Prospective

SCHEDULE 3E+WOther contractual terms

PART 1E+WProvision of services

Premises, facilities and equipment E+W

1.—(1) The contractor must ensure that the premises used for the provision of services under the contract—

(a)are suitable for the delivery of those services,

(b)are sufficient to meet the reasonable needs of the contractor’s patients, and

(c)meet or exceed the minimum standards set out in directions issued by the Welsh Ministers under the Act.

(2) The requirement in sub-paragraph (1) is subject to any plan included in the contract in accordance with regulation 18(5) which sets out steps to be taken by the contractor to bring the premises up to the required standard.

(3) In relation to each service it provides, the contractor must provide such facilities and equipment as are necessary to enable it properly to perform that service.

Telephone services E+W

2.—(1) The contractor must 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 084, 087, 090 or 091 or consists of a personal number, unless the service is provided free to the caller.

(2) The contractor must ensure their telephone lines are staffed—

(a)for the duration of core hours, unless any agreement has been reached between the Local Health Board and the contractor pursuant to regulation 18(7) which allows the use of an answer phone message for temporary periods, and

(b)answered by appropriately qualified members of the contractor’s staff that are located within the United Kingdom.

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

Cost of relevant calls E+W

3.—(1) The contractor must not enter into, renew or extend a contract or other arrangement for telephone services unless it is satisfied that, having regard to the arrangement as a whole, persons are not going to have to pay more to make relevant calls to the contractor’s practice than they would to make equivalent calls to a geographical number.

(2) In this paragraph—

“geographical number” (“rhif daearyddol”) means a number which has a geographical area code as its prefix;

“relevant calls” (“galwadau perthnasol”) means—

Access E+W

4.—(1) The contractor must—

(a)have a telephone system with a recording function for incoming and outgoing lines, that stack calls and allows for the analysis of call data,

(b)have a telephone introduction message recorded bilingually in Welsh and English that in total lasts no longer than 2 minutes,

(c)ensure that patients and care homes can order repeatable prescriptions digitally,

(d)for the duration of core hours, ensure that patients can digitally request a non-urgent appointment or a call back, and that the necessary governance arrangements are in place for this process,

(e)publicise information via the practice’s online resource on—

(i)the access requirements specified in this paragraph 4, and

(ii)how patients can—

(aa)access the contractor’s services, and

(bb)request an urgent, routine and advanced consultation,

(f)offer a same day consultation for—

(i)children under 16 with acute presentations, and

(ii)patients clinically triaged as requiring an urgent assessment,

(g)offer pre-bookable appointments to take place during core hours; and

(h)actively signpost patients to appropriate services—

(i)available from the members of the contractor’s cluster,

(ii)provided or commissioned by the Local Health Board, or

(iii)available locally or nationally.

(2) The contractor must self-declare quarterly that the requirements in sub-paragraph (1) have been met and if requested be prepared to provide the evidence to the Local Health Board as required.

Attendance at practice premises E+W

5.—(1) The contractor must take steps to ensure that any patient who—

(a)has not previously made an appointment, and

(b)attends at the practice premises for unified services between 8.30am and 6.00pm on a working day,

is provided with such services by an appropriate health care professional on that day.

(2) Sub-paragraph (1) does not apply where—

(a)it is more appropriate for the patient to be referred elsewhere for services under the Act, or

(b)the patient is then offered an appointment to attend again within a time which is appropriate and reasonable having regard to all the circumstances and the patient’s health would not thereby be jeopardised.

Attendance outside practice premises E+W

6.—(1) Where the medical condition of a patient is such that, in the reasonable opinion of the contractor—

(a)attendance on the patient is required, and

(b)it would be inappropriate for the patient to attend at the practice premises,

the contractor must provide services to that patient at whichever of the places described in sub-paragraph (2) is in the contractor’s judgement the most appropriate.

(2) The places described in this sub-paragraph are—

(a)the place recorded in the patient’s medical records as being the patient’s last home address,

(b)such other place as the contractor has informed the patient and the Local Health Board is the place where the contractor has agreed to visit and treat the patient, or

(c)another place in the contractor’s practice area.

(3) Nothing in this paragraph prevents the contractor from—

(a)arranging for the referral of the patient without first seeing the patient, in any case where the patient’s medical condition makes that course of action appropriate, or

(b)visiting the patient in circumstances where this paragraph does not place the contractor under an obligation to do so.

Newly registered patients E+W

7.—(1) Where a patient has been—

(a)accepted on a contractor’s list of patients, or

(b)assigned to that list by the Local Health Board,

the contractor must invite the patient to participate in a consultation either at the contractor’s practice premises or, if the patient’s medical condition so warrants, at one of the places referred to in paragraph 6(2).

(2) An invitation under sub-paragraph (1) must be issued by the contractor before the end of the period of 6 months beginning with the date of the acceptance of the patient on, or assignment of the patient to, the contractor’s list of patients.

(3) Where a patient (or, where appropriate, in the case of a patient who is a child, the child’s parent) agrees to participate in a consultation mentioned in sub-paragraph (1) the contractor must during the course of that consultation—

(a)make such inquiries and undertake such examinations as appear to the contractor to be appropriate in all the circumstances, and

(b)for all newly registered patients who have attained the age of 16 years, with the co-operation of the patient, complete the latest version of the national minimum dataset questionnaire issued by the Welsh Ministers in order to secure health screening information.

(4) Nothing in this paragraph affects the contractor’s other obligations under the contract in respect of the patient.

Patients not seen within 3 years E+W

8.—(1) This paragraph applies where a registered patient who has attained the age of 16 years but has not attained the age of 75 years—

(a)requests a consultation with the contractor, and

(b)has not attended either a consultation with, or a clinic provided by, the contractor within the period of 3 years prior to the date of the request.

(2) The contractor must—

(a)provide the patient with a consultation, and

(b)during that consultation, make such inquiries and undertake such examinations of the patient as the contractor considers appropriate in all the circumstances.

(3) Nothing in this paragraph affects the contractor’s other obligations under the contract in respect of the patient.

Patients aged 75 years and over E+W

9.—(1) Where a registered patient who requests a consultation—

(a)has attained the age of 75 years, and

(b)has not participated in a consultation within the year prior to the date of the request,

the contractor must provide such a consultation during which it must make such inquiries and undertake such examinations as it considers appropriate in all the circumstances.

(2) A consultation under sub-paragraph (1) must take place in the home of the patient where, in the reasonable opinion of the contractor, it would be inappropriate, as a result of the patient’s medical condition, for the patient to attend at the practice premises.

(3) Nothing in this paragraph affects the contractor’s other obligations under the contract in respect of the patient.

Clinical reports E+W

10.—(1) Where the contractor provides any clinical services, other than under a private arrangement, to a patient who is not on its list of patients, the contractor must, as soon as reasonably practicable, provide a clinical report relating to the consultation, and any treatment provided to the patient, to the Local Health Board.

(2) The Local Health Board must send any report received under sub-paragraph (1)—

(a)to the person with whom the patient is registered for the provision of unified services or their equivalent, or

(b)if the person referred to in paragraph (a) is not known to it, the Local Health Board in whose area the patient is resident.

Storage of vaccines E+W

11.  The contractor must ensure that—

(a)all vaccines are stored in accordance with the manufacturer’s instructions, and

(b)all refrigerators in which vaccines are stored have a maximum/minimum thermometer and that temperature readings are taken on all working days.

Infection control E+W

12.  The contractor must ensure that it has appropriate arrangements for infection control and decontamination.

Duty of co-operation in relation to supplementary services E+W

13.—(1) Where a contractor does not provide to its registered patients or to persons whom it has accepted as temporary residents a particular supplementary service it must comply with the requirements specified in sub-paragraph (2).

(2) The requirements specified in this sub-paragraph are that the contractor must in core hours—

(a)co-operate, insofar as is reasonable, with any person responsible for the provision of that service or those services, and

(b)comply with any reasonable request for information from such a person or from the Local Health Board relating to the provision of that service or those services.

Duty of co-operation in relation to out of hours services E+W

14.  The contractor must—

(a)ensure that any patient who contacts the contractor’s practice premises during the out of hours period is provided with information about how to obtain services during that period,

(b)ensure that the clinical details of all out of hours consultations received from the out of hours provider are reviewed by a clinician within the contractor’s practice on the same working day as those details are received by the practice or, exceptionally, on the next working day,

(c)ensure that any information requests received from the out of hours provider in respect of any out of hours consultations are responded to by a clinician within the contractor’s practice on the same day as those requests are received by the contractor’s practice, or on the next working day,

(d)take all reasonable steps to comply with any systems which the out of hours provider has in place to ensure the rapid, secure and effective transmission of patient data in respect of out of hours consultations, and

(e)agree with the out of hours provider a system for the rapid, secure and effective transmission of information about registered patients who, due to chronic disease or terminal illness, are predicted as more likely to present themselves for treatment during the out of hours period.

Membership of a cluster E+W

15.  A contract must contain a term which requires the contractor to be a member of a cluster.

Duty of co-operation: cluster working E+W

16.—(1) A contractor must comply with the requirements in sub-paragraph (2) where registered patients or temporary residents are provided with services by the contractor’s cluster.

(2) The requirements specified in this sub-paragraph are that the contractor must—

(a)co-operate, in so far as is reasonable, with any person responsible for the provision of the services,

(b)comply in core hours with any reasonable request for information from such a person or from the Local Health Board relating to the provision of the services,

(c)agree the mandate for the GP Collaborative representative at cluster meetings and take account of feedback from those cluster meetings,

(d)take reasonable steps to provide information to its registered patients about the services, including information on how to access the services and any changes to them, and

(e)ensure engagement in the planning and delivery of local services, as agreed within the cluster action plan, which includes suitable arrangements to enable the sharing of data, where appropriate safeguards are met, to support the delivery of the services and discussion of cluster funding and budgets.

Membership of a GP Collaborative E+W

17.—(1) A contract must contain a term which has the effect of requiring the contractor to be a member of a GP Collaborative.

(2) A contractor must—

(a)appoint at least 1 health care professional with authority to act on the contractor’s behalf in the dealings between the contractor and the GP Collaborative to which the contractor belongs, and

(b)attend at least 4 meetings of the GP Collaborative to which the contractor belongs in each financial year (unless agreed otherwise in writing by the Local Health Board), or appoint a senior practice clinician, or where appropriate a senior administrator, employed by the practice to attend those meetings and to act on the contractor’s behalf in those meetings.

Contribution to clusters and GP Collaboratives E+W

18.  A contractor must—

(a)contribute relevant information, including demand and capacity planning, to the cluster Integrated Medium Term Plan via the GP Collaborative, and the contribution must include information on demand and capacity planning,

(b)demonstrate how they have engaged in planning and delivery of local services agreed within the GP Collaborative’s contribution to the cluster plan, including evidence of wide partnership, multi-professional/multi-agency working, and development of integrated services, and

(c)contribute to delivering specific cluster-determined outcomes, including engagement in planning of local initiatives through engagement with the cluster via the GP Collaborative lead.

Demand and capacity E+W

19.  A contractor is required to engage with a GP Collaborative to assist the collaborative in—

(a)undertaking a population needs assessment of its patients,

(b)analysing the current services available to the GP Collaborative population, identifying any gaps in provision,

(c)analysing the current numbers and skills of the workforce and its development needs,

(d)undertaking a measurement of local health needs as determined by the GP Collaborative, and

(e)providing evidence of the demand and capacity assessment undertaken which is to be evidenced in the GP Collaborative Integrated Medium-Term Plan.

Cessation of service provision: information requests E+W

20.  Where a contractor ceases to provide a supplementary service to its patients the contractor must comply with any reasonable request for information relating to the provision of that service, or those services, made by the Local Health Board or by any person with whom the Local Health Board intends to enter into a contract for the provision of such services.

Welsh Language E+W

21.—(1) Where the contractor provides medical services under the contract through the medium of Welsh, it must notify the Local Health Board in writing.

(2) The contractor must make available a Welsh language version of any document or form for use by patients and/or members of the public, provided by the Local Health Board.

(3) Where the contractor displays a new sign or notice in connection with medical services provided under the contract, the text on the sign or notice must be in English and Welsh, and the contractor may utilise the translation service offered by the Local Health Board for this purpose.

(4) The contractor must encourage the wearing of a badge, provided by the Local Health Board, by those delivering medical services under the contract who are Welsh speaking, to convey that they are able to speak Welsh.

(5) The contractor must encourage those delivering medical services under the contract to utilise information and/or attend training courses and events provided by the Local Health Board, so that they can develop—

(a)an awareness of the Welsh language (including awareness of its history and its role in Welsh culture), and

(b)an understanding of how the Welsh language can be used when delivering medical services under the contract.

(6) The contractor must encourage those delivering medical services under the contract to establish and record the Welsh or English language preference expressed by or on behalf of a patient.