Chapter 7: The services an NHS GP Practice is obliged to provide to patients

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The services an NHS GP Practice is obliged to provide to patients (Extract)

 

 

This Chapter contains:

 

1.     Introduction.

2.     What are Essential Services within primary care?

3.     Who is owed a duty of “management” by a GP practice?

4.     Core hours.

5.     Home visits and other treatment outside the surgery.

6.     Out of Hours Services.

7.     The duty on GPs to provide emergency services.

8.     Additional Services.

9.     Enhanced Services.

10.  Other services that a GP practice is obliged to provide.

 

 

1.             Introduction.

 

1.1           This chapter seeks to identify which medical services GP Practices are obliged to provide as part of NHS funded treatment and where a GP is entitled to refer a patient to another NHS provider.  Section 83 of the National Health Service Act 2006[1] (“the NHS Act”) provides:

 

The Board[2] must, to the extent that it considers necessary to meet all reasonable requirements, exercise its powers so as to secure the provision of primary medical services throughout England”


1.2           “The Board” in the above section is a reference to the National Health Service Commissioning Board, known as NHS England.  The Board is referred to within this chapter as NHS England but citation from statutes refer to it as “the Board”.  Section 83(1) means that NHS England is under a statutory duty to secure the provision of primary medical services throughout England.   Sections 83(5) and (6) provide:

 

(5)      Regulations may provide that services of a prescribed description must, or must not, be regarded as primary medical services for the purposes of this Act.

 

(6)                        Regulations under this section may in particular describe services by reference to the manner or circumstances in which they are provided”

 

1.3           The relevant regulations under section 83 are the National Health Service (Primary Medical Services) (Miscellaneous Amendments and Transitional Provisions) Regulations 2013 (“the 2013 Regulations”).  However several sets of Regulations were made under the statutory predecessors of section 83[3] which remain in force to the extent that they have not been amended by the 2013 Regulations. 

 

1.4           The 2013 Regulations make extensive changes to the National Health Service (General Medical Services Contracts) Regulations 2004[4] (“the GMS Regulations) and the National Health Service (Personal Medical Services Agreements) Regulations 2004 (the “PMS Regulations”).  These Regulations define the contents of GMS and PMS contracts (and have been updated on numerous occasions since they were first published).  There are no Regulations for APMS contracts but the form of these contracts usually follows the GMS/PMS model, with amendments made to the model as required.

 

1.5           The current definitions of what are and are not “primary medical services” for the purposes of section 83 are contained within the GMS Regulations.   These Regulations define the services that those delivering primary care within the NHS are obliged to provide.  These definitions take effect as terms of practice contracts with NHS England held by GP practices.  The definitions of primary medical services include:

 

a)      essential services;

 

b)      additional services;

 

c)       enhanced services; and

 

d)      emergency services.

 



[1] The electronic version of the National Health Service Act 2006 on the www.legislation.gov.uk website has not yet been updated to show all the changes to the 2006 Act made by the Health and Social Care Act 2012.  Hence the present publicly accessible version of section 83 at http://www.legislation.gov.uk/ukpga/2006/41/section/83 still refers to the duty to provide primary care services being a duty resting on primary care trusts.

[2] Under the NHS Act 2006 as originally passed this duty rested on primary care trusts.  It was transferred to NHS England in April 2013 as a result of amendments made in the Health and Social Care Act 2012.

[3] Transitional provisions mean that Regulations made under the equivalent of section 83 in the National Health Service Act 2006 continue to have effect./

[4] The electronic version of the National Health Service (General Medical Services) Regulations 2004 on the www.legislation.gov.uk website has not yet been updated to show all the changes made by the numerous amending regulations made since the Regulations were introduced in 2004.  The original Regulations are at http://www.legislation.gov.uk/ssi/2004/115/contents/made but the wording quoted in this chapter is the version which is current at 1 January 2014 when this chapter has been written. 

David Lock QC

David Lock QC is a barrister at the Landmark Chambers.

180 Fleet Street
London, EC4A 2HG
DX 1042 (London)

He was called to the Bar in 1985 and was appointed Queens Counsel in 2011.

David Lock QC is Head of the Administrative & Public Law Group and the Judicial Review & high Court Challenges Group at No5 Chambers. - See more at: http://www.no5.com/barristers/barrister-details/137-david-lock-qc/#sthash.PcnGl1Eh.dpuf

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