RHAN 1CYFFREDINOL

Enwi, cychwyn, cymhwyso a dehongli

1.—(1) Enw'r Rheoliadau hyn yw Rheoliadau'r Gwasanaeth Iechyd Gwladol (Gwasanaethau Meddygol Sylfaenol) (Diwygiadau Amrywiol) (Cymru) 2006 a deuant i rym ar 1 Mawrth 2006.

(2) Mae'r Rheoliadau hyn yn gymwys o ran Cymru.

(3) Yn y Rheoliadau hyn—

• ystyr “Rheoliadau Contractau GMS (Cymru)” yw Rheoliadau'r Gwasanaeth Iechyd Gwladol (Contractau Gwasanaethau Meddygol Cyffredinol) (Cymru) 2004(3); ac

• ystyr “Rheoliadau Rhestri Perfformwyr (Cymru)” yw Rheoliadau'r Gwasanaeth Iechyd Gwladol (Rhestri Perfformwyr) (Cymru) 2004(4).

RHAN 2DIWYGIO RHEOLIADAU CONTRACTAU GMS (CYMRU)

Diwygio rheoliad 2 o Reoliadau Contractau GMS (Cymru)

2.—(1) Diwygier rheoliad 2(1) (dehongli) o Reoliadau Contractau GMS (Cymru) fel a ddarperir yn y paragraffau canlynol.

(2) Yn y diffiniad o “adjudicator” yn lle “paragraph 101(5)” rhodder “paragraph 99(5)”.

(3) Yn y diffiniad o “bank holiday”, ar ôl “proclaimed as a bank holiday” mewnosoder “in England and Wales”.

(4) Yn y diffiniad o “general medical practitioner”—

(a)ar ôl “means” mewnosoder “, unless the context otherwise requires”;

(b)ym mharagraff (a), hepgorer “otherwise than by virtue of paragraph 1(d) of Schedule 6 of that Order”;

(c)ym mharagraff (b)(i), ar ôl “Health and Personal Social Services (Northern Ireland) Order 1978”, mewnosoder “or a person who has an acquired right to practise as a general medical practitioner pursuant to regulation 5(1)(d) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994(5)”; ac

(ch)ym mharagraff (b)(ii), hepgorer “other than by virtue of having an acquired right under paragraph (1)(d) of Schedule 6 to the 2003 Order”.

(5) Yn lle'r diffiniad o “GP Registrar”, rhodder—

““GP Registrar” means a medical practitioner who is being trained in general practice by—

(6) Hepgorer y diffiniad o “GP Trainer”.

(7) Yn y diffiniad o “immediate family member”, ar ôl “spouse” mewnosoder “or civil partner”.

(8) Hepgorer y diffiniad o “NCAA”.

(9) Ar ôl y diffiniad o “normal hours” mewnosoder—

““NPSA” means the National Patient Safety Agency established as a Special Health Authority by the National Patient Safety Agency (Establishment and Constitution) Order 2001(7)”.

(10) Yn y diffiniad o “out of hours services”, ym mharagraff (a), ar ôl “if provided” mewnosoder “by a contractor to its registered patients”.

(11) Yn y diffiniad o “supplementary prescriber”—

(a)Ym mharagraff (b)(ii), hepgorer “or”;

(b)Ym mharagraff (b)(iii), hepgorer “and”; ac

(c)Ar ôl paragraph (b)(iii), mewnosoder-

“(iv)the part of the register maintained by the Health Professions Council in pursuance of article 5 of the Health Professions Order 2001(8) relating to-

(aa)chiropodists and podiatrists;

(bb)physiotherapists; or

(cc)radiographers: diagnostic or therapeutic, or

(v)the register of optometrists maintained by the General Optical Council in pursuance of section 7 of the Opticians Act 1989(9), and”;

(ch)Ym mharagraff (c), ar ôl “an annotation” mewnosoder “or entry”.

Diwygio rheoliad 4 o Reoliadau Contractau GMS (Cymru)

3.  Yn rheoliad 4 (amodau sy'n ymwneud yn unig ag ymarferwyr meddygol) o Reoliadau Contractau GMS (Cymru), ychwaneger—

“(4) In paragraph (1), (2)(a) and (3)(a), “general medical practitioner” does not include—

(a)from the coming into force of article 10 of the 2003 Order, a medical practitioner whose name is included in the General Practitioner Register by virtue of—

(i)paragraph 1(a) of Schedule 6 to that Order by virtue of the practitioner having been a restricted services principal included in a list specified in that paragraph,

(ii)paragraph 1(d) of that Schedule, or

(iii)article 11(2) of that Order because of an exemption under regulation 5(1)(d) of the regulations specified in paragraph (5);

(b)until the coming into force of article 10 of the 2003 Order, a medical practitioner who either—

(i)until the coming into force of paragraph 22 of Schedule 8 to that Order—

(aa)has an acquired right to practise as a general medical practitioner pursuant to regulation 5(1)(a) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994(10) only by virtue of having been a restricted services principal included in a list specified in that paragraph, or regulation 5(1)(d) of those Regulations; or

(bb)is exempt from the need to be suitably experienced by virtue of regulation 5(1)(d) of the regulations specified in paragraph (5), or

(ii)upon the coming into force of that paragraph of that Schedule to that Order, is an eligible general practitioner pursuant to that paragraph by virtue of an acquired right under the provisions listed in sub-paragraph (a)(i) to (iii).

(5) The regulations referred to in paragraph (4)(a)(iii) and (b)(i)(bb) are the National Health Service (Vocational Training for General Medical Practice) Regulations 1997(11), the National Health Service (Vocational Training for General Medical Practice) (Scotland) Regulations 1998(12) and the Medical Practitioners (Vocational Training) Regulations (Northern Ireland) 1998(13).

(6) In paragraph (4), “restricted services principal” has the same meaning as in the 2003 Order(14).”.

Diwygio rheoliad 5 o Reoliadau Contractau GMS (Cymru)

4.—(1) Yn rheoliad 5(2)(h) (amodau cyffredinol sy'n ymwneud â phob contract) o Reoliadau Contractau GMS (Cymru) yn lle “the Criminal Procedure Act (Scotland) 1995” rhodder “the Criminal Procedure (Scotland) Act 1995”.

(2) Yn rheoliad 5(2)(j) o Reoliadau Contractau GMS (Cymru) mewnosoder ar y dechrau “within the period of five years prior to signing the contract or commencement of the contract, whichever is the earlier,”.

Diwygio rheoliad 10 o Reoliadau Contractau GMS (Cymru)

5.  Yn rheoliad 10(2) (statws corff gwasanaeth iechyd) o Reoliadau Contractau GMS (Cymru) yn lle “body that fact, it” rhodder “body, that fact”.

Diwygio rheoliad 17 o Reoliadau Contractau GMS (Cymru)

6.  Yn rheoliad 17 (ymeithrio o wasanaethau ychwanegol a thu allan i oriau) o Reoliadau Contractau GMS (Cymru) yn lle “paragraph 4(8)” rhodder “paragraph 4(9)”.

Diwygio rheoliad 22 o Reoliadau Contractau GMS (Cymru)

7.  Yn rheoliad 22 (cyllid), o Reoliadau Contractau GMS (Cymru) ym mharagraff (1), yn lle “the Local Health Board to make payments to the contractor”, rhodder, “payments to be made”.

Diwygio rheoliad 23 o Reoliadau Contractau GMS (Cymru)

8.  Yn rheoliad 23 (cyllid) o Reoliadau Contractau GMS (Cymru)—

(i)yn lle “Assembly's” rhodder “(Assembly's”;

(ii)dileer “payments”.

Diwygio rheoliad 24 o Reoliadau Contractau GMS (Cymru)

9.  Yn rheoliad 24(4) (ffïoedd a thaliadau) o Reoliadau Contractau GMS (Cymru) yn lle “paragraph (e)” rhodder “paragraph 1(e)”.

Diwygio Atodlen 2 i Reoliadau Contractau GMS (Cymru)

10.—(1) Diwygier Atodlen 2 (gwasanaethau ychwanegol) i Reoliadau Contractau GMS (Cymru) fel a ddarperir yn y paragraffau canlynol.

(2) Ym mharagraff 2 (sgrinio ceg y groth), yn is-baragraff (2), yn lle paragraff (a) rhodder—

“(a)the provision of any necessary information and advice to assist relevant patients in making an informed decision as to participation in the Cervical Screening Wales Programme undertaken by Velindre NHS Trust;”

(3) Ar ôl is-baragraff (2) o baragraff 2 mewnosoder—

“(2A) For the purposes of paragraph (2) “relevant patients” means female patients on the contractor’s patient list who have been identified by Velindre NHS Trust as suitable candidates for a cervical screening test.”

(4) Ym mharagraff 4 (brechiadau ac imiwneiddio) o Atodlen 2 i Reoliadau Contractau GMS (Cymru), ym mharagraff (2)(a), yn lle “influenza vaccination” rhodder “influenza and pneumococcal vaccinations”.

Diwygio Atodlen 6 i Reoliadau Contractau GMS (Cymru)

11.—(1) Diwigier Atodlen 6 (telerau contractol eraill) i Reoliadau Contractau GMS (Cymru) fel a ddarperir yn y paragraffau canlynol.

(2) Ar ôl paragraff 1 (mangreoedd), mewnosoder—

“Telephone services

1A.—(1) From 1 April 2006 the contractor shall not be a party to any contract or other arrangements under which the number for telephone services to be used—

(a)by patients to contact the practice for any purpose related to the contract; or

(b)by any other person to contact the practice in relation to services provided as part of the health service,

starts with the digits 087, 090 or 091 or consists of a personal number, unless the service is provided free to the caller.

(2) In this paragraph, “personal number” means a telephone number which starts with the number 070 followed by a further 8 digits.”.

(3) Ym mharagraff 7 (adroddiadau clinigol), ar y diwedd mewnosoder—

“(3) This paragraph does not apply in relation to out of hours services provided by a contractor on or after 1 March 2006.”.

(4) Ym mharagraff 11 (safonau ar gyfer gwasanaethau y tu allan i oriau) ar ôl y gair “must” mewnosoder y geiriau “have regard to” a hepgorer y gair “meet”.

(5) Ar ôl paragraff 11 (safonau ar gyfer gwasanaethau y tu allan i oriau), mewnosoder—

“Supply of medicines etc. by contractors providing out of hours services

11A.—(1) In this paragraph—

“the Charges Regulations” means the National Health Service (Charges for Drugs and Appliances) (Wales) Regulations 2001(15);

“complete course” means the course of treatment appropriate to the patient’s condition, being the same as the amount that would have been prescribed if the patient had been seen during core hours;

“necessary drugs, medicines and appliances” means those drugs, medicines and appliances which the patient requires and for which, in the reasonable opinion of the contractor, and in the light of the patient’s medical condition, it would not be reasonable in all the circumstances for the patient to wait until such time as he or she could obtain them during core hours;

“out of hours performer” means a prescriber, a person acting in accordance with a Patient Group Direction or any other health professional employed or engaged by the contractor who can lawfully supply a drug, medicine or appliance, who is performing out of hours services under the contract;

“Patient Group Direction” has the same meaning as in the Prescription Only Medicines (Human Use) Order 1997(16); and

“supply form” means a form provided by a Local Health Board and completed by or on behalf of the contractor for the purpose of recording the provision of drugs, medicines or appliances to a patient during the out of hours period.

(2) Where a contractor whose contract includes the provision of out of hours services has agreed with the Local Health Board that its contract should also include the supply of necessary drugs, medicines and appliances to patients at the time that it is providing them with out of hours services, the contractor shall comply with the requirements in sub-paragraphs (3) to (5).

(3) The contractor shall ensure that an out of hours performer—

(a)only supplies necessary drugs, medicines and appliances;

(b)supplies the complete course of the necessary medicine or drug required to treat the patient; and

(c)does not supply—

(i)drugs, medicines or appliances which he or she could not lawfully supply,

(ii)appliances which are not listed in Part IX of the Drug Tariff,

(iii)restricted availability appliances, except where the patient is a person, or it is for a purpose, specified in the Drug Tariff, or

(iv)a drug, medicine or other substance listed in Schedule 1 to the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc) (Wales) Regulations 2004(17), or a drug, medicine or other substance listed in Schedule 2 to those Regulations other than in the circumstances specified in that Schedule.

(4) The out of hours performer shall record on a separate supply form for each patient any drugs, medicines or appliances supplied to the patient provided that a single supply form may be completed where the out of hours performer supplies necessary drugs, medicines or appliances to two or more persons in a school or other institution in which at least 20 persons normally reside, when the out of hours performer may write on the supply form the name of the school or institution rather than the name of the individual patient.

(5) The out of hours performer shall—

(a)ask any person who makes a declaration that the patient does not have to pay the charges, specified in or payable by virtue of regulation 4(1) of the Charges Regulations(18), by virtue of either—

(i)entitlement to exemption under regulation 8(1) of the Charges Regulations, or

(ii)entitlement to remission of charges under regulation 3 of the National Health Service (Travelling Expenses and Remission of Charges) Regulations 1988(19),

to produce satisfactory evidence of such entitlement, unless the declaration is in respect of entitlement to exemption by virtue of regulation 8(1) of the Charges Regulations, and at the time of the declaration the out of hours performer already has such evidence available to him or her; and

(b)if no satisfactory evidence is produced to him or her (and, where it is relevant, none is already available to him or her as mentioned in paragraph (a)), endorse the supply form to that effect.

(6) Subject to paragraph (7), nothing in this paragraph shall prevent an out of hours performer supplying a Scheduled drug or a restricted availability appliance in the course of treating a patient under a private arrangement.

(7) The provisions of regulation 24 (fees and charges) apply in respect of the supply of necessary drugs, medicines and appliances as they apply in respect of prescriptions for drugs, medicines and appliances. ”.

(6) Ym mharagraff 19 (tynnu oddi ar y rhestr ar gais y claf) yn is-baragraf (5), yn lle “(9), 21(6) and (7), 23 and 26,” rhodder “(10), 21(6) and (7), 23, 26 and 28”.

(7) Ym mharagraff 31 (gwrthod hysbysiad cau gan y Bwrdd Iechyd Lleol), ar ôl is-baragraff (8) mewnosoder—

“(8A) Subject to sub-paragraph (8B), the contractor’s list of patients shall remain closed for the period specified by the assessment panel in accordance with sub-paragraph (8)(b).

(8B) The contractor’s list of patients shall re-open before the expiry of the period mentioned in sub-paragraph (8A) if—

(a)the number of the contractor’s registered patients falls to the number specified by the assessment panel in accordance with sub-paragraph (8)(b) as the number of registered patients which, if that number were reached, would trigger the re-opening of the contractor’s list of patients; or

(b)the Local Health Board and the contractor agree that the list of patients should re-open.

(8C) If the contractor’s list of patients has re-opened pursuant to sub-paragraph (8B)(a), it shall nevertheless close again if, during the period specified by the assessment panel as the period for which the list should remain closed, the number of the contractor’s registered patients rises to the number specified by the assessment panel in accordance with sub-paragraph (8)(b) as the number of registered patients which, if that number were reached, would trigger the re-closure of the contractor’s list of patients.

(8D) Except in cases where the contractor’s list of patients is already open pursuant to paragraph (8B), the Local Health Board shall notify the contractor in writing between seven and fourteen days before the expiry of the closure period specified in paragraph (8A), confirming the date on which the contractor’s list of patients will re-open.”.

(8) Ym mharagraff 36 (aseiniadau i restri caeedig: gweithdrefn datrys anghydfod y GIG ynghylch penderfyniadau'r panel asesu), yn is-baragraff (13) yn lle “him” rhodder “it”.

(9) Ym mharagraff 40 (gwasanaethau presgripsiynau y mae modd eu rhoi'n aml), yn is-baragraff (2), hepgorer paragraff (a).

(10) Ym mharagraff 43 (cyfyngu ar ragnodi gan ragnodwyr atodol) hepgorer is-baragraffau (2)(b), (4)(c) ac (f) a (6).

(11) Ym mharagraff 48 (cydsynio i weinyddu), yn is-baragraff (6)(a), yn lle “paragraph (2)” rhodder “paragraph (1)(c)”.

(12) Ym mharagraff 49 (telerau ynghylch darparu gwasanaethau gweinyddu), yn lle is-baragraff (8) rhodder—

“(8) A contractor providing dispensing services shall comply with paragraph 36 (terms of service for doctors who provide pharmaceutical services) of Schedule 2 to the Pharmaceutical Regulations, as if modified as follows—

(a)for “paragraph 34(1)” substitute “paragraph 49(4) of Schedule 6 to the GMS Regulations”;

(b)for “paragraph 35(a)” substitute “paragraph 49(2)(a) of Schedule 6 to the GMS Regulations”;

(c)for “a doctor who is authorised or required by the Local Health Board under regulation 20 to provide drugs and appliances to a patient”, substitute “a contractors providing dispensing services to a patient”; and

(d)for “doctor”, in both places where it appears substitute “medical practitioner”.”.

(13) Ym mharagraff 52 (cymwysterau perfformwyr), yn is-baragraff (2)—

(a)yn lle paragraff (c) rhodder—

“(c)a GP Registrar who has applied to a Local Health Board to have his or her name included in its medical performers list until the first of the following events arises—

(i)the Local Health Board notifies him or her of its decision on that application; or

(ii)the end of a period of two months, starting with the date on which his or her vocational training scheme began.”; a

(b)ar y diwedd, ychwaneger—

“(3) In this paragraph, “vocational training scheme” has the meaning given in regulation 21(2) of the National Health Service (Performers Lists) (Wales) Regulations 2004(20).”.

(14) Ym mharagraff 63 (trefniadau ar gyfer Cofrestryddion Ymarferwyr Cyffredinol), yn is-baragraff (1), hepgorer “for the purpose of being trained by a GP Trainer with the agreement of the Assembly and”.

(15) Ym mharagraff 67 (arfarnu ac asesu), yn is-baragraff (1)(b), yn lle “NCAA” rhodder “NPSA”.

(16) Ym mharagraff 71, yn lle is-baragraff (2) rhodder—

“(2) A notice served under sub-paragraph (1) shall take effect on the date on which it is received by the contractor.”.

(17) Ym mharagraff 72 (cofnodion cleifion), yn is-baragraff (4)(c), yn lle ““Good Practice Guidelines for General Practice Electronic Patient Records” published on 26 September 2003”, rhodder, ““Good Practice Guidelines for General Practice Electronic Patient Records (Version 3.1)” published on 29 July 2005(21).”

(18) Hepgorer paragraff 73 (mynediad i gofnodion at ddiben y Cynllun Paratoi Gwybodaeth o Ansawdd).

(19) Ym mharagraff 76 (darparu gwybodaeth), ar y diwedd mewnosoder—

“(3) The contractor shall produce the information requested, or, as the case may be, allow access to it—

(a)by such date as has been agreed as reasonable between the contractor and the Local Health Board; or

(b)in the absence of such agreement, within 28 days of the request being made.”.

(20) Ym mharagraff 79 (ffurflen ac adolygiad blynyddol)—

(a)ar ôl is-baragraff (1), mewnosoder—

“(1A) Subject to article 50 (annual returns and reviews) of the General Medical Services Transitional and Consequential Provisions (Wales) (No.2) Order 2004(22), one such return may be requested by the Local Health Board at any time during each financial year in relation to such period (not including any period covered by a previous annual return) as may be specified in the request.

(1B) The contractor shall submit the completed return to the Local Health Board—

(a)by such date as has been agreed as reasonable between the contractor and the Local Health Board; or

(b)in the absence of such agreement, within 28 days of the request being made.”; a

(b)ar y diwedd mewnosoder—

“(6) In this paragraph, “financial year” means the twelve months ending with 31 March.”.

(21) Ym mharagraff 83 (darpariathau hysbysu sy'n benodol i gontract gyda chwmni cyfyngedig gan gyfrannau)—

(a)yn is-baragraff (1), ar ôl paragraff (a) mewnosoder—

“(aa)a new director or secretary is appointed;”; a

(b)ar ôl is-baragraff (2), mewnosoder—

“(3) A notice under sub-paragraph (1)(aa) shall confirm that the new director or, as the case may be, secretary meets the conditions imposed on directors and secretaries by virtue of regulation 5.”.

(22) Ym mharagraff 89 (mynd i mewn ac arolwg gan Gomisiwn Archwilio ac Arolygu Gofal Iechyd a chan Gynulliad Cenedlaethol Cymru) yn lle “enter and inspect the premises in accordance with section 66 and 73” rhodder “exercise their functions in accordance with sections 66, 67, 72 and 73”.

(23) Ym mharagraff 96 (darparu gwybodaeth am gwynion)—

(a)ailrifer y ddarpariaeth bresennol fel is-baragraff (1); a

(b)ar ôl y ddarpariaeth honno, mewnosoder—

“(2) This paragraph does not apply in relation to out of hours services provided by a contractor on or after 1 March 2006.”.

(24) Ym mharagraff 99 (gweithdrefn datrys anghydfod y GIG), yn is-baragraff (6), ar ôl “the matter”, yn y ddau le y digwydd, mewnosoder “under dispute”.

(25) Ym mharagraff 102 (amrywio contract: yn gyffredinol) yn is-baragraff (1) mewnosoder coma ar ôl “Schedule 3” a'r geiriau “of this Schedule” ar ôl “115”.

(26) Ym mharagraff 103 (amrywio darpariaethau sy'n benodol i gontract gydag ymarferydd meddygol sy'n unigolyn) yn is-baragraff (2), o flaen “proposing” mewnosoder “is”.

(27) Ym mharagraff 104 (amrywio darpariaethau sy'n benodol i gontract gyda dau unigolyn neu fwy sy'n ymarfer mewn partneriaeth)—

(a)yn is-baragraff (4), hepgorer y geiriau o “sub-paragraphs (1), (2) and (3)” hyd at y diwedd ac yn eu lle rhodder “the remaining individual shall notify the Local Health Board in writing as soon as is reasonably practicable of the death of his partner and sub-paragraph (4A) or (4B) shall apply.”;

(b) ar ôl is-baragraph (4), mewnosoder—

“(4A) If the remaining individual is a general medical practitioner, the contract shall continue with that individual.

(4B) If sub-paragraph (4A) does not apply, the Local Health Board may, if it thinks fit, serve notice in writing on the remaining individual confirming that the Local Health Board will allow the contract to continue with that individual, for a period specified by the Local Health Board of up to six months (the “interim period”) provided that he or she consents to the Local Health Board employing or supplying a general medical practitioner to him or her for the interim period to assist in the provision of clinical services under the contract.

(4C) Before deciding whether to serve a notice pursuant to paragraph (4B), the Local Health Board shall, whenever it is reasonably practicable to do so, consult the Local Medical Committee (if any) for its area.

(4D) If, during the interim period, the contractor withdraws his or her consent to the Local Health Board employing or supplying a general medical practitioner, the Local Health Board shall serve notice in writing on the contractor terminating the contract forthwith.

(4E) If, at the end of the interim period, the contractor has not entered into partnership with a general medical practitioner who is not a limited partner, the Local Health Board shall serve notice on the contractor terminating the contract forthwith.”;

(c)yn is-baragraffau (5) a (6), yn lle “(4)(b)” rhodder “(4)”; ac

(ch)ar ôl is-baragraff (7), ychwaneger—

“(8) In this paragraph, “general medical practitioner” has the same meaning as in regulation 4(1).”.

(28) Ar ôl paragraff 105 (terfynu drwy gytundeb), mewnosoder—

“Termination on the death of an individual medical practitioner

105A.—(1) Where the contract is with an individual medical practitioner and that practitioner dies, the contract shall terminate at the end of the period of seven days after the date of the practitioner’s death unless, before the end of that period—

(a)the Local Health Board has agreed in writing with the contractor’s personal representatives that the contract should continue for a further period, not exceeding 28 days after the end of the period of seven days; and

(b)the contractor’s personal representatives have consented in writing to the Local Health Board employing or supplying one or more general medical practitioners to assist in the provision of general medical services under the contract throughout the period for which it continues.

(2) In sub-paragraph (1), “general medical practitioner” has the same meaning as in regulation 4(1).

(3) Sub-paragraph (1) does not affect any other rights to terminate the contract which the Local Health Board may have under paragraphs 112 to 115.”.

(29) Ym mharagraff 109 (terfynu gan y Bwrdd Iechyd Lleol am dorri amodau yn rheoliad 4)—

(a)yn is-baragraff (1), mewnosoder ar y dechrau “Subject to sub-paragraph (1A),”;

(b)ar ôl is-baragraff (1) mewnosoder—

“(1A) Where the failure of an individual medical practitioner to continue to satisfy the condition specified in regulation 4(1) is the result of a suspension specified in sub-paragraph (3B), sub-paragraph (1) shall not apply unless—

(a)the contractor is unable to satisfy the Local Health Board that it has in place adequate arrangements for the provision of clinical services under the contract for so long as the suspension continues; or

(b)the Local Health Board is satisfied that the circumstances of the suspension are such that if the contract is not terminated forthwith—

(i)the safety of the contractor’s patients is at serious risk, or

(ii)the Local Health Board is at risk of material financial loss.”;

(c)yn is-baragraff (2), mewnosoder ar y dechrau “Except in a case to which paragraph 106(4) applies,”;

(ch)yn is-baragraff (3), yn lle “of up to six months” rhodder “in accordance with paragraph (3A)”;

(d)ar ôl is-baragraff (3) mewnosoder—

“(3A) The period specified by the Local Health Board under sub-paragraph (3)(b) shall not exceed—

(a)six months; or

(b)in a case where the failure of the contractor to continue to satisfy the condition in regulation 4(2)(a) or, as the case may be, 4(3)(a), is the result of a suspension referred to in subparagraph (3B), the period for which that suspension continues.

(3B) The suspensions referred to in sub-paragraphs (1A) and (3A)(b) are suspension—

(a)by a Fitness to Practise Panel under—

(i)section 35D (functions of a fitness to practise panel) of the Medical Act 1983(23) in a health case, other than an indefinite suspension under section 35D(6), or

(ii)section 38(1) (power to order immediate suspension etc after a finding of impairment of fitness to practise) of that Act; or

(b)by a Fitness to Practise Panel or an Interim Orders Panel under section 41A (interim orders) of that Act.

(3C) In paragraph (3B), “health case” has the meaning given in section 35E(4) of the Medical Act 1983”; ac

(e)ar ôl is-baragraff (6), ychwaneger—

“(7) In sub-paragraphs (3) and (5), “general medical practitioner” has the same meaning as in regulation 4(1).”.

(30) Ym mharagraff 110 (terfynu gan y Bwrdd Iechyd Lleol am roi gwybodaeth anwir etc.) yn lle'r geiriau “by the contractor before the contract” i'r diwedd rhodder—

• “by the contractor—

  (a)

  before the contract was entered into; or

  (b)

  pursuant to paragraph 85(2) or (3) or 86(2),

  in relation to the conditions set out in regulations 4 and 5 (and compliance with those conditions) was, when given, untrue or inaccurate in a material respect.”.

(31) Ym mharagraff 111 (seiliau eraill dros derfynu gan y Bwrdd Iechyd Lleol)—

(a)yn is-baragraff (1) ar ôl “the existence of the contract” mewnosoder “or, if later, on or after the date on which a notice in respect of his or her compliance with the conditions in regulation 5 was given under paragraph 85(2) or (3) or 86(2)”.

(b)yn is-baragraff (2)(e) yn lle “efficiency” rhodder “inefficiency”.

(32) Ym mharagraff 117 (terfynu a gweithdrefn datrys anghydfod y GIG), yn is-baragraff (1), yn lle “or 113(4) or (6)” rhodder “113(4) or (6) or 114(2)”.

(33) Ym mharagraff 120 (yswiriant), yn is-baragraff (3)(b) yn lle “an employee of its in connection with clinical services which that employee” rhodder “a person employed or engaged by it in connection with clinical services which that person”.

(34) Ym mharagraff 122 (rhoddion), yn is-baragraff (2)(f), ar ôl “spouse” mewnosoder “or civil partner”.

Diwygio Atodlen 7 i Reoliadau Contractau GMS (Cymru)

12.  Ym mharagraff 5 (tynnu cymeradwyaeth yn ôl ar unwaith ac eithrio ar ôl adolygiad)—

(i)yn is-baragraff (2) yn lle “(1)(b) and (c)” rhodder “(1)(a) and (b)”;

(ii)yn is-baragraff (3) yn lle “1(c)” rhodder “(1)(b)”.

Diwygio Atodlen 9 i Reoliadau Contractau GMS (Cymru)

13.  Hepgorer Atodlen 9 (Byrddau Iechyd Lleol a bennir at ddibenion presgripsiynau y mae modd eu rhoi yn aml) i Reoliadau Contractau GMS (Cymru).

RHAN 3DARPARIAETH DROSIANNOL

Darpariaeth Drosiannol ynghylch rheoliad 4 o Reoliadau Contractau GMS (Cymru)

14.—(1) Mae'r rheoliad hwn yn gymwys, o ran contract gwasanathau cyffredinol yr ymrwymwyd iddo cyn 1 Mawrth 2006, os yw'r unig berson a oedd yn cael ei gyfrif fel yr ymarferydd meddygol cyffredinol at ddibenion rheoliad 4(1), (2)(a) neu (3)(a) o Reoliadau Contractau GMS (Cymru) yn dod o fewn rheoliad 4(4) o'r Rheoliadau hynny fel y'i mewnosodwyd gan reoliad 3 o'r Rheoliadau hyn.

(2) Ni chaiff Bwrdd Iechyd Lleol derfynu contract gwasanaethau cyffredinol o dan baragraff 109 o Atodlen 6 i Reoliadau Contractau GMS (Cymru) ar y sail nad yw'r person y cyfeirir ato ym mharagraff (1) bellach yn dod o fewn y diffiniad o ymarferydd meddygol at ddibenion rheoliad 4(1), (2)(a) neu (3)(a) o Reoliadau Contractau GMS (Cymru) fel y'u diwygiwyd gan y Rheoliadau hyn.

RHAN 4

Diwygio rheoliad 2 o Reoliadau Rhestri Perfformwyr (Cymru)

15.  Yn rheoliad 2 (dehongli ac addasu) o Reoliadau Rhestri Perfformwyr (Cymru), ar ôl y diffiniad o “notice” mewnosoder “"the NPSA” means the National Patient Safety Agency established as a special health authority under section 11;

Diwygio rheoliad 4 o Reoliadau Rhestri Perfformwyr (Cymru)

16.  Yn rheoliad 4 (cais am gael cynnwys enw ar restr perfformwyr) o Reoliadau Rhestri Perfformwyr (Cymru)—

(a)ym mharagraph (3)(d) (cais i gael bod ar restr perfformwyr) yn lle “NCAA” rhodder “NPSA”.

(b)Yn lle paragraff (4)(d) ac (e) rhodder—

“(d)has accepted a conditional offer under section 302 of the Criminal Procedure (Scotland) Act 1995(24) (fixed penalty: conditional offer by procurator fiscal) or agreed to pay a penalty under section 115A of the Social Security Administration Act 1992(25) (penalty as alternative to prosecution);

(e)has, in proceedings in Scotland for an offence, been the subject of an order under section 246(2) or (3) of the Criminal Procedure (Scotland) Act 1995 discharging him or her absolutely;”.

Diwygio rheoliad 6 o Reoliadau Rhestri Perfformwyr (Cymru)

17.  Yn rheoliad 6 (penderfyniadau a seiliau dros wrthod) o Reoliadau Rhestri Perfformwyr (Cymru), ym mharagraff (4)(f), yn lle “to which Part I of the Sexual Offences Act 1997 applies, or if it had been committed in England or Wales, would have applied” rhodder “for the purposes of Part 2 of the Sexual Offences Act 2003(26), or if it had been committed in England and Wales, would have been such an offence”.

Diwygio rheoliad 9 o Reoliadau Rhestri Perfformwyr (Cymru)

18.  Yn rheoliad 9 (gofynion y mae'n rhaid i berfformiwr ar restr perfformwyr gydymffurfio â hwy) o Reoliadau Rhestri Perfformwyr (Cymru), yn lle paragraph (1)(d) ac (e) rhodder—

“(d)has accepted a conditional offer under section 302 of the Criminal Procedure (Scotland) Act 1995(27) (fixed penalty: conditional offer by procurator fiscal) or agreed to pay a penalty under section 115A of the Social Security Administration Act 1992(28) (penalty as alternative to prosecution);

(e)has, in proceedings in Scotland for an offence, been the subject of an order under section 246(2) or (3) of the Criminal Procedure (Scotland) Act 1995 discharging him or her absolutely;”.

Diwygio rheoliad 11 o Reoliadau Rhestri Perfformwyr (Cymru)

19.  Yn rheoliad 11 (meini prawf ar gyfer penderfyniad i dynnu enw oddi ar y rhestr) o Reoliadau Rhestri Perfformwyr (Cymru)—

(a)ym mharagraff (2)(f), yn lle “to which Part I of the Sexual Offences Act 1997 applies, or if it had been committed in England and Wales, would have applied” rhodder “for the purposes of Part 2 of the Sexual Offences Act 2003, or if it had been committed in England and Wales, would have been such an offence”.

(b)ym mharagraff (6)(e) ar ôl “NCAA” mewnosoder “on or before 31 March 2005 or thereafter by the NPSA”.

Diwygio rheoliad 16 o Reoliadau Rhestri Perfformwyr (Cymru)

20.  Yn rheoliad 16(2)(g) (hysbysu) o Reoliadau Rhestri Perfformwyr (Cymru), yn lle “NCAA” rhodder “NPSA”.

Diwygio rheoliad 20 o Reoliadau Rhestri Perfformwyr (Cymru)

21.  Yn rheoliad 20(1)(f) (datgelu gwybodaeth) o Reoliadau Rhestri Perfformwyr (Cymru), yn lle “NCAA” rhodder “NPSA”.

Nodyn Esboniadol

(Nid yw'r nodyn hwn yn rhan o'r Rheoliadau)

Mae'r Rheoliadau hyn yn gwneud diwygiadau i reoliadau penodol ynghylch contractau gwasanaethau meddygol cyffredinol yng Nghymru a Rheoliadau'r Gwasanaeth Iechyd Gwladol (Rhestri Perfformwyr) (Cymru) 2004.

Mae Rhan 2 yn diwygio Rheoliadau'r Gwasanaeth Iechyd Gwladol (Contractau Gwasanaethau Meddygol Cyffredinol) (Cymru) 2004 (Rheoliadau Contractau GMS (Cymru)). Yn benodol—

• mae'n ehangu'r diffiniad o ymarferydd meddygol cyffredinol yn rheoliad 2 o Reoliadau Contractau GMS (Cymru) i gynnwys pob ymarferydd meddygol sydd ar y Gofrestr Ymarferwyr Cyffredinol neu sydd, cyn i'r Gofrestr honno ddod i rym, wedi cael profiad addas o fewn ystyr adran 31 o Ddeddf y Gwasanaeth Iechyd Gwladol 1977 (“Deddf 1977”) neu sydd wedi caffael yr hawl i ymarfer (rheoliad 2(4));

• mae'n darparu y bydd darpariaethau sy'n ymwneud â phriod yn ymwneud hefyd â phartner sifil er mwyn cymryd i ystyriaeth effaith Deddf Partneriaethau Sifil 2004 (rheoliadau 2(7) ac 11(34));

• mae'n diwygio'r diffiniad o ragnodydd atodol i gynnwys ciropodyddion, podiatryddion, ffysiotherapyddion a radiograffyddion ac optometryddion ar restr y rhai y ceir eu cydnabod (rheoliad 2(10));

• mae'n cyfyngu'r categorïau o ymarferydd cyffredinol meddygol sydd, o dan reoliad 4 o Reoliadau Contractau GMS (Cymru), yn gallu gweithredu fel yr ymarferydd meddygol gorfodol at ddibenion contract gwasanaethau meddygol cyffredinol (rheoliad 3). Mae'n eithrio o'r rôl honno ymarferwyr a oedd, cyn 1 Ebrill 2004 yn brif ymarferwyr gwasanaethau cyfyngedig neu ymarferwyr yr ystyriwyd nad oedd ganddynt brofiad addas at ddibenion gweithredu fel prif ymarferydd wrth ddarparu gwasanaethau meddygol cyffredinol o dan adran 29 o Ddeddf 1977;

• mae rheoliadau 4 i 10 yn darparu ar gyfer nifer o fân gywiriadau a diwygiadau;

• mae'n gwahardd defnyddio gwasanaethau ffôn at ddibenion contractau gwasanaethau meddygol cyffredinol sy'n defnyddio Rhif au cyfradd genedlaethol (sy'n dechrau gyda 087), Rhif au cyfradd premiwm (sy'n dechrau gyda 090) neu rifau personol (sy'n dechrau gyda 070) (rheoliad 11(2));

• mae'n datgymhwyso'r darpariaethau ynghylch adroddiadau clinigol yn achos gwasanaethau y tu allan i oriau (rheoliad 11(3));

• mae'n mewnosod darpariaethau i alluogi cyflenwi meddyginiaethau i gleifion gan ddarparwyr gwasanaethau y tu allan i oriau pan fodlonir amodau penodol (rheoliad 11(5));

• mae'n diwygio paragraff 31 o Atodlen 6 i Reoliadau Contractau GMS (Cymru) i alluogi rhestr cleifion contractiwr a gafodd ei chau o ganlyniad i benderfyniad gan banel asesu i ailagor drwy gytundeb cyn diwedd y cyfnod cau a bennwyd gan y panel hwnnw ac, mewn amgylchiadau penodol, i ail-gau eto yn ystod y cyfnod hwnnw (rheoliad 11(7));

• mae'n tynnu'r cyfyngiadau sy'n rhwystro rhagnodwyr atodol rhag rhagnodi cyffuriau a reolir neu feddyginiaethau didrwydded (rheoliadau 11(10));

• mae'n newid yr amgylchiadau ym mharagraff 52 o Atodlen 6 y caiff Cofrestrydd Ymarferydd Cyffredinol gyflawni gwasanaethau meddygol o dan gontract heb iddo gael ei gynnwys ar restr perfformwyr meddygol (rheoliad 11(13)). Mae'n eu cysoni â'r rheini yn rheoliad 22(3) o Reoliadau'r Gwasanaeth Iechyd Gwladol (Rhestri Perfformwyr) (Cymru) 2004;

• mae'n tynnu'r gofyniad ym mharagraff 63 o Atodlen 6 i Gynulliad Cenedlaethol Cymru gydsynio i gyflogi Cofrestrydd Ymarferydd Cyffredinol (rheoliad 11(14);

• mae'n tynnu'r ddarpariaeth ynghylch y Cynllun Paratoi Gwybodaeth o Ansawdd (rheoliad 11(18));

• mae'n mewnosod ym mharagraff 76 o Atodlen 6 amserlen ar gyfer darparu gwybodaeth gan gontractwyr i'r Bwrdd Iechyd Lleol (rheoliad 11(19));

• mae'n egluro'r amserlen ar gyfer cyflwyno ffurflenni blynyddol i'r Byrddau Iechyd Lleol o dan baragraff 79 o Atodlen 6 (rheoliad 11(20));

• mae rheoliad 11(21) yn ei gwneud yn ofynnol i gontractwyr sy'n gwmnïau cyfyngedig gan gyfrannau hysbysu'r Bwrdd Iechyd Lleol o newid cyfarwyddwr neu ysgrifennydd a galluogi'r Bwrdd Iechyd Lleol i ddod â'r contract i ben os rhoir gwybodaeth anwir fod y cyfarwyddwr neu'r ysgrifennydd hwnnw wedi cydymffurfio â'r amodau yn rheoliad 5 o Reoliadau Contractau GMS (Cymru);

• mae rheoliad 11(23) yn datgymhwyso'r ddarpariaeth ynghylch darparu gwybodaeth am gwynion mewn achos gwasanaethau y tu allan i oriau y mae'r gofynion ansawdd y cyfeirir atynt ym mharagraff 11 o Atodlen 6 yn ymwneud â hwy;

• mae'n galluogi Bwrdd Iechyd Lleol i amrywio contract er mwyn caniatáu iddo barhau o leiaf am gyfnod dros dro ar ôl marwolaeth partner mewn partneriaeth o ddau hyd yn oed os nad yw'r unigolyn sy'n goroesi yn ymarferydd meddygol (rheoliad 11(27);

• mae'n darparu y bydd contract ag unigolyn sy'n ymarferydd meddygol yn dod i ben saith niwrnod ar ôl marwolaeth yr ymarferydd hwnnw oni wnaed trefniadau cyn hynny i'r contract barhau am gyfnod byr pellach (rheoliad 11(28));

• mae'n galluogi Bwrdd Iechyd Lleol i barhau contract am gyfnod cyfyngedig gydag ymarferydd meddygol nad yw bellach yn bodloni'r amodau yn rheoliad 4:

  (i)

  os y rheswm dros y methiant hwnnw yw am iddo gael ei atal o'r gwaith ar unwaith neu dros dro neu gael ei atal ar sail iechyd o dan Ddeddf Feddygol 1983,

  (ii)

  os oes trefniadau digonol ar waith i ddarparu gwasanaethau clinigol yn ystod cyfnod yr atal, a

  (iii)

  os nad yw terfyniad ar unwaith yn angenrheidiol ar sail diogelwch cleifion neu er mwyn diogelu cyllid cyhoeddus; (rheoliad 11(29));

• mae'n egluro bod y seiliau dros derfynu'r contract ym mharagraff 111 o Atodlen 6 i Reoliadau Contractau GMS (Cymru) yn gymwys yn unig i bartneriaid, cyfranddalwyr a chyfarwyddwyr sy'n ymuno â'r corff contractio ar ôl i'r contract ddechrau o ran amgylchiadau sy'n codi ar ôl iddynt ymuno yn y modd hwnnw (rheoliad 11(31));

• mae rheoliad 11(33) yn diwygio paragraff 120 o Atodlen 6 i ddarparu, at ddibenion bodloni ei rwymedigaeth o ddal yswiriant digonol, y gall contractiwr ddibynnu ar yswiriant a ddelir gan berson a gymerir ymlaen ganddo yn ogystal â chan gyflogai;

• mae rheoliad 12 yn cywiro mân wallau yn Atodlen 7 i Reoliadau Contractau GMS (Cymru).

Mae Rhan 3 o'r Rheoliadau yn gwneud darpariaeth drosiannol o ran tynnu, yn rhinwedd rheoliad 3, hawl personau penodol i fod yn ymarferydd meddygol cyffredinol gorfodol at ddibenion contract gwasanaethau meddygol cyffredinol. Mae'n darparu pan fydd person o'r fath wedi bod yn ymarferydd meddygol gorfodol at ddibenion contract gwasanaethau meddygol cyffredinol yr ymrwymwyd iddo cyn y dyddiad y daw'r Rheoliadau hyn i rym, ni ellir terfynu'r contract oherwydd torri'r gofynion diwygiedig (rheoliad 14).

Mae Rhan 4 o'r Rheoliadau yn gwneud nifer o fân ddiwygiadau i Reoliadau'r Gwasanaeth Iechyd Cenedlaethol (Rhestri Perfformwyr) (Cymru) 2004.