The National Health Service (General Medical Services Contracts) (Wales) Regulations 2023

Prospective

Assignment to closed lists: NHS dispute resolution procedure relating to determinations of the assessment panel E+W

46.—(1) Where an assessment panel makes a determination under paragraph 45(7) that the Local Health Board may assign new patients to contractors who have closed their lists of patients, any contractor specified in the determination may refer the matter to the Welsh Ministers to review that determination.

(2) Where a matter is referred to the Welsh Ministers under sub-paragraph (1), it must be reviewed in accordance with the procedure specified in the following sub-paragraphs.

(3) Where more than one contractor specified in the determination would like to refer the matter for dispute resolution, those contractors may, if they all agree, refer the matter jointly and, in that case, the Welsh Ministers must review the matter in relation to those contractors together.

(4) The contractor (or contractors) must send to the Welsh Ministers, before the end of the period of 7 days beginning with the date of the determination of the assessment panel in accordance with paragraph 45(7), a written request for dispute resolution which must include or be accompanied by—

(a)the names and addresses of the parties to the dispute,

(b)a copy of the contract (or contracts), and

(c)a brief statement describing the nature of and circumstances giving rise to the dispute.

(5) The Welsh Ministers must, before the end of the period of 7 days beginning with the date on which the matter was referred to the Welsh Ministers—

(a)give notice in writing to the parties that the Welsh Ministers are dealing with the matter, and

(b)include with the notice a written request to the parties to make, in writing before the end of a specified period, any representations which those parties would like to make about the dispute.

(6) The Welsh Ministers must give, with the notice under sub-paragraph (5), to the party other than the one which referred the matter to dispute resolution, a copy of any document by which the dispute was referred to dispute resolution.

(7) The Welsh Ministers must, upon receiving any representations from a party—

(a)give a copy of those representations to each other party, and

(b)request, in writing, that each party to which a copy of those representations is given makes, before the end of a specified period, any written observations which the party would like to make about those representations.

(8) The Welsh Ministers may—

(a)invite representatives of the parties to appear before, and make oral representations to, the Welsh Ministers either together or, with the agreement of the parties, separately, and may, in advance, provide the parties with a list of matters or questions to which the Welsh Ministers would like them to give special consideration, or

(b)consult other persons whose expertise the Welsh Ministers considers is likely to assist the Welsh Ministers consideration of the dispute.

(9) Where the Welsh Ministers consult another person under sub-paragraph (8)(b), the Welsh Ministers must—

(a)give notice in writing to that effect to the parties, and

(b)where the Welsh Ministers consider that the interests of any party might be substantially affected by the results of the consultation, give to the parties such opportunity as the Welsh Ministers consider reasonable in the circumstances to make observations about those results.

(10) In considering the dispute, the Welsh Ministers must take into account—

(a)any written representations made in response to a request under sub-paragraph (5)(b), but only if those representations are made before the end of the specified period,

(b)any written observations made in response to a request under sub-paragraph (7), but only if those written observations are made before the end of the specified period,

(c)any oral representations made in response to an invitation under sub-paragraph (8)(a),

(d)the results of any consultation under sub-paragraph (8)(b), and

(e)any observations made in accordance with an opportunity given under sub-paragraph (9).

(11) Subject to the other provisions of this paragraph and to any agreement between the parties, the Welsh Ministers may determine the procedure which is to apply to the dispute resolution in such manner as the Welsh Ministers consider appropriate in order to ensure the just, expeditious, economical and final determination of the dispute.

(12) In this paragraph, “specified period” means—

(a)such period as the Welsh Ministers specify in the request being a period of not less than 7 days and not more than 14 days beginning with the date on which the notice referred to is given, or

(b)such longer period as the Welsh Ministers may allow for the determination of the dispute where the period for determination of the dispute has been extended in accordance with sub-paragraph (16), and where the Welsh Ministers do so allow, a reference in this paragraph to the specified period is to the period as so extended.

(13) Subject to sub-paragraph (16), the Welsh Ministers must—

(a)determine the dispute before the end of the period of 21 days beginning with the date on which the matter was referred to the Welsh Ministers,

(b)determine whether the Local Health Board may assign new patients to contractors which have closed their lists of patients, and

(c)if the Welsh Ministers determine that the Local Health Board may assign new patients to those contractors, determine the contractors to which the new patients may be assigned.

(14) The Welsh Ministers must not determine that patients may be assigned to a contractor which was not specified in the determination of the assessment panel under paragraph 45(7)(b).

(15) In the case of a matter referred jointly by contractors in accordance with sub-paragraph (3), the Welsh Ministers may determine that patients may be assigned to one, some or all of the contractors which referred the matter.

(16) The period of 21 days referred to in sub-paragraph (13) may be extended (even after it has expired) by a further specified number of days if an agreement to that effect is reached by—

(a)the Welsh Ministers,

(b)the Local Health Board, and

(c)the contractor (or contractors) which referred the matter to dispute resolution.

(17) The Welsh Ministers must—

(a)record the determination, and the reasons for it, in writing, and

(b)give notice in writing of the determination (including the record of the reasons) to the parties.