The National Health Service (Personal Medical Services Agreements) Regulations 2015

Regulation 24A

[F1SCHEDULE 2AE+WSuspension and reactivation of personal medical services agreements

InterpretationE+W

1.  In this Schedule—

“integrated care provider” means a person, other than a person specified in paragraph 3(3), who is party to an integrated care provider contract;

“integrated care provider contract” has the meaning given in paragraph 3.

Right to suspend a personal medical services agreementE+W

2.—(1) Where a contractor wishes to perform or provide primary medical services under an integrated care provider contract, the contractor must give notice in writing to [F2NHS England] of that intention in accordance with paragraph 4 and [F2NHS England] must agree to suspend the operation of the contractor’s agreement in accordance with the requirements of, and subject to the conditions set out in, this Schedule.

(2) [F2NHS England] must not suspend the contractor’s agreement until—

(a)the contractor has informed [F2NHS England] of the date on which the contractor intends to begin performing or, as the case may be, providing primary medical services under an integrated care provider contract; and

(b)[F2NHS England] has given notice in writing to each person on the contractor’s list of registered patients that—

(i)the contractor intends to perform or, as the case may be, provide primary medical services under an integrated care provider contract with effect from that date, and

(ii)the person will be transferred on to the list of registered service users of the integrated care provider on that date unless the person decides to register with another provider of primary medical services before that date.

(3) Where [F2NHS England] suspends the operation of a contractor’s agreement under sub-paragraph (1), the contractor is released from any obligation to provide primary medical services under that agreement to the contractor’s list of registered patients from the date on which that suspension takes effect.

Integrated care provider contractsE+W

3.—(1) For the purposes of this Schedule, an “integrated care provider contract” is a contract entered into on or after 1st April 2019 which satisfies the following sub-paragraphs.

(2) An integrated care provider contract must be between—

(a)one or more of the persons specified in sub-paragraph (3); and

(b)a person who is a provider of services specified in sub-paragraph (5).

(3) The persons specified in this sub-paragraph are—

(a)[F2NHS England];

(b)one or more [F3integrated care boards]; or

(c)one or more local authorities in England.

(4) An integrated care provider contract must—

(a)relate to the provision of two or more of the services specified in sub-paragraph (5); and

(b)not be a contract to which sub-paragraph (6) applies.

(5) The services specified in this sub-paragraph are—

(a)primary medical services;

(b)secondary care services;

(c)public health services; and

(d)adult social care services,

and include such services where they are provided under arrangements entered into by an NHS body or a local authority in England by virtue of section 75 of the Act.

(6) This sub-paragraph applies to a contract for the provision of primary medical services to which directions given by the Secretary of State under section 98A of the Act (exercise of functions) relating to the provision of alternative provider medical services under section 83(2) of the Act apply.

(7) In this paragraph—

“adult social care services” means services provided pursuant to the exercise of the adult social services functions of a local authority in England;

“adult social services functions” means social services functions within the meaning of section 1A of the Local Authority and Social Services Act 1970 so far as relating to persons aged 18 or over, excluding any function to which Chapter 4 of Part 8 of the Education and Inspections Act 2006 applies;

“primary medical services” means services which [F2NHS England] considers it appropriate to secure the provision of under section 83(2) of the 2006 Act (primary medical services);

“public health functions” means—

“public health services” are services which are provided pursuant to the exercise of public health functions;

“secondary care services” means—

(8) For the purposes of this paragraph, any of the following is a local authority in England—

(a)a county council;

(b)a county borough council;

(c)a district council;

(d)a London borough council;

(e)the Common Council of the City of London;

(f)the Council of the Isles of Scilly.

Notice of intention to suspend a personal medical services agreementE+W

4.  A notice under paragraph 2(1) must—

(a)state that the contractor wishes to suspend the agreement and specify the date on which the contractor would like the proposed suspension to take effect which must be a date which—

(i)falls at least one month after the date on which the notice was given, and

(ii)immediately precedes the date on which the contractor intends to begin performing or, as the case may be, providing primary medical services under the relevant integrated care provider contract;

(b)give the name of each person who is a party to the agreement who intends to perform or, as the case may be, provide primary medical services under an integrated care provider contract; and

(c)confirm that the contractor has agreed, as appropriate, to the suspension of the agreement.

Suspension of a personal medical services agreement: generalE+W

5.—(1) Subject to sub-paragraph (2), the suspension of an agreement is effective for a minimum period of two years beginning with the date on which that suspension takes effect which must be—

(a)the date specified in the notice given under paragraph 2(1); or

(b)such later date as [F2NHS England] may approve in the circumstances of a particular case.

(2) The suspension of an agreement is effective for a period of less than two years beginning with the date on which that suspension takes effect under sub-paragraph (1) only in a case where the relevant integrated care provider contract terminates or expires or is varied as described in paragraph 9(1) before the end of that period.

(3) Where [F2NHS England] suspends an agreement, the contractor may not receive payments from [F2NHS England] in respect of any period during which that agreement is suspended.

(4) [F2NHS England] must, before the end of the period of—

(a)three months beginning with the date on which the suspension of the agreement takes effect; or

(b)such longer period as may be agreed between [F2NHS England] and the contractor in the circumstances of a particular case,

pay the contractor any outstanding payments owed to the contractor in respect of the provision of primary medical services by the contractor under the agreement in accordance with the payment terms of that agreement.

(5) A contractor may not exercise the right to a general medical services contract which exists under regulation 32 in relation to a suspended agreement during any period in respect of which that agreement is suspended.

Notice of intention to reactivate a personal medical services agreementE+W

6.—(1) A notice under paragraph 7(1) must be given to [F2NHS England] by the contractor at least six months before the date on which the proposed reactivation of the agreement is to take effect.

(2) A notice under paragraph 7(1) must—

(a)state that the contractor wishes to reactivate the agreement and specify the date on which the contractor would like the proposed reactivation to take effect which must be a date which—

(i)falls at least six months after the date on which the notice was given, and

(ii)immediately follows the date on which the contractor intends to cease performing or, as the case may be, providing primary medical services under the relevant integrated care provider contract;

(b)give the name of each person who is a party to the agreement who intends to resume the provision of primary medical services under the agreement;

(c)confirm that the contractor has agreed, as appropriate, to the reactivation of the agreement; and

(d)if the contractor wishes to reactivate the agreement as a general medical services contract, state that this is the case and confirm that the parties to the agreement have agreed, as appropriate, to the reactivation of the agreement as a general medical services contract.

Right to reactivate a personal medical services agreementE+W

7.—(1) [F2NHS England] must reactivate an agreement under this paragraph where the contractor has given notice in writing to [F2NHS England] in accordance with paragraph 6 of the intention to reactivate the agreement in accordance with, and subject to the conditions set out in, this Schedule.

(2) [F2NHS England] must only reactivate an agreement under this paragraph with effect from—

(a)the date which falls on the second anniversary of the date on which the suspension of that agreement took effect; or

(b)subsequently, on a date which falls every two years after the date specified in paragraph (a) during the duration of the integrated care provider contract.

(3) [F2NHS England] must not reactivate an agreement which is of time limited duration where that agreement is to cease to have effect on a date which falls earlier than any of the dates specified in sub-paragraph (2)(a) or (b).

(4) Subject to paragraph 8(7), [F2NHS England] may reactivate a suspended agreement as a general medical services contract where, in respect of that agreement, the right to a general medical services contract under regulation 32 exists.

Reactivation of a personal medical services agreement: generalE+W

8.—(1) The reactivation of an agreement is effective on the date which falls immediately after the date on which the contractor ceases performing or, as the case may be, providing primary medical services under an integrated care provider contract which must be—

(a)the date specified in the notice given under paragraph 7(1); or

(b)such later date as [F2NHS England] may approve in the circumstances of a particular case.

(2) [F2NHS England] must not reactivate an agreement unless the conditions specified in sub-paragraph (3) are met.

(3) The conditions specified in this sub-paragraph are that—

(a)the contractor remains eligible to hold an agreement in accordance with the conditions set out in regulation 5 at the date on which the reactivation of the agreement is to take effect; and

(b)[F2NHS England] is satisfied that, during the period in which the contractor’s agreement was suspended, the contractor has not acted or failed to act in a manner that gives rise to [F2NHS England’s] right to terminate the agreement under any of the provisions of Part 8 of Schedule 2.

(4) Where the reactivation of the contractor’s agreement is intended to take effect on the second anniversary of the date on which the suspension of that agreement took effect, [F2NHS England] must notify in writing each person who resides in the contractor’s former practice area and who was on the list of registered service users of the integrated care provider that—

(a)the contractor intends to resume the provision of primary medical services under the agreement in respect of people who reside in the contractor’s former practice area from the date specified in the notice; and

(b)if the person was on the contractor’s list of registered patients immediately prior to the date on which the suspension of the contractor’s agreement took effect, the person will transfer onto the contractor’s list of registered patients from the date specified in the notice unless the person decides to remain registered with the integrated care provider or registers with another provider of primary medical services before that date.

(5) Where the reactivation of the contractor’s agreement is intended to take effect after the second anniversary of the date on which the suspension of that agreement took effect, [F2NHS England] must notify in writing each person who resides in the contractor’s former practice area and who was on the list of registered service users of the integrated care provider that—

(a)the contractor intends to resume the provision of primary medical services under the agreement in respect of people who reside in the contractor’s former practice area from the date specified in the notice; and

(b)the person will remain on the list of registered service users of the integrated care provider from the date specified in the notice unless the person decides to register with the contractor or with another provider of primary medical services before that date.

(6) Where a suspended agreement is reactivated by [F2NHS England], the terms of that agreement which are to apply are those terms which are effective at the date on which the reactivation takes effect, subject to any variation of those terms which may be agreed between the contractor and [F2NHS England], including in respect of the right to a general medical services contract under regulation 32.

(7) [F2NHS England] must not reactivate a suspended agreement as a general medical services contract unless—

(a)the parties to that agreement have agreed, as appropriate, to the reactivation of that agreement as a general medical services contract; and

(b)[F2NHS England] is satisfied that—

(i)during the period in which the contractor’s agreement was suspended, the contractor has not acted or failed to act in a manner that gives rise to [F2NHS England’s] right to terminate the agreement under any of the provisions of Part 8 of Schedule 2; and

(ii)the parties to that agreement are eligible to hold a general medical services contract in accordance with the conditions set out in regulations 5 and 6 of the General Medical Services Contracts Regulations at the date on which the reactivation of the agreement as a general medical services contract is to take effect.

Termination, expiry or variation of an integrated care provider contractE+W

9.—(1) Where, at any time, an integrated care provider contract terminates or expires or is varied so that it no longer requires the integrated care provider to provide primary medical services to people who reside in a contractor’s former practice area—

(a)[F2NHS England] must, subject to the conditions specified in paragraph 8(3), reactivate the contractor’s agreement with effect from the date which falls immediately after the date on which the integrated care provider contract terminated or, as the case may be, expired or was varied; and

(b)the contractor must, with effect from that date, resume the provision of primary medical services under the agreement to people who reside in the contractor’s former practice area.

(2) Where an integrated care provider contract terminates or expires or is varied as described in sub-paragraph (1), [F2NHS England] must notify in writing each person who resides in the contractor’s former practice area and who was on the list of registered service users of the integrated care provider immediately before the date on which the integrated care provider contract terminated or, as the case may be, expired or was varied that—

(a)the contractor has resumed providing primary medical services under the agreement from a specified date in respect of people who reside in the contractor’s former practice area; and

(b)the person will transfer onto the contractor’s list of registered patients from the date specified unless the person decides to register with another provider of primary medical services before that date.]