Statutory Instruments 1999 No. 261
The National Health Service (Fund-holding Practices) Amendment Regulations 1999 - continued

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Amendment of regulation 25A of the principal Regulations
     23. In regulation 25A of the principal Regulations (redundancy payments)[26], in paragraph (1), omit "22 or".

Amendment of regulation 26 of the principal Regulations
     24. In regulation 26 of the principal Regulations (recovery of misapplied sums), in paragraph (1) omit "19," and "22,".

Amendment of Schedule 1 to the principal Regulations
     25. In Schedule 1 to the principal Regulations (conditions for obtaining recognition) - 

Amendment of Schedule 2 to the principal Regulations
     26.  - (1) Schedule 2 to the principal Regulations (conditions for continuing recognition) is amended as follows.

    (2) Omit paragraphs 1 and 2.

    (3) In paragraph 5, for "19, 20, 22, 23, 24 and 25" substitute "20, 23, 24, 24A, 25 and 25A".

    (4) In paragraph 15[28], for ", in the case of standard fund-holding practices in Part I, and in the case of community fund-holding practices in Part II, of" substitute "in".

    (5) After paragraph 15 add the following - 

New Schedule 3 to the principal Regulations
     27. After Schedule 2 to the principal Regulations, add the new Schedule 3 set out in the Schedule to these Regulations.

Revocations
     28. Regulations 2, 8, 19 and 22 of the principal Regulations are hereby revoked.

Saving
     29.  - (1) The amendments made by regulation 13 of these Regulations do not affect the members or former members of any fund-holding practice from which a member has withdrawn before 1st April 1999 in circumstances other than death or retirement, provided that the notice required in accordance with regulation 9(2)(a) of the principal Regulations has been sent before 1st April 1999; and in such cases regulation 9 of the principal Regulations shall continue to apply in relation to members and former members of such practices, as if the amendments referred to above had not been made.

    (2) The amendment made by regulation 22 of these Regulations does not affect any consent given, or appeal right which arose, before Part III of these Regulations came into force, or the application of savings for any of the purposes specified in paragraph (2)(a) to (f) or paragraph (2A) of regulation 25 of the principal Regulations pursuant to a consent given before Part III came into force; and in such cases regulations 24, 25 and 25A of the principal Regulations shall continue to apply in relation to that consent, or to the application of those savings, as if the amendments referred to above had not been made.

    (3) The amendments made by regulation 22(7)(b), (8) and (9) of these Regulations shall not apply to the members of any fund-holding practice whose relevant Health Authority is in Wales, which has ceased to be a recognised fund-holding practice with effect from midnight on 31st March 1999; and in such cases regulation 25(3B) and (3C) shall continue to apply to the application of savings, as if the amendments referred to above had not been made.

    (4) In respect of any part of an allotted sum applied before 1st April 1999, regulation 26 shall continue to have effect as though the amendments made by regulations 24 and 28 of these Regulations had not been made, notwithstanding that the Secretary of State does not make his determination until on or after that date.



PART IV

TRANSITION TO NEW SYSTEM

Applications for recognition as a fund-holding practice
     30.  - (1) Where the Secretary of State has granted recognition in accordance with regulation 5(2)[29] as a standard fund-holding practice, a community fund-holding practice or a GP commissioning group, but the recognition has not taken effect before 1st April 1999, such recognition (when it takes effect) shall be as a residual fund-holding practice.

    (2) Where, by midnight on 31st March 1999, the Secretary of State has neither granted nor refused recognition in respect of any outstanding application for recognition as a standard fund-holding practice or as a community fund-holding practice that outstanding application shall be deemed to be for recognition as a residual fund-holding practice.

    (3) In this regulation, "residual fund-holding practice" means a fund-holding practice recognised as from 1st April 1999, in accordance with the principal Regulations as amended by these Regulations.

Change in status of recognised fund-holding practices
     31.  - (1) Where the members of a standard fund-holding practice or a community fund-holding practice wish the practice to continue to be recognised as a fund-holding practice on and after 1st April 1999, they shall send a written notice of their intention to remain a fund-holding practice to the Health Authority to be received no later than 3rd March 1999.

    (2) Where the members of a GP commissioning group wish the practice to be recognised as a fund-holding practice on and after 1st April 1999 they shall send an application for change of status to the Health Authority to be received no later than 3rd March 1999.

    (3) Regulation 3 of the principal Regulations shall apply to an application by a GP commissioning group for a change of status to a fund-holding practice as it applies to an application for recognition as a fund-holding practice, but as if the references in that regulation to an application were references to an application for change of status to a fund-holding practice.

    (4) For the purposes of this regulation a notice or application may be sent by fax.

Removal of recognition
     32.  - (1) Subject to paragraphs (3) to (6), where the notice referred to in regulation 31(1) has not been received on or before 3rd March 1999 from the members of any fund-holding practice (other than a GP commissioning group), the Secretary of State shall remove recognition from them with effect from midnight on 31st March 1999.

    (2) Subject to paragraphs (3) to (6), where the application referred to in regulation 31(2) has not been received on or before 3rd March 1999 from the members of a GP commissioning group, the Secretary of State shall remove recognition from them with effect from midnight on 31st March 1999.

    (3) Where recognition is to be removed in circumstances specified in this regulation, the Secretary of State shall - 

    (a) send to each member of the practice notice of removal of recognition;

    (b) include in the notice a statement of the reason for removal of recognition and that the removal takes effect from midnight on 31st March 1999;

    (c) inform the members of the practice that they may, subject to paragraphs 4 and 5, make representations in writing to the Secretary of State concerning the matter; and

    (d) inform each member of the practice of the consequences of removal of recognition.

    (4) Where the members of the practice wish to make representations in writing against the removal of recognition, the representations may be sent to the Secretary of State within the period of three weeks beginning with the date on which the notice referred to in paragraph (3) was sent.

    (5) Where the Secretary of State decides, having taken into account the representations of the members of the fund-holding practice, not to remove recognition he shall - 

    (a) write to each member of the fund-holding practice withdrawing the notice referred to in paragraph (3); and

    (b) inform them of a new date by which the notice or application referred to in regulation 31(1) or (2), as the case may be, must be received by the Health Authority.

    (6) Where the Secretary of State informs the members of a fund-holding practice that their notice or application must be received by a new date in accordance with paragraph (5)(b), and the notice or application is not received by that new date the Secretary of State shall remove recognition from them forthwith and paragraph (3)(a), (b) and (d) shall apply, save that paragraph (b) shall apply as if "forthwith" were substituted for "from midnight on 31st March 1999".

Consequences of removal of recognition
     33. Where recognition is removed from a practice in accordance with regulation 31(1), (2) or (6) the consequences shall be the same as the consequences of the practice's having renounced recognition and - 



Signed by authority of the Secretary of State for Health


John Denham
Minister of State, Department of Health

8th February 1999



Signed by authority of the Secretary of State for Wales


Peter Hain

Parliamentary Under Secretary of State, Welsh Office 8th February 1999



SCHEDULE
Regulation 27



SCHEDULE 3
Regulation 20


GOODS AND SERVICES WHICH MAY BE PURCHASED BY A FUND-HOLDING PRACTICE


Diagnostic tests and investigations provided on an outpatient basis or at the practice surgery (including diagnostic tests following an abnormal cervical smear and any diagnostic test carried out by the Public Health Laboratory Service, but excluding tests which form part of general medical services under section 29 of the 1977 Act)

Pregnancy tests

Antenatal blood tests (except where provided as part of an outpatient appointment)

The following therapy services provided by the National Health Service:

    Speech and language therapy

    Occupational therapy

    Chiropody

    Dietetics


EXPLANATORY NOTE

(This note is not part of the Regulations)


These Regulations amend the National Health Service (Fund-holding Practices) Regulations 1996, which contain provisions relating to the recognition and operation of fund-holding practices.

As from 1st April 1999, the three existing types of fund-holding practice, standard fund-holding practices, community fund-holding practices and GP commissioning groups will be replaced by a single type of fund-holding practice to which the amended regulations will apply.

Part II of these Regulations makes changes to the principal Regulations which come into force before the three types of practice cease to exist including - 

Regulation 3, amending regulation 3 of the principal Regulations (application for recognition as a fund-holding practice) and regulation 8, which revokes regulation 10 and 10A of the principal Regulations, prevent practices changing between the three types of fund-holding practice between the coming into force of these Regulations and the types of practice ceasing to exist on 1st April 1999.

Regulation 7 amends regulation 18 of the principal Regulations so that the date for determination of the allotted sum becomes 30th April. Regulation 5 makes a consequential amendment.

Part III sets out the new rules which will apply to the single type of fund-holding practice from 1st April 1999.

Regulation 13 amends regulation 9 of the principal Regulations so that the membership of a fund-holding practice shall not change, except by death or retirement of a member.

Regulation 14 amends regulation 11 of the principal Regulations to permit renunciation of recognition other than at the end of a financial year.

Regulation 17 amends regulation 20 so that the only goods and services which may be bought are those listed in a new Schedule 3 to the principal Regulations (inserted by regulation 27 of these Regulations). Goods and services are only to be purchased from health service bodies.

Regulation 19 amends regulation 23 of the principal Regulations so that management expenses may not be spent on purchasing computers or on paying members of the practice.

Regulation 21 inserts a new regulation 24A limiting the duration of new contracts entered into by fund-holding practices to 6 months.

Regulation 22 amends regulation 25 of the principal Regulations to amend the list of items on which savings from the allotted sum may be spent, requiring that Health Authority consent is to be obtained before any savings are spent and setting the maximum amount of savings which may be spent in one financial year.

Regulation 25 amends Schedule 1 to the principal Regulations (conditions for obtaining recognition) and regulation 26 amends Schedule 2 (conditions for continuing recognition) so that the number of patients on a practice's list do not affect recognition. New conditions are inserted in Schedule 2 making it a condition of continued recognition that there be no changes in the membership of a fund-holding practice (other than because of death or retirement) and that the fund-holding account not become overdrawn.

Regulations 2 and 8 of the principal Regulations are revoked by way of consequential amendments and regulations 19 and 22 are revoked so that the allotted sum shall not be paid to the Health Authority for drugs, medicines and listed appliances nor spent on staff costs, except as permitted by regulations 23 and 25 of the principal Regulations.

Regulation 29 makes saving provisions in respect of regulations 9 (withdrawal or death of a member of a fund-holding practice), 25 (savings from the allotted sum) and 26 (recovery of misapplied sums) of the principal Regulations.

The other regulations make consequential amendments removing references to the three types of fund-holding practice and to the revoked regulations.

Part IV set out the steps which fund-holding practices will have to follow to retain recognition beyond 1st April 1999.

Regulation 30 makes arrangements for practices in respect of which recognition has been granted as one of the three types of fund-holding practice but not taken effect before 1st April 1999.

Regulations 31 and 32 require standard and community fund-holding practices to notify their health authorities that they wish to continue to be recognised as fund-holding practices and require GP commissioning groups to apply for a change of status by 3rd March. Failing such notice or application recognition will be removed, subject to regulation 32 which also sets out the procedure for making representations against such a decision to remove recognition.

Regulation 33 provides that the consequences of removal of recognition in such circumstances will be the same as where a practice has renounced recognition rather than as provided by regulation 17 of the principal Regulations.

Notes:

 [26] Regulation 25A was inserted by S.I. 1998/693, regulation 10(3).back

[27] Paragraph 6 was inserted by S.I. 1998/693, regulation 7.back

[28] Paragraph 15 was inserted by S.I. 1998/693, regulation 8.back

[29] Regulation 5(2) was substituted by S.I. 1997/1678.back


ISBN 0 11 080473 2


 
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