The General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004

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"the 1990 Act" means the National Health Service and Community Care Act 1990[2];

"the 1992 Regulations" means the National Health Service (General Medical Services) Regulations 1992[3];

"the 2003 Act" means the Health and Social Care (Community Health and Standards) Act 2003;

"the 2003 Order" means the General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003[4];

"the 2004 Regulations" means the National Health Service (General Medical Services Contracts) Regulations 2004[5];

"accredited service provider" has the same meaning as in the Out of Hours Regulations;

"additional services" has the same meaning as in the 2004 Regulations;

"bank holiday" means any day that is specified or proclaimed as a bank holiday pursuant to section 1 of the Banking and Financial Dealings Act 1971[6];

"the Choice Regulations" means the National Health Service (Choice of Medical Practitioner) Regulations 1998[7];

"contractor" has, unless the context otherwise requires, the meaning given in article 57;

"core hours" means the period beginning at 8am and ending at 6.30pm on any day from Monday to Friday except Good Friday, Christmas Day or bank holidays;

"default contract" means a contract under article 13 of the Transitional Order and "default contractor" shall, except in Part 3, where it has the meaning given in article 43(3), be construed accordingly;

"essential services" means the services described in regulation 15(3), (5), (6) and (8) of the 2004 Regulations;

"FHSAA" means the Family Health Services Appeal Authority constituted under section 49S of the 1977 Act[8];

"general medical services contract" means a contract under section 28Q of the 1977 Act[9] and "general medical services contractor" shall, except in Part 3, where it has the meaning given in article 43(3), be construed accordingly;

"list of patients" means - 

(a) in relation to a person providing general medical services under section 29 of the 1977 Act[10], the list of patients of a medical practitioner prepared by the Primary Care Trust under regulation 19 of the 1992 Regulations;

(b) in relation to a general medical services contractor or a default contractor, the list prepared and maintained by the Primary Care Trust under the term of a general medical services contract which gives effect to paragraph 14 of Schedule 6 to the 2004 Regulations or under the equivalent term of a default contract; and

(c) in relation to a person providing services under an agreement for primary medical services made (or, pursuant to article 58, deemed to be made) under section 28C of the 1977 Act[11] - 


(i) the list prepared and maintained by the Primary Care Trust under the term of that agreement which gives effect to paragraph 13 of Schedule 5 to the Personal Medical Services Agreements Regulations, or

(ii) the doctor's or pooled list required to be kept under the terms of any directions made by the Secretary of State under section 17 of the 1977 Act[12] in relation to patient lists for transitional agreements;

"Local Medical Committee" means - 

(a) until 1st April 2004, a committee recognised under section 44 of the 1977 Act [13];

(b) from that date, a committee recognised under section 45A of that Act[14];

"medical list" means the list of medical practitioners undertaking to provide general medical services for persons in its area kept by a Primary Care Trust under regulations made under section 29(2)(a) of the 1977 Act[15];

"medical performers list" means a list of medical practitioners prepared and published pursuant to regulation 3(1) of the Performers Lists Regulations;

"the NHS dispute resolution procedure" means, except in Part 4, the procedure for resolution of disputes specified in paragraphs 101 and 102 of Schedule 6 to the 2004 Regulations;

"out of hours period", unless the context otherwise requires, has the same meaning as in regulation 2(1) of the 2004 Regulations;

"Out of Hours Regulations" means the National Health Service (Out of Hours Medical Services) and National Health Service (General Medical Services) Amendment Regulations 2002[16];

"Performers Lists Regulations" means the National Health Service (Performers Lists) Regulations 2004[17];

"personal medical services agreement" means an agreement made under section 28C of the 1977 Act;

"the Personal Medical Services Agreements Regulations" means the National Health Service (Personal Medical Services Agreements) Regulations 2004[18];

"pilot scheme" means an agreement made under Part 1 of the National Health Service (Primary Care) Act 1997[19];

"pilot scheme provider" means a person who is providing services under a pilot scheme;

"PMS contractor" means - 

(a) a contractor as defined in regulation 2 of the Personal Medical Services Agreements Regulations; or

(b) in relation to a transitional agreement, a contractor as defined in article 57;

"practice premises", in relation to a person providing services under section 29 of the 1977 Act, has the same meaning as in regulation 2(1) of the 1992 Regulations and, in relation to a general medical services contractor or a default contractor, has the same meaning as in regulation 2(1) of the 2004 Regulations;

"registered patient" means - 

(a) a person who is recorded by the Primary Care Trust as being on the list of patients of a default contractor or a general medical services contractor, or

(b) a person whom a default contractor or a general medical services contractor has accepted for inclusion on its list of patients, whether or not notification of that acceptance has been received by the Primary Care Trust and who has not been notified by the Primary Care Trust as having ceased to be on that list;

"temporary resident" means a person accepted by a general medical services contractor or a default contractor as a temporary resident under the term of its general medical services contract which gives effect to paragraph 16 of Schedule 6 to the 2004 Regulations (or under the equivalent term of its default contract) and for whom the contractor's responsibility has not been terminated in accordance with the terms of the general medical services contract or default contract;

"transitional agreement" means an agreement which is deemed under article 58 to have been made under section 28C of the 1977 Act and which has not been varied in accordance with article 59;

"the Transitional Order" means the General Medical Services Transitional and Consequential Provisions Order 2004[20].

Applications for inclusion in lists of patients
     3. Where, on or before 31st March 2004, a person had applied to a relevant medical practitioner for inclusion in his list of patients pursuant to regulation 2 or 3(1) of the Choice Regulations but on 31st March 2004 that application had not yet been determined, the application shall, on 1st April 2004, be regarded as if it had been made to the succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 15 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

Acceptance of applications for inclusion in lists of patients
     4.  - (1) Where, on or before 31st March 2004, a relevant medical practitioner had agreed to accept a person on his list of patients pursuant to paragraph 6 of Schedule 2 to the 1992 Regulations[21] but on 31st March 2004 he had not yet sent the signed medical card or the application to the Primary Care Trust in accordance with sub-paragraph (3) of that paragraph, that acceptance shall be regarded on 1st April 2004 as an acceptance by the succeeding contractor and notification of that acceptance shall be sent by the succeeding contractor to the Primary Care Trust in accordance with - 

(a) the term of its general medical services contract which gives effect to paragraph 15(5) of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

    (2) In paragraph (1), "medical card" has the same meaning as in regulation 2(1) of the 2004 Regulations.

Removal from the list of patients at the request of the patient
     5. Where, on or before 31st March 2004, a Primary Care Trust had received notice from a patient under regulation 23(1)(a) of the 1992 Regulations[22] that he wished to be removed from a relevant medical practitioner's list of patients but on 31st March 2004 that removal had not yet taken effect in accordance with regulation 23(1)(b) of those Regulations, the removal shall take effect as a removal from the list of patients of the succeeding contractor as if it were a removal pursuant to a request received by the Primary Care Trust in accordance with - 

(a) the term of the succeeding contractor's general medical services contract which gives effect to paragraph 19 of Schedule 6 to the 2004 Regulations, subject to the modification that the reference to the period of 14 days in the term which gives effect to paragraph 19(3)(b) shall be read as a reference to the period of 14 days after the date on which the request made under regulation 23(1)(a) of the 1992 Regulations was received by the Primary Care Trust; or

(b) the equivalent term of its default contract subject to a modification to the same effect.

Removal from the list of patients at the request of the relevant medical practitioner
     6.  - (1) Where, on or before 31st March 2004, a relevant medical practitioner had notified the Primary Care Trust that he wished to have a patient removed from his list of patients in accordance with paragraph 9 of Schedule 2 to the 1992 Regulations[23] but that removal had, on 31st March 2004, not yet taken effect, paragraph (2) shall apply.

    (2) Except where paragraph (3) applies, the removal shall take effect as a removal from the list of patients of the succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 20(8) of Schedule 6 to the 2004 Regulations, subject to the modification that the reference in that term to the eighth day after the Primary Care Trust receives the notice shall be read as a reference to the eighth day after the Primary Care Trust received the notice sent under paragraph 9 of Schedule 2 to the 1992 Regulations; or

(b) the equivalent term of its default contract, subject to a modification to the same effect.

    (3) Where, on or before 31st March 2004, the Primary Care Trust had been - 

(a) informed by the relevant medical practitioner under paragraph 9(2) of Schedule 2 to the 1992 Regulations that he was treating the patient at intervals of less than seven days but had not yet been notified by him that the patient no longer needed such treatment; or

(b) notified by the relevant medical practitioner under that paragraph that the person no longer needed treatment at intervals of less than seven days,

paragraph (4) shall apply.

    (4) In a case which falls within paragraph (3), the removal shall take effect as a removal from the list of patients of the succeeding contractor on - 

(a) the date on which the Primary Care Trust receives notification of the registration of the person with another provider of essential services (or their equivalent);

(b) the eighth day after the Primary Care Trust received notice from the relevant medical practitioner that the person no longer needed treatment at intervals of less than seven days; or

(c) the eighth day after the Primary Care Trust receives notice from the succeeding contractor that the patient no longer needs treatment at intervals of less than seven days,

whichever is the sooner.

Removals from the list of patients who are violent
     7.  - (1) This article applies where, on or before 31st March 2004, a person had been removed from a relevant medical practitioner's list of patients with immediate effect pursuant to paragraph 9A of Schedule 2 to the 1992 Regulations[24] but - 

(a) confirmation in writing had not yet been given to the Primary Care Trust under paragraph 9A(2);

(b) reasonable steps had not yet been taken by the relevant medical practitioner under paragraph 9A(4) to inform the person whose name had been removed; or

(c) written notice of the removal had not yet been given to the person by the Primary Care Trust under regulation 19(6B) of the 1992 Regulations[25].

    (2) In a case to which paragraph (1)(a) applies written confirmation of the request for removal shall be given to the Primary Care Trust by the succeeding contractor within 7 days from the date on which notification was given under paragraph 9A(1).

    (3) In a case to which paragraph (1)(b) applies, reasonable steps shall be taken by the succeeding contractor to inform the patient of the request for removal.

    (4) In a case to which paragraph (1)(c) applies, the Primary Care Trust shall send written notice of the removal to the patient.

Removals from the list of patients who have moved
     8.  - (1) Where, on or before 31st March 2004, a Primary Care Trust had informed a patient and a relevant medical practitioner, in accordance with regulation 23(2) of the 1992 Regulations[26], that the medical practitioner was no longer obliged to visit and treat him but the 30 days referred to in that regulation had not yet expired, that information shall be regarded as if it had been given under - 

(a) the term of the succeeding contractor's general medical services contract which gives effect to paragraph 23 of Schedule 6 to the 2004 Regulations, subject to the modification that the reference to the period of 30 days in the term which gives effect to paragraph 23(1)(c) shall be read as a reference to 30 days from the date of the information given by the Primary Care Trust under regulation 23(2) of the 1992 Regulations; or

(b) the equivalent term of its default contract subject to a modification to the same effect.

    (2) Where, on or before 31st March 2004, a Primary Care Trust had given a relevant medical practitioner notice in writing, in accordance with regulation 23(4) of the 1992 Regulations[27], that it intended to remove a person from the practitioner's list of patients but the six months referred to in that regulation had not yet expired, that notice shall be regarded as if it had been given to the succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 24 of Schedule 6 to the 2004 Regulations, subject to the modification that the reference to the period of six months in the term which gives effect to paragraph 24(a) shall be read as a reference to six months from the date of the notice given by the Primary Care Trust under regulation 23(4) of the 1992 Regulations; or

(b) the equivalent term of its default contract subject to a modification to the same effect.

Removals not reflected in the list of patients on 31st March 2004
     9.  - (1) This article applies where - 

(a) on or before 31st March 2004, the removal of a patient from a relevant medical practitioner's list of patients had taken effect under the 1992 Regulations; and

(b) the Primary Care Trust had not, on 31st March 2004, reflected that removal in the list of patients of that medical practitioner which it maintained under regulation 19 of the 1992 Regulations.

    (2) In a case to which this article applies, the Primary Care Trust shall - 

(a) remove the patient from the succeeding contractor's list of patients as soon as reasonably practicable after 1st April 2004; and

(b) if notification of the removal was required to be given to the medical practitioner or the patient under the provision of the 1992 Regulations relevant to the removal and had not been given on or before 31st March 2004, notify the succeeding contractor and the patient of the removal.

Applications for acceptance as a temporary resident
     10. Where, on or before 31st March 2004, a person had applied to a relevant medical practitioner for acceptance as a temporary resident under regulation 7 of the Choice Regulations but on 31st March 2004 that application had not yet been determined, the application shall be regarded as if it had been made to the succeeding contractor and shall be dealt with in accordance with - 

(a) the term of its general medical services contract which gives effect to paragraphs 16 and 17 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent terms of its default contract.

Acceptance of temporary residents
     11.  - (1) This article applies where - 

(a) on or before 31st March 2004, a relevant medical practitioner had accepted a person as a temporary resident under paragraph 7(b) of Schedule 2 to the 1992 Regulations[28]; and

(b) on 31st March 2004, his responsibility for that patient had not yet been terminated under paragraphs 9 and 10 of that Schedule[29] or the period for which the person was accepted as a temporary resident had not yet come to an end.

    (2) In a case to which this article applies, the person shall, on 1st April 2004, be treated as if he had been accepted as a temporary resident by the succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 16 of Schedule 6 to the 2004 Regulations, subject to the modification that reference to a period of three months in that term shall be read as a reference to a period of three months starting with the date on which the person was accepted as a temporary resident by the relevant medical practitioner under paragraph 7 of Schedule 2 to the 1992 Regulations; or

(b) the equivalent term of its default contract subject to a modification to the same effect.

Termination of responsibility for temporary residents
     12. Where, on or before 31st March 2004, a relevant medical practitioner had informed the Primary Care Trust in writing in accordance with paragraph 10 of Schedule 2 to the 1992 Regulations that he wished to terminate his responsibility for a temporary resident but, on 31st March 2004, that responsibility had not yet terminated under paragraph 9 of that Schedule, the responsibility of the succeeding contractor for that temporary resident shall terminate seven days after the date on which the information under paragraph 10 of Schedule 2 to the 1992 Regulations was given to the Primary Care Trust by the relevant medical practitioner.

Provision of immediately necessary treatment
     13. Where, on 31st March 2004, a relevant medical practitioner was responsible for providing immediately necessary treatment to any person under paragraph 4(4) of Schedule 2 to the 1992 Regulations[30], the succeeding contractor shall continue to be responsible for providing such treatment to that person for the period for which the relevant medical practitioner would have been responsible if that paragraph had not been revoked.

Newly registered patients
     14.  - (1) This article applies where, on 31st March 2004, a patient specified in paragraph (2) - 

(a) was entitled to be invited to participate in a consultation under paragraph 14(5) of Schedule 2 to the 1992 Regulations[31]; and

(b) had not been given such an invitation.

    (2) The patient referred to in paragraph (1) is a patient - 

(a) who, on or before 31st March 2004 - 


(i) had applied for inclusion in a relevant medical practitioner's list of patients under regulation 2 or 3 of the Choice Regulations[32] and whose application had been accepted, or

(ii) had been assigned to a relevant medical practitioner's list under regulation 4 of the Choice Regulations; and



(b) in respect of whom a Primary Care Trust had not granted deferment of the obligation to invite him to participate in a consultation under paragraph 14 of Schedule 2 to the 1992 Regulations.

    (3) A patient to whom this article applies shall, on 1st April 2004, be regarded as a patient who falls within - 

(a) the term of the succeeding contractor's general medical services contract which gives effect to paragraph 4 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

Appointments system
     15. Where, on or before 31st March 2004, a relevant medical practitioner had notified a Primary Care Trust under paragraph 31 of Schedule 2 to the 1992 Regulations - 

(a) that he intended to operate an appointments system; or

(b) of any proposal to discontinue such a system,

that notice shall be regarded as a notice given by the succeeding contractor to the Primary Care Trust for the purposes of the term of the general medical services contract which gives effect to paragraph 82(c) of Schedule 6 to the 2004 Regulations or the equivalent term of the default contract.

Qualifications of performers
     16.  - (1) Where, on 1st April 2004, a succeeding contractor continues to employ or engage a person who on 31st March 2004 was employed or engaged in accordance with the requirements of Schedule 2 to the 1992 Regulations by the relevant medical practitioner in relation to whom it is a succeeding contractor, paragraphs (2) and (3) shall apply.

    (2) The requirements to make checks contained in the terms of the general medical services contract which give effect to paragraphs 57(1)(b) and 58(1) of Schedule 6 to the 2004 Regulations, or in the equivalent terms of the default contract - 

(a) in a case where equivalent checks have previously been carried out in respect of that person by the relevant medical practitioner, shall not apply; or

(b) in any other case, shall apply subject to the modification that the checks may be carried out at any time up to 30th June 2004.

    (3) The requirement to obtain references in the term of the general medical services contract which gives effect to paragraph 59 of Schedule 6 to the 2004 Regulations, or in the equivalent term of the default contract, shall not apply if such references have been obtained, checked and found to be satisfactory by the relevant medical practitioner by whom the health care professional was employed or engaged on 31st March 2004.

Independent nurse prescribers and supplementary prescribers
     17.  - (1) Where, on or before 31st March 2004, a relevant medical practitioner had notified the Primary Care Trust of any matters relating to an independent nurse prescriber or a supplementary prescriber under paragraph 28A of Schedule 2 to the 1992 Regulations[33], the succeeding contractor shall not be required to notify the Primary Care Trust of those same matters under - 

(a) the term of its general medical services contract which gives effect to paragraph 65 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

    (2) In paragraph (1), "independent nurse prescriber" and "supplementary prescriber" have the same meaning as in paragraph 1 of Schedule 2 to the 1992 Regulations[34].

Repeatable prescribing services
     18.  - (1) Where, on 31st March 2004, a relevant medical practitioner met the requirements for providing repeatable prescribing services in regulation 33A of the 1992 Regulations[35] and had, on or before that date, notified the Primary Care Trust of his intention to provide such services in accordance with that paragraph, that notification shall be regarded, on 1st April 2004, as a notification given by the succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 40 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

    (2) For the purposes of a notification regarded as given under sub-paragraph (1), the date on which the succeeding contractor intends to begin to provide repeatable prescribing services included in the notification shall be deemed to be 1st April 2004.

    (3) In this paragraph, "repeatable prescribing services" in relation to a relevant medical practitioner has the same meaning as in regulation 2(1) of the 1992 Regulations[36] and in relation to a general medical services contractor or a default contractor has the same meaning as in regulation 2(1) of the 2004 Regulations.

Patient records
     19.  - (1) Where, on 31st March 2004, a relevant medical practitioner had the written consent of the Primary Care Trust to the keeping of computerised records under paragraph 36 of Schedule 2 to the 1992 Regulations[37] and that consent had not been withdrawn, that consent shall be regarded as written consent to the succeeding contractor for the purposes of  - 

(a) the term of its general medical services contract which gives effect to paragraph 73 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of the default contract.

    (2) Where - 

(a) on or before 31st March 2004, a Primary Care Trust had requested a relevant medical practitioner to send it the records relating to a patient under paragraph 36(6) of Schedule 2 to the 1992 Regulations; and

(b) on 31st March 2004 that request had not yet been complied with,

the records requested shall be sent by the succeeding contractor to the Primary Care Trust as soon as possible.

    (3) Where, on or before 31st March 2004, a relevant medical practitioner had been informed of the death of a patient on its list by the Primary Care Trust or had otherwise learned of the death of such a patient but on 31st March 2004 had not yet sent that patient's records to the Primary Care Trust in accordance with paragraph 36(6)(b) of Schedule 2 to the 1992 Regulations, those records shall be sent to the Primary Care Trust by the succeeding contractor - 

(a) in a case in which the relevant medical practitioner was informed of the death by the Primary Care Trust, within 14 days of the date on which he was so informed; or

(b) in any other case, within one month of the date on which the relevant medical practitioner learned of the death.

Rights of entry
     20.  - (1) Where, on or before 31st March 2004, a relevant medical practitioner had received a written request for inspection of his practice premises under paragraph 27(b) of Schedule 2 to the 1992 Regulations[38] but, on 31st March 2004, no inspection had yet taken place pursuant to that request, the request shall, on 1st April 2004, be regarded as notice of an intended entry to the succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 89 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

    (2) In determining whether reasonable notice was given of any entry to the practice premises following a notice referred to in paragraph (1), regard shall be had to the date on which the request under paragraph 27(b) of Schedule 2 to the 1992 Regulations was made.

Refusal of approval of premises under paragraphs 29 and 29A of Schedule 2 to the 1992 Regulations
     21.  - (1) Where, on or before 31st March 2004, a Primary Care Trust had notified a relevant medical practitioner under paragraph 29(12) of Schedule 2 to the 1992 Regulations[39] of its refusal of an application made under - 

(a) paragraphs 29(1) or (17) of that Schedule in relation to any place at which he was to be available; or

(b) paragraphs 29A(1) or (6) of that Schedule[40] in relation to the treatment of patients other than at his practice premises,

paragraphs (2) and (3) shall apply.

    (2) Where, on 31st March 2004, the time for appealing against the refusal specified in paragraph 29(13) of Schedule 2 to the 1992 Regulations had not expired and no appeal had yet been made, the time for appealing shall continue as if paragraph 29 and, if applicable, paragraph 29A of that Schedule had not been revoked.

    (3) Where - 

(a) on 31st March 2004, the relevant medical practitioner had appealed in writing against that refusal under paragraph 29(13) of Schedule 2 to the 1992 Regulations but the appeal had not been determined or withdrawn; or

(b) after 31st March 2004, an appeal is made pursuant to paragraph (2),

that appeal shall be dealt with, or continue to be dealt with, as if paragraph 29 and, if applicable, paragraph 29A of that Schedule had not been revoked.

    (4) Where an appeal dealt with under paragraph (3) is successful, the Primary Care Trust shall agree to a variation of the contract which it holds with the succeeding contractor which has the effect of adding to the list of practice premises under that contract the premises approved as a result of the appeal.

    (5) A variation agreed by the Primary Care Trust pursuant to paragraph (4) shall have effect - 

(a) from a date no later than 28 days after the date on which the outcome of the appeal was notified to the relevant medical practitioner; and

(b) only if it is in writing and signed by or on behalf of the Primary Care Trust and the succeeding contractor.

Withdrawal of approval of premises under paragraph 29A of Schedule 2 to the 1992 Regulations
     22.  - (1) Where - 

(a) on or before 31st March 2004, a Primary Care Trust had notified a relevant medical practitioner of withdrawal of its approval of premises under paragraph 29A(10) of Schedule 2 to the 1992 Regulations; and

(b) on 31st March 2004, the time for appealing specified in sub-paragraph (11) of that paragraph had not expired and no appeal had yet been made,

the time for appealing shall continue as if paragraph 29A of Schedule 2 to the 1992 Regulations had not been revoked.

    (2) Where - 

(a) on or before 31st March 2004, the relevant medical practitioner had appealed in writing against a withdrawal of approval under paragraph 29A(11) of Schedule 2 to the 1992 Regulations but the appeal had not been determined or withdrawn; or

(b) after 31st March 2004, an appeal is made pursuant to paragraph (1),

that appeal shall be dealt with, or continue to be dealt with, as if paragraph 29 and, if applicable, paragraph 29A of Schedule 2 to the 1992 Regulations were still in force.

    (3) Where an appeal dealt with under paragraph (2) is successful, the Primary Care Trust shall agree to a variation of the contract which it holds with the succeeding contractor which has the effect of adding to the list of practice premises under that contract the premises approved as a result of the appeal.

    (4) A variation agreed by the Primary Care Trust pursuant to paragraph (3) shall have effect - 

(a) from a date no later than 28 days after the date on which the outcome of the appeal was notified to the relevant medical practitioner; and

(b) only if it is in writing and signed by or on behalf of the Primary Care Trust and the succeeding contractor.

Investigation of outstanding complaints
     23.  - (1) Where, on 31st March 2004 - 

(a) a complaint had been made under paragraph 47A of Schedule 2 to the 1992 Regulations[41] by or on behalf of a patient or former patient of a relevant medical practitioner; and

(b) the investigation of that complaint under the practice based complaints procedure required to be established under paragraph 47A had not concluded,

that complaint must, from 1st April 2004, be investigated, or in an appropriate case continue to be investigated, by the succeeding contractor as if paragraph 47A had not been revoked.

    (2) Where, on 31st March 2004 - 

(a) a complaint had been made under paragraph 47A of Schedule 2 to the 1992 Regulations by or on behalf of a patient or former patient of a medical practitioner to whom there is no succeeding contractor; and

(b) the investigation of that complaint under the practice based complaints procedure required to be established under paragraph 47A had not concluded,

that complaint must be investigated by one of the persons specified in paragraph (3) as if paragraph 47A had not been revoked.

    (3) The persons referred to in paragraph (2) are - 

(a) the person or persons who was or were the former partner or partners of the medical practitioner on whose list of patients the complainant was included, if he or they meet the requirements in paragraph (4);

(b) if the person or persons specified in paragraph (a) satisfy the Primary Care Trust on whose medical list their former partner was included for the purposes of providing general medical services to the complainant that, having regard to the nature of the complaint, it would not be appropriate for the complaint to be investigated by him or them, that Primary Care Trust; or

(c) in any other case, the Primary Care Trust on whose medical list the medical practitioner was included for the purposes of providing general medical services to the complainant.

    (4) The requirements referred to in paragraph (3) are that the former partner or partners - 

(a) has or have entered into a default contract or a general medical services contract, as an individual medical practitioner or as one of two or more individuals practising in partnership, with the Primary Care Trust on whose medical list their former partner was included for the purposes of providing general medical services to the complainant; or

(b) is a legal and beneficial shareholder or are legal and beneficial shareholders in a company which has entered into a general medical services contract with that Primary Care Trust.

    (5) Where, under paragraph (3), a complaint made by or on behalf of a patient or former patient would fall to be investigated, or continue to be investigated, by more than one general medical services contractor or default contractor, the contractors concerned shall - 

(a) enter into discussions as to which of them would be the most appropriate person to deal with the complaint; and

(b) if they are unable to reach agreement, refer the matter to the Primary Care Trust on whose medical list their former partner was included for the purposes of providing general medical services to the complainant and that Primary Care Trust shall investigate the complaint itself.

    (6) Where, under this article, a complaint falls to be investigated by a Primary Care Trust the investigation shall be carried out in accordance with the directions dated 29th June 1998 on dealing with complaints about family health services practitioners given by the Secretary of State under section 17 of the 1977 Act[42].

Complaints relating to general medical services made after 31st March 2004
     24. The complaints procedure established and operated by a succeeding contractor under - 

(a) the term of its general medical services contract which gives effect to paragraph 92 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of the default contract,

shall apply to any complaint which a patient or former patient of the relevant medical practitioner to whom it is a succeeding contractor could have made (but did not make) on or before 31st March 2004 under paragraph 47A of Schedule 2 to the 1992 Regulations as it applies to complaints made by a patient or former patient of the succeeding contractor in relation to any matter reasonably connected with the provision of services under the contract.

Reports to a medical officer
     25.  - (1) Where, on or before 31st March 2004, a relevant medical practitioner had received a request for information or an inquiry from a medical officer (or an officer of the Department for Work and Pensions on his behalf or at his direction) under paragraph 48 of Schedule 2 to the 1992 Regulations[43] but, on 31st March 2004, he had not yet responded to that request or inquiry, the succeeding contractor shall respond as if the request or inquiry had been made under - 

(a) the term of its general medical services contract which gives effect to paragraph 80 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

    (2) In this article, "medical officer" means a medical practitioner who is - 

(a) employed or engaged by the Department for Work and Pensions; or

(b) provided by an organisation in pursuance of a contract entered into with the Secretary of State for Work and Pensions.

Inquiries about prescriptions and referrals
     26. Where, on or before 31st March 2004, a relevant medical practitioner had received an inquiry about prescriptions or referrals from a Primary Care Trust under paragraph 49 of Schedule 2 to the 1992 Regulations[44] but had not yet responded to that inquiry, the succeeding contractor shall respond as if the inquiry had been made under - 

(a) the term of its general medical services contract which gives effect to paragraph 79 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

Notification of deaths
     27. Where, on 31st March 2004, there was an outstanding requirement to report the death of a person on the practice premises of a relevant medical practitioner to the Primary Care Trust in accordance with paragraph 36C of Schedule 2 to the 1992 Regulations[45], the death shall be reported on 1st April 2004 by the succeeding contractor in accordance with - 

(a) the term of its general medical services contract which gives effect to paragraph 87 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of its default contract.

Arrangements with organisations providing deputy doctors
     28.  - (1) Where - 

(a) on 31st March 2004 - 


(i) a Primary Care Trust had, on or before that date, issued a remedial notice to a relevant medical practitioner under paragraph 21A(7) of Schedule 2 to the 1992 Regulations[46]; and

(ii) the date specified in the notice as the one before which remedial action should be taken had not yet been reached; and



(b) on 1st April 2004, the arrangements covered by the remedial notice are continuing in the form of a sub-contract with the succeeding contractor,

the remedial notice issued under paragraph 21A(7) of Schedule 2 to the 1992 Regulations shall be regarded as a remedial notice served in the same terms on the succeeding contractor on 1st April 2004 under the term of its general medical services contract which gives effect to paragraph 115(1) of Schedule 6 to the 2004 Regulations (or under the equivalent term of its default contract).

    (2) A remedial notice deemed to have been served on the succeeding contractor pursuant to paragraph (1) shall not count as a remedial notice for the purposes of the term of the general medical services contract which gives effect to paragraph 115(6) of Schedule 6 to the 2004 Regulations (or for the purposes of the equivalent term of the default contract).

    (3) In this article, "remedial notice" means, in relation to a notice issued before 1st April 2004, a notice issued under paragraph 21A(7) of Schedule 2 to the 1992 Regulations and, in relation to a notice issued after that date, a notice served under the term of the general medical services contract which gives effect to paragraph 115(1) of Schedule 6 to the 2004 Regulations (or under the equivalent term of the default contract).

Notification of sub-contracts under general medical services contracts
     29.  - (1) Where - 

(a) on 31st March 2004, a relevant medical practitioner had in place - 


(i) arrangements for the engagement of a deputy of which he had informed the Primary Care Trust under paragraph 21(1) of Schedule 2 to the 1992 Regulations[47], or

(ii) arrangements he had made with an organisation providing deputy doctors of which he had notified the Primary Care Trust under paragraph 21A(3) of that Schedule and in relation to which the Primary Care Trust had not served a notice under paragraph 21A(10) of that Schedule; and



(b) the succeeding general medical services contractor wishes to continue those arrangements after 31st March 2004 in the form of a sub-contract to which paragraph 69 of Schedule 6 to the 2004 Regulations applies,

any requirement for the succeeding contractor to notify the Primary Care Trust of its intention to enter into that sub-contract contained in the term of its general medical services contract which gives effect to paragraph 69(1)(b) of Schedule 6 to the 2004 Regulations shall not apply, unless the date of termination of the arrangements is extended beyond the date which applied to them on 31st March 2004 or there is a material variation in the nature of those arrangements.

    (2) In this article - 

"deputy" has the meaning given in paragraph 1 of Schedule 2 to the 1992 Regulations; and

"organisation providing deputy doctors" has the same meaning as in paragraph 21A(1) of that Schedule.

Practice leaflet
     30.  - (1) This article applies where a relevant medical practitioner had compiled a practice leaflet which met the requirements of paragraph 47 of Schedule 2 to the 1992 Regulations[48] and that leaflet was, on 31st March 2004, available to patients on his list.

    (2) In the circumstances to which this article applies, the practice leaflet made available to patients by - 

(a) the succeeding contractor; or

(b) a general medical services contractor who enters into a general medical services contract before 31st July 2004 which takes effect immediately after its default contract with the same Primary Care Trust ceases to have effect,

need not, until 1st August 2004, include all the information specified in the term of the general medical services contract which gives effect to Schedule 10 to the 2004 Regulations (or in the equivalent term of the default contract) provided that, from the date of commencement of the contract until the practice leaflet does so comply, the general medical services contractor or the default contractor makes available to patients in written form the information specified in paragraph (3).

    (3) The information referred to in paragraph (2) is - 

(a) the services available under the general medical services contract or the default contract;

(b) the opening hours of the practice premises and the method of obtaining access to services throughout the core hours;

(c) the arrangements for services in the out of hours period (whether or not provided by the general medical services contractor or the default contractor) and how the patient may contact such services; and

(d) if the services in sub-paragraph (c) are not provided by the general medical services contractor or the default contractor, the fact that the Primary Care Trust which is a party to the general medical services contract or the default contract is responsible for commissioning the services and the name, address and telephone number of that Primary Care Trust.

    (4) In this article, "practice leaflet" - 

(a) in relation to the period before 1st April 2004, has the meaning given in paragraph 47 of Schedule 2 to the 1992 Regulations; and

(b) in relation to the period from 1st April 2004, has the meaning given in regulation 2(1) of the 2004 Regulations.

Medical examination of medical practitioners
     31. Where, on or before 31st March 2004 - 

(a) a Primary Care Trust had required a relevant medical practitioner to be medically examined under regulation 25(5) of the 1992 Regulations; and

(b) that medical examination had not yet taken place,

the requirement shall, on 1st April 2004, unless the Primary Care Trust notifies him otherwise in writing, be regarded as a request made to that medical practitioner for him to be medically examined on the grounds that he is incapable of adequately providing services under the succeeding contract and arrangements for the medical examination shall, with the consent of the medical practitioner, continue to be made by the Local Medical Committee for the area of the Primary Care Trust which is a party to the succeeding contract, pursuant to the function conferred on that committee by regulation 27 of the 2004 Regulations.

Patients not seen within three years
     32. The term of a general medical services contract which gives effect to paragraph 5 of Schedule 6 to the 2004 Regulations (or the equivalent term of a default contract) shall be read as if the reference to a consultation or clinic provided by the general medical services contractor (or the default contractor) included a reference to a consultation or clinic provided by - 

(a) the relevant medical practitioner in relation to whom it is a succeeding contractor; or

(b) in the case of a general medical services contract which takes effect immediately after a default contract between the same parties ceases to have effect, the contractor who held that default contract.

Patients aged 75 years and over
     33. The term of a general medical services contract which gives effect to paragraph 6 of Schedule 6 to the 2004 Regulations (or the equivalent term of a default contract) shall be read as if the reference to participating in a consultation under that term included a reference to participating in a consultation under - 

(a) paragraph 16 of Schedule 2 to the 1992 Regulations; or

(b) in the case of a general medical services contract which takes effect immediately after a default contract between the same parties ceases to have effect, under the term of the default contract which was equivalent to paragraph 6 of Schedule 6 to the 2004 Regulations.

Arrangements for GP Registrars
     34.  - (1) Where, before 1st April 2005, a general medical services contractor or a default contractor employs a GP Registrar for the purpose of being trained by a GP Trainer, the requirement for the general medical services contractor or the default contractor to have the agreement of the Secretary of State to that employment in - 

(a) the term of the general medical services contract which gives effect to paragraph 64 of Schedule 6 to the 2004 Regulations; or

(b) the equivalent term of the default contract,

shall not apply.

    (2) In this article, "GP Registrar" and "GP Trainer" have the same meaning as in regulation 2(1) of the 2004 Regulations.

Refund of fees paid under paragraph 38(f) of Schedule 2 to the 1992 Regulations
     35. Where, on 31st March 2004, a patient had paid a fee to a medical practitioner under paragraph 38(f) of Schedule 2 to the 1992 Regulations but - 

(a) the period for applying for a refund of that fee under paragraph 39(1) of that Schedule[49] had not yet expired; or

(b) an application for refund of the fee had been made but not yet determined,

the period for applying for a refund and the powers of the Primary Care Trust in dealing with any application for a refund shall continue as if paragraph 39(1) of that Schedule had not been revoked.

Annual reports
     36. Notwithstanding the revocation of the 1992 Regulations, any medical practitioner to whom paragraph 50 of Schedule 2 to those Regulations (annual reports)[50] applied shall, by 30th June 2004, provide, either individually or as a member of a partnership, to the Primary Care Trust on whose medical list he appeared on 31st March 2004, an annual report in respect of the period of 12 months ending on 31st March 2004 which includes - 

(a) the number of complaints received in accordance with paragraph 47A of Schedule 2 to the 1992 Regulations[51]; and

(b) if the Primary Care Trust, having considered whether the information is available to it from another source and having consulted the Local Medical Committee, so requests, the information specified in paragraph 3 of Schedule 13 to those Regulations[52].

Determination of question whether a substance is a drug
     37.  - (1) Where, on 31st March 2004, a Primary Care Trust had, under regulation 36(7) of the 1992 Regulations[53], informed a medical practitioner of its decision that a substance ordered by him was not a drug but - 

(a) the medical practitioner had not given notice of appeal under paragraph (8) of that regulation; and

(b) the time for appealing in that paragraph had not yet expired,

the time for appealing shall continue as if regulation 36 of the 1992 Regulations were still in force.

    (2) Where - 

(a) on 31st March 2004, a medical practitioner had given notice of appeal against a decision of a Primary Care Trust under regulation 36 of the 1992 Regulations but that appeal had not been determined or withdrawn; or

(b) a medical practitioner has given notice of such an appeal after 31st March 2004, pursuant to paragraph (1),

that appeal shall continue to be dealt with as if regulation 36 of the 1992 Regulations were still in force.

Entry on to medical performers list of persons approved under regulation 18A or 18B of the 1992 Regulations
     38. Where a Primary Care Trust - 

(a) had, on 31st March 2004, approved a medical practitioner under regulation 18A or 18B of the 1992 Regulations[54] but had not yet entered his name on its medical list in accordance with regulation 18F(1) of those Regulations[55]; and

(b) intends to enter into a default contract or general medical services contract with two or more individuals practising in partnership one of whom is the person so approved,

it shall add that person's name to its medical performers list unless he is already on the medical performers list of another Primary Care Trust and is not withdrawing from that list.

Outstanding appeals against refusal of approval under regulation 18A or 18B of the 1992 Regulations
     39.  - (1) Where, on 31st March 2004 - 

(a) a Primary Care Trust had refused to approve a medical practitioner under regulation 18A or 18B of the 1992 Regulations; and

(b) he had a right of appeal under regulation 18G or 18GG of the 1992 Regulations[56] and the time for appealing had not yet expired,

the time for appealing shall continue as if those regulations had not been revoked.

    (2) Where a medical practitioner whose nomination a Primary Care Trust had refused to approve under regulation 18A or 18B of the 1992 Regulations - 

(a) had, on or before 31st March 2004, given notice of appeal to the FHSAA under regulation 18G or 18GG of the 1992 Regulations but that appeal had not yet been determined or withdrawn; or

(b) has given notice of such an appeal after 31st March 2004 pursuant to paragraph (1),

that appeal shall continue to be dealt with as if regulation 18G or, as the case may be, 18GG of the 1992 Regulations had not been revoked.

    (3) Where - 

(a) following an appeal dealt with under paragraph (2), the FHSAA determines that the nomination of the medical practitioner should have been approved by the Primary Care Trust; and

(b) a default contractor or a general medical services contractor notifies the Primary Care Trust that the person concerned is to join it as a partner,

the Primary Care Trust shall add that person's name to its medical performers list unless he is already on the medical performers list of another Primary Care Trust and is not withdrawing from that list.

Permission for use of facilities in private practice under section 72 of the 1977 Act
     40. Where, on 31st March 2004, a relevant medical practitioner had the permission of the Secretary of State under section 72 of the 1977 Act (permission for use of facilities in private practice), that permission shall be regarded, from 1st April 2004, as permission granted under that section to the succeeding contractor.

Recovery of overpayments
     41.  - (1) Where, on or before 31st March 2004, a medical practitioner had admitted an overpayment drawn to its attention by a Primary Care Trust under regulation 35(2) of the 1992 Regulations[57] (claims and overpayments) but the overpayment, or any part of it, had not been recovered, the amount overpaid, or any part of it not recovered before 31st March 2004, shall, notwithstanding the repeal of the 1992 Regulations, continue to be recoverable by that Primary Care Trust and shall be treated as a debt owed by that medical practitioner to that Primary Care Trust.

    (2) Notwithstanding the repeal of the 1992 Regulations, where a Primary Care Trust considers that a payment has been made to a medical practitioner under the Statement of Fees and Allowances when it was not due and has not drawn that alleged overpayment to the attention of the medical practitioner on or before 31st March 2004, the Primary Care Trust may draw that overpayment to the attention of the medical practitioner and - 

(a) where the overpayment is admitted by him, the Primary Care Trust may recover the amount overpaid from him as a civil debt; and

(b) where the overpayment is not admitted by him, the arrangements for appeals set out in paragraph 80 of the Statement of Fees and Allowances shall apply.

    (3) In this article "Statement of Fees and Allowances" means the statement determined and published by the Secretary of State under regulation 34 of the 1992 Regulations[58], as that statement had effect on 31st March 2004.

Continuation of pre-contract disputes relating to general medical services contracts
     42.  - (1) Where, on or before 31st March 2004 - 

(a) a prospective party to a general medical services contract had referred a pre-contract dispute to the Secretary of State to consider and determine under section 4(4) of the 1990 Act or under regulation 9 of the 2004 Regulations; and

(b) that party entered into the general medical services contract whose terms were subject to dispute before that dispute had been determined or withdrawn,

the dispute shall, notwithstanding that the parties to the dispute have entered into a general medical services contract, continue to be dealt with under the procedure specified in regulation 9(2) of the 2004 Regulations.

    (2) In the case of a dispute dealt with pursuant to paragraph (1), the determination - 

(a) may require the parties to agree an amendment or variation to the general medical services contract; and

(b) shall be binding upon the parties to that contract.

Carry over of approvals, applications, notices etc.
     44.  - (1) Subject to paragraph (3), in a case to which this Part applies - 

(a) any approval, authorisation or consent given by the Primary Care Trust for the purposes of the default contract and still in force on the date on which that default contract ceases to have effect, shall be deemed to be an approval, authorisation or consent for the purposes of the general medical services contract on the date on which that general medical services contract takes effect and any such approval, authorisation or consent shall be on the same terms and subject to the same conditions (if any) as applied to the approval, authorisation or consent given under the default contract;

(b) any application made to the Primary Care Trust by the default contractor under its default contract, and which has not been dealt with or determined on or before the date on which the default contract ceases to have effect, shall be deemed to be an application made by the general medical services contractor under its general medical services contract and any time specified in the general medical services contract for dealing with any such application shall be deemed to run from the date on which the application was made under the default contract;

(c) any application or request made by a patient to the default contractor under its default contract and which has not been dealt with or determined on or before the date on which the default contract ceases to have effect, shall be deemed to be an application or request made by the patient to the general medical services contractor under its general medical services contract and any time specified in the general medical services contract in relation to that application or request shall be deemed to run from the date on which the application or request was made under the default contract;

(d) any notice given to or served on the default contractor under its default contract by the Primary Care Trust which - 


(i) requires it to provide or cease providing services, or

(ii) withdraws, suspends or varies an approval previously given to it by the Primary Care Trust,



from a date which is after the date on which the default contract ceases to have effect, shall be deemed to be a notice served on the general medical services contractor under its general medical services contract which takes effect on the date on which it would have taken effect had the default contract continued in force and any time specified in the general medical services contract for referring the matter to the NHS dispute resolution procedure shall be deemed to run from the date on which the notice was given to or served on the default contractor;

(e) subject to paragraph (2), any notification or information given to the Primary Care Trust or a patient by the default contractor under its default contract shall be deemed to be a notification or information given by the general medical services contractor under the equivalent term of its general medical services contract on the date on which the general medical services contract takes effect and any reference in the relevant term of the general medical services contract to the date on which the event referred to in the notification shall take effect shall be read as a reference to the date on which that event would have taken effect had the default contract remained in force;

(f) any report, notification or information (other than a notification required to be given under the term of the default contract equivalent to paragraph 86 of Schedule 6 to the 2004 Regulations) which, on the date on which the default contract ceased to have effect, was required to be given to any person by the default contractor under its default contract but had not been so given, shall be given by the general medical services contractor as if it was required to be given under the general medical services contract, subject to the modification that the timescale for giving any such report, notification or information shall be that which would have applied to the default contractor had the default contract remained in force;

(g) any notifications or acknowledgements required to be given by the Primary Care Trust to to a default contractor under its default contract on the date on which it ceases to have effect but which had not been so given shall be given by the Primary Care Trust to the general medical services contractor as if it is was required under the terms of the general medical services contract;

(h) any notifications required to be given by the Primary Care Trust under a default contract to a patient on the default contractor's list of patients on the date on which the default contract ceases to have effect but which had not been so given, shall be given to that patient by the Primary Care Trust - 



(i) if the patient is included in the list of patients of the general medical services contractor, as if the notification were required to be given under the general medical services contract, or

(ii) in any other case, as soon as possible after the default contract ceases to have effect;



(i) any request or inquiry made to the default contractor under the default contract but which has not been complied with on or before the date on which the default contract ceases to have effect, shall be complied with by the general medical services contractor as if it was a request or inquiry made under the equivalent term of the general medical services contract and any time specified in the general medical services contract for responding to any such request shall be deemed to run from the date on which the request was made to the default contractor;

(j) any preference expressed by a patient under the default contract to receive services from a particular performer or class of performer under that default contract and which he has not withdrawn on or before the date on which the default contract ceases to have effect shall, with effect from the date on which the general medical services contract takes effect, be regarded, for the purposes of that general medical services contract, as a preference expressed under the term of that contract which gives effect to paragraph 18 of Schedule 6 to the 2004 Regulations;

(k) any checks which the default contractor has made under the terms of its default contract which are equivalent to paragraphs 57 to 59 of Schedule 6 to the 2004 Regulations or steps which it has taken to satisfy itself under the terms of that contract equivalent to paragraphs 58(1)(b), 60 or 69(1) of that Schedule shall be regarded as checks made or steps taken by the general medical services contractor under the terms of its general medical services contract which give effect to those paragraphs;

(l) any records relating to a patient which are required to be sent to the Primary Care Trust by the default contractor under the term of its default contract which is equivalent to paragraph 73(6) of Schedule 6 to the 2004 Regulations but which have not been sent on or before the date on which the default contract ceases to have effect, shall be sent to the Primary Care Trust by the general medical services contractor by the date on which the default contractor would have been required to send them had its default contract not ceased to have effect;

(m) the reference to a warning given by the general medical services contractor in the term of the general medical services contract which gives effect to paragraph 20(3) of Schedule 6 to the 2004 Regulations shall be deemed to include a reference to a warning given by the default contractor.

    (2) Where - 

(a) pursuant to paragraph (1)(e), a notification is deemed to have been given by a general medical services contractor under the term of its contract which gives effect to paragraph 69(1) of Schedule 6 to the 2004 Regulations on the date on which the general medical services contract takes effect; and

(b) the notification under the equivalent provision of the default contract was given more than 28 days before the date on which the default contract ceased to have effect,

the right of the Primary Care Trust under the term of the general medical services contract which gives effect to paragraph 69 of Schedule 6 to the 2004 Regulations to object to the sub-contract covered by that notification shall not apply.

    (3) Paragraph (1) does not apply to any action taken or required to be taken by either party to a default contract under - 

(a) the dispute resolution procedure;

(b) the provisions relating to variation of the contract; or

(c) the provisions relating to termination of the contract,

contained in the default contract.

Newly registered patients
     45.  - (1) Where a patient of a default contractor - 

(a) was, immediately before the default contract ceased to have effect, entitled to be invited to participate in a consultation under the term of the default contract equivalent to paragraph 4 of Schedule 6 to the 2004 Regulations; and

(b) had not been given such an invitation,

that patient shall be regarded as a patient of the general medical services contractor who, on the date on which the general medical services contract takes effect, falls within the term of the general medical services contract which gives effect to paragraph 4 of Schedule 6 to the 2004 Regulations.

    (2) In the case of a patient to whom paragraph (1) applies, the reference to a period of six months in the term of the general medical services contract which gives effect to paragraph 4(2) of Schedule 6 to the 2004 Regulations shall be read as if it was a reference to six months from the date of the patient's acceptance on or assignment to the default contractor's list.

Temporary residents
     46. Where, on the date on which the default contract ceases to have effect - 

(a) a default contractor has accepted a person as a temporary resident under the term of its default contract equivalent to paragraph 16 of Schedule 6 to the 2004 Regulations; and

(b) its responsibility for that patient has not yet been terminated under that term,

the person shall be treated as if he had been accepted as a temporary resident by the general medical services contractor under the term of its general medical services contract which gives effect to paragraph 16 of Schedule 6 to the 2004 Regulations, subject to the modification that the reference to a period of three months in that term shall be read as a reference to a period of three months starting with the date on which the person was accepted as a temporary resident by the default contractor.

Provision of immediately necessary treatment
     47. Where, on the date on which the default contract ceases to have effect, a default contractor is responsible for providing immediately necessary treatment to any person under the term of the default contract equivalent to regulation 15 of the 2004 Regulations, the general medical services contractor shall continue to be responsible for providing such treatment to that person for the period for which the default contractor would have been responsible if the default contract had remained in force.

Removals from the list of patients
     48.  - (1) Where, on the date on which the default contract ceases to have effect, a Primary Care Trust has received a request from a patient to be removed from a default contractor's list of patients but that removal has not yet taken effect under the term of the default contract equivalent to paragraph 19(3) of Schedule 6 to the 2004 Regulations, that removal shall take effect as a removal from the list of patients of the general medical services contractor on the date on which it would have taken effect had the default contract remained in force.

    (2) Where, on the date on which the default contract ceases to have effect, a Primary Care Trust has informed a default contractor and one of its registered patients of the matters required under the term of the default contract equivalent to paragraph 23 of Schedule 6 to the 2004 Regulations but the 30 days referred to in that term has not expired, the information shall be regarded as if it had been given under the term of the general medical services contract which gives effect to paragraph 23 of Schedule 6 to the 2004 Regulations subject to the modification that the reference in that term to 30 days shall be read as a reference to 30 days from the date of the advice given to the patient by the default contractor.

    (3) Where, on the date on which the default contract ceases to have effect, a Primary Care Trust has given notice in writing to a default contractor in accordance with the term of its contract which is equivalent to paragraph 24 of Schedule 6 to the 2004 Regulations but the six months referred to in that term has not expired, the notice shall be regarded as if it had been given under the term of the general medical services contract which gives effect to paragraph 24 of Schedule 6 to the 2004 Regulations subject to the modification that the reference in that term to six months shall be read as a reference to six months commencing with the date of the notice to the default contractor.

Requirement to provide dispensing services
     49.  - (1) Where, on the date on which the default contract ceases to have effect - 

(a) a default contractor has received a request from a patient to provide dispensing services under the term of its default contract equivalent to paragraph 47(5) of Schedule 6 to the 2004 Regulations;

(b) 30 or more days have elapsed since the date on which the patient made his request; and

(c) the default contractor has not applied to the Primary Care Trust for the right to provide dispensing services to that patient,

the Primary Care Trust may give notice to the general medical services contractor under the term of its general medical services contract which gives effect to paragraph 47(5) of Schedule 6 to the 2004 Regulations as if the request had been made by the patient to the general medical services contractor on the date on which it was made to the default contractor.

    (2) Where the Primary Care Trust has given notice to the default contractor under its default contract that it requires it to provide dispensing services to a patient from a date before the date on which the default contract ceases to have effect, that notice shall be regarded as a notice served on the general medical services contractor under the term of its general medical services contract which gives effect to paragraph 47(5) of Schedule 6 to the 2004 Regulations requiring it to provide dispensing services to the patient from the date on which the general medical services contract takes effect.

    (3) In this article "dispensing services" has the same meaning as in regulation 2(1) of the 2004 Regulations.

Sub-contracting
     50.  - (1) Where - 

(a) on the date on which the default contract ceases to have effect, the default contractor has in place a sub-contract, other than a contract for services with a health care professional for the provision by that professional personally of clinical services, which is in accordance with the terms of the default contract; and

(b) the general medical services contractor wishes to continue that sub-contract for the period for which it would have continued had the default contract remained in force,

the term of the general medical services contract which gives effect to paragraph 69(1)(b) of Schedule 6 to the 2004 Regulations shall not apply to that sub-contract unless it is extended beyond the date referred to in sub-paragraph (b) or there is a material variation in its terms.

    (2) In this article, "health care professional" has the same meaning as in section 28M of the 1977 Act[59].

Complaints
     51.  - (1) Where - 

(a) a complaint - 


(i) has been made to a default contractor under the complaints procedure established in accordance with the term of the default contract equivalent to paragraph 92 of Schedule 6 to the 2004 Regulations, or

(ii) falls to be investigated by a default contractor pursuant to articles 23 or 24; and



(b) on the date on which the default contract ceases to have effect the investigation of that complaint has not been concluded,

the complaint shall be investigated or, in an appropriate case, continue to be investigated, by the general medical services contractor under the complaints procedure established in accordance with the term of its general medical services contract which gives effect to paragraph 92 of Schedule 6 to the 2004 Regulations.

    (2) In a case to which this Part applies, any references in the terms of the general medical services contract which give effect to paragraphs 92 to 96 and 98 of Schedule 6 to the 2004 Regulations to - 

(a) services provided by or received from the general medical services contractor;

(b) a patient or former patient of the general medical services contractor; or

(c) complaints made to the general medical services contractor,

shall be read as if they included a reference to services provided by or received from the default contractor, to the patient or former patient of the default contractor or to complaints made to the default contractor.

Refund of fees
     52.  - (1) Where, on the date on which a default contract ceases to have effect, a patient has paid a fee to the default contractor under the term of its default contract equivalent to regulation 24(3) of the 2004 Regulations but - 

(a) the period in that term for applying for refund of the fee has not yet expired; or

(b) an application for refund of the fee has been made but not yet determined,

the fee shall be regarded as if it had been paid to the general medical services contractor under its general medical services contract and the term of the general medical services contract which gives effect to regulation 24(4) of the 2004 Regulations shall apply subject to the modifications specified in paragraph (2).

    (2) The modifications referred to in paragraph (1) are that - 

(a) references to the date on which the fee was paid shall be read as references to the date on which the fee was paid to the default contractor; and

(b) the reference to the general medical services contractor's list of patients shall be read as a reference to the list of patients of the default contractor.

Annual returns and reviews
     53.  - (1) Where, in a case to which this Part applies, the periods or part of the periods covered by the default contract and the general medical services contract fall in the same financial year - 

(a) notwithstanding the term of the general medical services contract which gives effect to paragraph 81 of Schedule 6 to the 2004 Regulations, the Primary Care Trust shall not require an annual return from the general medical services contractor if a return covering all or part of the same financial year has been requested from the default contractor; and

(b) any annual return submitted by the general medical services contractor for a financial year in which it also held a default contract shall provide the required information in relation to the default contract as well as in relation to the general medical services contract.

    (2) In this article, "financial year" means the twelve months ending with 31st March.

Carry-over of disputes between default and general medical services contracts
     54.  - (1) Where - 

(a) on or before the date on which a default contract ceases to have effect, a default contractor has referred a dispute arising out of or in connection with the default contract, other than one to which article 88 applies, to be determined in accordance with the NHS dispute resolution procedure; and

(b) on the date on which the default contract ceases to have effect, that dispute has not been determined or withdrawn,

the adjudicator shall, in determining the dispute, consider the relevance of his determination to the general medical services contract which took effect immediately after the default contract ceased to have effect and, if he considers that his determination is relevant to that general medical services contract, he shall determine the dispute as if it were a dispute referred to him by the general medical services contractor under the NHS dispute resolution procedure contained in the general medical services contract.

    (2) In this article, "adjudicator" means the Secretary of State or a person or persons appointed by the Secretary of State under section 4(5) of the 1990 Act or paragraph 101(5) of Schedule 6 to the 2004 Regulations.

Grounds for termination of the general medical services contract
     55. Where, on or before the date on which the default contract ceases to have effect - 

(a) circumstances arise which would entitle the Primary Care Trust on or before that date to terminate the default contract under the term of the default contract equivalent to paragraph 113 of Schedule 6 to the 2004 Regulations; and

(b) the Primary Care Trust has not terminated the default contract on those grounds,

those circumstances shall, for the purposes of the term of the general medical services contract which gives effect to paragraph 113 of Schedule 6 to the 2004 Regulations, be regarded as if they had arisen during the existence of the general medical services contract.

Notifications to patients affected by differences between the terms of a default and a general medical services contract
     56. Where, in a case to which this Part applies - 

(a) the range of services provided to the registered patients of the general medical services contractor is to be different from that provided by the default contractor; or

(b) patients who were on the default contractor's list of patients are not to be included on the list of patients of the general medical services contractor as a result of a change in the practice area,

the Primary Care Trust shall notify those patients in writing of the change and inform them of the steps they can take to obtain elsewhere the services in question or, as the case may be, register elsewhere for the provision of essential services (or their equivalent).