 Act, section 25 and amended by the 2002 Act, Schedule 2; provision corresponding to it may be made by virtue of the 2003 Act, section 28X(4).back

[16] Section 43D was inserted by the 2001 Act, section 14 and amended by the 2002 Act, Schedule 2, and by the 2003 Act Schedule 11, paragraph 20.back

[17] Section 8ZA was inserted by the 2001 Act, section 26(2), and amended by the 2002 Act, Schedule 2.back

[18] Section 28DA was inserted by the 2001 Act, section 26(1) and amended by the 2002 Act, Schedule 2.back

[19] Section 46 was revoked by the 2001 Act, s. 67, Schedule 5, paragraph 5 and Schedule 6, part I.back

[20] See S.I. 2001/3738, article 2(5) and (6)(b), which sets out the prescribed cases for England and S.I. 2002/1919, article 2(2) and (3)(b), which sets out the prescribed cases for Wales.back

[21] 1997 c.50.back

[22] 1995 c. 46.back

[23] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[24] 1997 c.51.back

[25] 1995 c. 46.back

[26] 1992 c. 5; section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c. 47).back

[27] 1997 c.50.back

[28] 1984 c.22.back

[29] 1952 c.52.back

[30] 1997 c. 51.back

[31] Section 49N was inserted by the 2001 Act, section 25,and amedned by the 2002 Act, Schedule 2, paragraph 25 and the 2003, section 184 and Schedule 11, paragraph 24.back

[32] S.I. 2002/3135back

[33] S.I 2003/1250back

[34] Section 28C was inserted by the National Health Service (Primary Care) Act 1997, section 21(1) and amended by the 1999 Act, section 65(1) and Schedule 4, the 2001 Act, section 40 and Schedule 5 and the 2003 Act, section 180 and Schedule 11, paragraph 414.back

[35] Paragraph 19E is inserted by article 5(3) of the 2002 Order, with effect from such date as the Secretary of State may specify.back

[36] 1978 c.29back

[37] S.I. 1978/1907 (N.I. 26) or would have been so considered notwithstanding the repeal of the relevant provisionback

[38] S.I. 1994/3130.back

[39] Section 35 is inserted by article 8 of the 2002Order, with eddect from such date as the Secretary of State may specify.back

[40] 1983 c.54.back

[41] S.I. 1997/2817, as amended by S.I. 1998/669 and 2003/3148.back

[42] Relevant amendments to sections 15 and 21 are S.I. 1996/1591 and s. 41(10) of and paragraph 61(1) and (4) of Schedule 2 to the 1997 Act.back

[43] Relevant amendments are s. 35(1) and (4) of the 1997 Act.back

[44] S.I. 1994/3130, as amended by S.I. 1998/669 and 2003/3148.back

[45] S.I. 2004/1478 (W.78).back

[46] Section 36 was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 5 and by S.I. 2000/1803, articles 2 and 5.back

[47] Section 37 was amended by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 6 and by S.I. 2000/1803, articles 2 and 7.back

[48] Section 36A was inserted by the 1995 Act, section 1 and amended by S.I. 2000/1803, articles 2 and 6 and paragraph 5A of Schedule 4 was added by the 1995 Act, section 4 and Schedule 1, paragraphs 1 and 20.back

[49] Section 41A was inserted by S.I. 2000/1803, articles 2 and 10.back

[50] Section 35D is inserted by article 13 of the 2002 Order, with effect from such date as the Secretary of State may specifyback

[51] Schedule 4 is substituted by article 14 of the 2002 Order with effect from such date as the Secretary of State may specify.back

[52] Section 36 was amended by S.I. 2000/1803.back

[53] Section 38(1) was amended by the 1995 Act, section 4 and Schedule1, paragraphs 1 and 7.back

[54] Sections 35D and 38 inserted by article 13 of the 2002 Order, with effect from such dates as the Secretary of State may specify.back

[55] Schedule 4 is inserted by article 14 of the 2002 order, with effect from such date as the Secretary of State may specify.back

[56] 1998 c.38.back

[57] S.I. 2001/3750 as amended by S.I. 2002/1921 and 2469.back

[58] 1997 c.50.back

[59] S.I. 2002/1882 (W.191) as amended by S.I. 2002/2802 (W.270).back


ISBN 0 11090930 5


  © Crown copyright 2004

Prepared 15 April 2004


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