|
| |
|
(a) | whose sight is tested by a person who is a party to a general ophthalmic |
| |
| |
(b) | who is shown during the testing or within a prescribed time after it to |
| |
fall within any of paragraphs (a) to (d) of subsection (2), |
| |
| must be taken for the purposes of the testing to have so fallen immediately |
| 5 |
before his sight was tested. |
| |
(10) | In the case mentioned in subsection (9), the testing of his sight must (unless it |
| |
took place in circumstances prescribed under subsection (2)) be treated as a |
| |
testing under the sight-testing service mentioned in subsection (1)(a)— |
| |
(a) | for the purposes of remuneration in respect of the testing, and |
| 10 |
(b) | for any such other purpose as may be prescribed. |
| |
116 | Regulations under section 115: supplementary |
| |
(1) | Regulations under section 115 which refer to an Act of Parliament or an |
| |
instrument made under an Act of Parliament may direct that the reference |
| |
must be construed as a reference to that Act or instrument— |
| 15 |
(a) | as it has effect at the time when the regulations are made, or |
| |
(b) | both as it has effect at that time and as amended subsequently. |
| |
(2) | Descriptions of persons may be prescribed under section 115(2)(e) by reference |
| |
to any criterion, including the following— |
| |
| 20 |
(b) | the fact that a prescribed person or a prescribed body accepts them as |
| |
suffering from a prescribed medical condition, |
| |
(c) | the fact that a prescribed person or a prescribed body accepts that a |
| |
prescribed medical condition from which they suffer arose in |
| |
prescribed circumstances, |
| 25 |
(d) | their receipt of benefit in money or kind under any enactment or their |
| |
entitlement to receive any such benefit, |
| |
(e) | the receipt of any such benefit by other persons satisfying prescribed |
| |
conditions or the entitlement of other persons satisfying prescribed |
| |
conditions to receive such benefits. |
| 30 |
(3) | Regulations under section 115(3)(b) may direct that a person’s resources and |
| |
requirements be calculated— |
| |
(a) | by a method set out in the regulations, |
| |
(b) | by a method described by reference to a method of calculating or |
| |
estimating income or capital specified in an enactment other than this |
| 35 |
section or in an instrument made under an Act of Parliament or by |
| |
reference to such a method but subject to prescribed modifications, |
| |
(c) | by reference to an amount applicable for the purposes of a payment |
| |
under an Act of Parliament or an instrument made under an Act of |
| |
| 40 |
(d) | by reference to the person’s being or having been entitled to payment |
| |
under an Act of Parliament or an instrument made under an Act of |
| |
| |
|
| |
|
| |
|
General ophthalmic services contracts |
| |
117 | General ophthalmic services contracts: introductory |
| |
(1) | A Primary Care Trust may enter into a contract under which primary |
| |
ophthalmic services are provided in accordance with the following provisions |
| |
| 5 |
(2) | A contract under this section is called in this Act a “general ophthalmic services |
| |
| |
(3) | A general ophthalmic services contract may make such provision as may be |
| |
agreed between the Primary Care Trust and the contractor or contractors in |
| |
| 10 |
(a) | the services to be provided under the contract, |
| |
(b) | remuneration under the contract, and |
| |
| |
(4) | The services to be provided under a general ophthalmic services contract may |
| |
| 15 |
(a) | services which are not primary ophthalmic services, |
| |
(b) | services to be provided outside the area of the Primary Care Trust. |
| |
(5) | In this Part, “contractor”, in relation to a general ophthalmic services contract, |
| |
means any person entering into the contract with the Primary Care Trust. |
| |
118 | Persons eligible to enter into GOS contracts |
| 20 |
(1) | A Primary Care Trust may, subject to such conditions and exceptions as may |
| |
be prescribed, enter into a general ophthalmic services contract with any |
| |
| |
(2) | But it may not enter into such a contract with a person who has been |
| |
disqualified from doing so by an order of disqualification made by virtue of |
| 25 |
regulations under section 119. |
| |
119 | Exclusion of contractors |
| |
(1) | The Secretary of State may make regulations conferring on a Primary Care |
| |
Trust, or another prescribed person, a right to apply to the FHSAA in |
| |
prescribed circumstances for an order that a person (“P”) be disqualified from |
| 30 |
entering into a general ophthalmic services contract. |
| |
(2) | The regulations may in particular provide for— |
| |
(a) | the review by the FHSAA of an order of disqualification made by virtue |
| |
of regulations under this section, |
| |
(b) | what will happen in relation to general ophthalmic services contracts to |
| 35 |
which P is a party when the order is made. |
| |
120 | GOS contracts: payments |
| |
(1) | The Secretary of State may give directions as to payments to be made under |
| |
general ophthalmic services contracts. |
| |
(2) | A general ophthalmic services contract must require payments to be made |
| 40 |
under the contract in accordance with directions under this section. |
| |
|
| |
|
| |
|
(3) | A direction under subsection (1) may in particular— |
| |
(a) | provide for payments to be made by reference to compliance with |
| |
standards or the achievement of levels of performance, |
| |
(b) | provide for payments to be made by reference to— |
| |
(i) | any scheme or scale specified in the direction, or |
| 5 |
(ii) | a determination made by any person in accordance with factors |
| |
specified in the direction, |
| |
(c) | provide for the making of payments in respect of individual |
| |
| |
(d) | provide that the whole or any part of a payment is subject to conditions |
| 10 |
(and may provide that payments are payable by a Primary Care Trust |
| |
only if it is satisfied as to certain conditions), |
| |
(e) | make provision having effect from a date before the date of the |
| |
direction, provided that, having regard to the direction as a whole, the |
| |
provision is not detrimental to the persons to whose remuneration it |
| 15 |
| |
(4) | Before giving a direction under subsection (1), the Secretary of State— |
| |
(a) | must consult any body appearing to him to be representative of persons |
| |
to whose remuneration the direction would relate, and |
| |
(b) | may consult such other persons as he considers appropriate. |
| 20 |
(5) | “Payments” includes fees, allowances, reimbursements, loans and repayments. |
| |
121 | GOS contracts: other required terms |
| |
(1) | A general ophthalmic services contract must contain such provision as may be |
| |
prescribed (in addition to the provision required by the preceding provisions |
| |
| 25 |
(2) | Regulations under subsection (1) may in particular make provision as to— |
| |
(a) | the manner in which, and standards to which, services must be |
| |
| |
(b) | the persons who perform services, |
| |
(c) | the persons to whom services will be provided, |
| 30 |
(d) | the variation of contract terms (other than terms required by or under |
| |
| |
(e) | rights of entry and inspection (including inspection of clinical records |
| |
| |
(f) | the circumstances in which, and the manner in which, the contract may |
| 35 |
| |
| |
(h) | the adjudication of disputes. |
| |
(3) | Regulations under subsection (2)(d) may— |
| |
(a) | make provision as to the circumstances in which a Primary Care Trust |
| 40 |
may impose a variation of contract terms, |
| |
(b) | make provision as to the suspension or termination of any duty under |
| |
the contract to provide services of a prescribed description. |
| |
(4) | Regulations making provision of the kind described in subsection (3)(b) may |
| |
prescribe services by reference to the manner or circumstances in which they |
| 45 |
| |
|
| |
|
| |
|
(5) | Regulations under subsection (1) must make provision as to the right of |
| |
persons to whom services are provided to choose the persons from whom they |
| |
| |
122 | GOS contracts: disputes and enforcement |
| |
(1) | Regulations may make provision for the resolution of disputes as to the terms |
| 5 |
of a proposed general ophthalmic services contract. |
| |
(2) | Regulations under subsection (1) may make provision— |
| |
(a) | for the referral of the terms of the proposed contract to the Secretary of |
| |
| |
(b) | for the Secretary of State, or a person appointed by him, to determine |
| 10 |
the terms on which the contract may be entered into. |
| |
(3) | Regulations may make provision for a person or persons entering into a |
| |
general ophthalmic services contract to be regarded, in circumstances where he |
| |
or they so elect, as a health service body for the purposes of section 9, but only |
| |
so far as concerns the general ophthalmic services contract (and not for any |
| 15 |
| |
(4) | Regulations under subsection (3) may include provision as to the application |
| |
of section 9 in cases where— |
| |
(a) | persons practising in partnership elect to become a health service body, |
| |
| 20 |
(b) | there is a change in the membership of the partnership. |
| |
| |
(a) | by virtue of regulations under subsection (3), subsection section 9(11) |
| |
applies in relation to a general ophthalmic services contract, and |
| |
(b) | a direction as to payments is made under that provision in relation to |
| 25 |
| |
| the direction is enforceable in a county court (if the court so orders) as if it were |
| |
a judgment or order of that court. |
| |
Performance of primary ophthalmic services |
| |
123 | Persons performing primary ophthalmic services |
| 30 |
(1) | Regulations may provide that a health care professional of a prescribed |
| |
description may not perform any primary ophthalmic service for which a |
| |
Primary Care Trust is responsible unless he is included in a list maintained |
| |
under the regulations by a Primary Care Trust. |
| |
(2) | For the purposes of this section— |
| 35 |
(a) | “health care professional” means a person who is a member of a |
| |
profession regulated by a body mentioned in section 25(3) of the |
| |
National Health Service Reform and Health Care Professions Act 2002 |
| |
| |
(b) | a Primary Care Trust is responsible for an ophthalmic service if it |
| 40 |
provides the service, or secures its provision, by or under any |
| |
| |
(3) | Regulations under this section may make provision in relation to lists under |
| |
this section and in particular as to— |
| |
|
| |
|
| |
|
(a) | the preparation, maintenance and publication of a list, |
| |
(b) | eligibility for inclusion in a list, |
| |
(c) | applications for inclusion (including provision as to the Primary |
| |
Care Trust to which an application must be made, and for the |
| |
procedure for applications and the documents to be supplied on |
| 5 |
| |
(d) | the grounds on which an application for inclusion may or must be |
| |
| |
(e) | requirements with which a person included in a list must comply |
| |
(including the declaration of financial interests and gifts and other |
| 10 |
| |
(f) | suspension or removal from a list (including provision for the |
| |
grounds for, and consequences of, suspension or removal), |
| |
(g) | circumstances in which a person included in a list may not withdraw |
| |
| 15 |
(h) | payments to be made in respect of a person suspended from a list |
| |
(including provision for the amount of the payment, or the method of |
| |
calculating the payment, to be determined by the Secretary of State or a |
| |
person appointed by him), |
| |
(i) | the criteria to be applied in making decisions under the regulations, |
| 20 |
(j) | appeals against decisions made by a Primary Care Trust under the |
| |
| |
(k) | disclosure of information about applicants for inclusion, grants or |
| |
refusals of applications or suspensions or removals, |
| |
| and may make any provision corresponding to anything in sections 151 to 159. |
| 25 |
(4) | Regulations under this section may, in particular, also provide for— |
| |
(a) | a person’s inclusion in a list to be subject to conditions determined by |
| |
| |
(b) | a Primary Care Trust to vary the conditions or impose different ones, |
| |
(c) | the consequences of failing to comply with a condition (including |
| 30 |
| |
(d) | the review by a Primary Care Trust of decisions made by it by virtue of |
| |
| |
(5) | The imposition of such conditions must be with a view to— |
| |
(a) | preventing any prejudice to the efficiency of the services to which a list |
| 35 |
| |
| |
(6) | Regulations under this section may, in particular, also prescribe the |
| |
qualifications and experience which a medical practitioner who applies for |
| |
inclusion in a list under this section must have, and may— |
| 40 |
(a) | provide for the practitioner to show to the satisfaction of a committee |
| |
recognised by the Secretary of State for the purpose that he possesses |
| |
such qualifications and experience, |
| |
(b) | confer on a person who is dissatisfied with the determination of such a |
| |
committee a right of appeal to a committee appointed by the Secretary |
| 45 |
| |
(c) | provide for anything which appears to the Secretary of State to be |
| |
appropriate in connection with that right of appeal. |
| |
|
| |
|
| |
|
(7) | Regulations making provision as to the matters referred to in subsection (3)(k) |
| |
may in particular authorise the disclosure of information— |
| |
(a) | by a Primary Care Trust to the Secretary of State, and |
| |
(b) | by the Secretary of State to a Primary Care Trust. |
| |
| 5 |
124 | Assistance and support: primary ophthalmic services |
| |
(1) | A Primary Care Trust may provide assistance or support to any person |
| |
providing or proposing to provide primary ophthalmic services under a |
| |
general ophthalmic services contract. |
| |
(2) | Assistance or support provided by a Primary Care Trust under subsection (1) |
| 10 |
is provided on such terms, including terms as to payment, as the Primary Care |
| |
Trust considers appropriate. |
| |
(3) | “Assistance” includes financial assistance. |
| |
| |
125 | Local Optical Committees |
| 15 |
(1) | A Primary Care Trust may recognise a committee formed for its area, or for its |
| |
area and that of one or more other Primary Care Trusts, which it is satisfied is |
| |
| |
(a) | the persons to whom subsection (2) applies, and |
| |
(b) | the persons to whom subsection (3) applies. |
| 20 |
(2) | This subsection applies to each person who, under a general ophthalmic |
| |
services contract entered into by him, is providing primary ophthalmic |
| |
services in the area for which the committee is formed. |
| |
(3) | This subsection applies to each optometrist not falling within subsection (2)— |
| |
(a) | who is performing primary ophthalmic services in the area for which |
| 25 |
the committee is formed, whether under section 115(4)(a), or under a |
| |
general ophthalmic services contract, and |
| |
(b) | who has notified the Primary Care Trust that he wishes to be |
| |
represented by the committee (and has not notified it that he wishes to |
| |
cease to be so represented). |
| 30 |
(4) | A committee recognised under this section is called the Local Optical |
| |
Committee for the area for which it is formed. |
| |
(5) | Any such committee may delegate any of its functions, with or without |
| |
restrictions or conditions, to sub-committees composed of members of that |
| |
| 35 |
(6) | Any such committee may co-opt persons not falling within subsection (2) or (3) |
| |
on such terms as it considers appropriate. |
| |
(7) | Regulations may require a Primary Care Trust, in the exercise of its functions |
| |
relating to primary ophthalmic services, to consult any committee recognised |
| |
by it under this section on such occasions and to such extent as may be |
| 40 |
| |
|
| |
|
| |
|
(8) | A committee recognised under this section has such other functions as may be |
| |
| |
(9) | A committee recognised under this section must in respect of each year |
| |
determine the amount of its administrative expenses for that year. |
| |
(10) | A Primary Care Trust may— |
| 5 |
(a) | on the request of a committee recognised by it, allot to that committee |
| |
such sums as the Primary Care Trust may determine for defraying the |
| |
committee’s administrative expenses, and |
| |
(b) | deduct the amount of such sums from the remuneration of persons of |
| |
whom the committee is representative under subsection (1)(a) under |
| 10 |
the general ophthalmic services contracts entered into by those persons |
| |
with the Primary Care Trust. |
| |
(11) | The administrative expenses of a committee include the travelling and |
| |
subsistence allowances payable to its members. |
| |
| 15 |
Pharmaceutical services and local pharmaceutical services |
| |
| |
Provision of pharmaceutical services |
| |
126 | Arrangements for pharmaceutical services |
| |
(1) | Each Primary Care Trust must, in accordance with regulations, make the |
| 20 |
arrangements mentioned in subsection (3). |
| |
(2) | The Secretary of State must make regulations for the purpose of subsection (1). |
| |
(3) | The arrangements are arrangements as respects the area of the Primary Care |
| |
Trust for the provision to persons who are in that area of— |
| |
(a) | proper and sufficient drugs and medicines and listed appliances |
| 25 |
which are ordered for those persons by a medical practitioner in |
| |
pursuance of his functions in the health service, the Scottish health |
| |
service, the Northern Ireland health service or the armed forces of the |
| |
| |
(b) | proper and sufficient drugs and medicines and listed appliances which |
| 30 |
are ordered for those persons by a dental practitioner in pursuance of— |
| |
(i) | his functions in the health service, the Scottish health service |
| |
or the Northern Ireland health service (other than functions |
| |
exercised in pursuance of the provision of services mentioned in |
| |
| 35 |
(ii) | his functions in the armed forces of the Crown, |
| |
(c) | listed drugs and medicines and listed appliances which are ordered for |
| |
those persons by a dental practitioner in pursuance of the provision of |
| |
primary dental services or equivalent services in the Scottish health |
| |
service or the Northern Ireland health service, |
| 40 |
(d) | such drugs and medicines and such listed appliances as may be |
| |
determined by the Secretary of State for the purposes of this paragraph |
| |
and which are ordered for those persons by a prescribed description of |
| |
person in accordance with such conditions, if any, as may be |
| |
|
| |
|