The National Health Service (General Ophthalmic Services etc.) Amendment Regulations 2006

• Citation: S.I. 2006/1550
• Sections: 6

Section 1 Citation, commencement, application and interpretation

(1) These Regulations may be cited as the National Health Service (General Ophthalmic Services etc.) Amendment Regulations 2006 and shall come into force on 19th July 2006.

(2) These Regulations apply in relation to England only.

(3) In these Regulations—

“the Principal Regulations ” means the National Health Service (General Ophthalmic Services) Regulations 1986 ; and

“the Schedule” means Schedule 1 (terms of service) to the Principal Regulations .

Section 2 Amendment of regulation 12A of the Principal Regulations

(1) Regulation 12A (suspension) of the Principal Regulations shall be amended in accordance with the provisions of this regulation.

(2) For paragraphs (1) to (5) substitute—

(1) During a period of suspension payments may be made to or in respect of a suspended ophthalmic medical practitioner or optician in accordance with a determination by the Secretary of State.

(3) For paragraph (7) substitute—

(7) If a payment is made pursuant to a determination under paragraph (1), but the payee was not entitled to receive all or any part of it, if the amount to which he was not entitled has not been recovered by other means, it may be recovered as a civil debt.

(8) If an ophthalmic medical practitioner or optician is dissatisfied with a decision of a Primary Care Trust (“the original decision”)—

(a) to refuse to make a payment to, or in respect of, him pursuant to a determination under paragraph (1);

(b) to make a payment to, or in respect of, him pursuant to a determination under paragraph (1), but at a lower level than the level to which he considers to be correct; or

(c) in respect of recovery of what the Primary Care Trust considers to be an overpayment,

he may ask the Primary Care Trust in writing to review the original decision and, if he does so, the Primary Care Trust shall reconsider that decision, and once it has done so, it must notify the ophthalmic medical practitioner or optician of the decision that is the outcome of its reconsideration of its original decision (“the reconsidered decision”), and give him notice of the reasons for its reconsidered decision.

(9) If the ophthalmic medical practitioner or optician remains dissatisfied (whether on the same or different grounds), he may appeal to the Secretary of State by giving him a notice of appeal within a period of 28 days beginning on the day that the Primary Care Trust notified him of the reconsidered decision.

(10) A notice of appeal under paragraph (9) shall include—

(a) the names and addresses of the parties to the disputed decision;

(b) a copy of the reconsidered decision; and

(c) a brief statement of the grounds for appeal.

(11) The Secretary of State shall then send a written request to the parties to make, in writing and within a period specified by him, any representations they may wish to make about the matter (and the request to the Primary Care Trust shall include a copy of the ophthalmic medical practitioner or optician’s brief statement of the grounds for appeal).

(12) Once the period specified pursuant to paragraph (11) has elapsed, the Secretary of State shall—

(a) give a copy of the representations received from a party to the other party; and

(b) request in writing a party to whom a copy of representations is given to make within a period specified by him any written observations which he or it wishes to make on those representations.

(13) Once the period specified pursuant to paragraph (12)(b) has elapsed, the Secretary of State shall, as soon as is reasonably practicable, having taken into account any such representations or observations as are referred to in paragraphs (11) and (12) (if submitted within the specified periods) and such other evidence as he sees fit to consider–—

(a) determine the appeal, and shall give notice of the determination (including a record of the reasons for it) to both parties; and

(b) give the Primary Care Trust such directions in writing, if any, on the matter as he thinks fit.

Section 3 Amendment of regulation 13 of the Principal Regulations

In regulation 13(2A) (sight tests – eligibility) of the Principal Regulations for “article 8 of the European Specialist Medical Qualifications Order 1995” substitute “article 13(1) of the General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003 ”.

Section 4 Amendment of Schedule 1 to the Principal Regulations

(1) The Schedule shall be amended in accordance with this regulation.

(2) In paragraph 8B —

(a) in sub-paragraph (1), for the words “or Primary Care Trust” to the end of the sub-paragraph, substitute “or the Commission for Healthcare, Audit and Inspection in accordance with the National Health Service (Complaints) Regulations 2004 , whether the investigation follows one under the practice based complaints procedure or not.”; and

(b) in sub-paragraph (2), for “or Primary Care Trust”, in each place it appears, substitute “or the Commission for Healthcare, Audit and Inspection”.

(3) At the end, there shall be added paragraph 12—

Telephone services

(12)

(1) A contractor shall not be a party to any contract or other arrangement under which the number for telephone services to be used by—

(a) patients to contact the contractor for any purpose related to the provision of general ophthalmic services; or

(b) any other person to contact the contractor in relation to services provided as part of the health service, and

starts with the digits 087, 090 or 091 or consists of a personal number, unless the service is provided free to the caller.

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

Section 5 Amendment of regulation 13 of the Supplementary List Regulations

At the end of regulation 13 (suspension) of the National Health Service (General Ophthalmic Services Supplementary List) and (General Ophthalmic Services Amendment and Consequential Amendments) Regulations 2005 add—

(18) If a payment is made pursuant to a determination under paragraph (17), but the payee was not entitled to receive all or any part of it, if the amount to which he was not entitled has not been recovered by other means, it may be recovered as a civil debt.

(19) If an ophthalmic medical practitioner or optician is dissatisfied with a decision of a Primary Care Trust (“the original decision”)—

(a) to refuse to make a payment to, or in respect of, him pursuant to a determination under paragraph (17);

(b) to make a payment to, or in respect of, him pursuant to a determination under paragraph (17), but at a lower level than the level to which he considers to be correct; or

(c) in respect of recovery of what the Primary Care Trust considers to be an overpayment,

he may ask the Primary Care Trust in writing to review the original decision and, if he does so, the Primary Care Trust shall reconsider that decision, and once it has done so, it must notify the ophthalmic medical practitioner or optician of the decision that is the outcome of its reconsideration of its original decision (“the reconsidered decision”), and give him notice of the reasons for its reconsidered decision.

(20) If the ophthalmic medical practitioner or optician remains dissatisfied (whether on the same or different grounds), he may appeal to the Secretary of State by giving him a notice of appeal within a period of 28 days beginning on the day that the Primary Care Trust notified him of the reconsidered decision.

(21) A notice of appeal under paragraph (20) shall include—

(a) the names and addresses of the parties to the disputed decision;

(b) a copy of the reconsidered decision; and

(c) a brief statement of the grounds for appeal.

(22) The Secretary of State shall then send a written request to the parties to make, in writing and within a period specified by him, any representations they may wish to make about the matter (and the request to the Primary Care Trust shall include a copy of the ophthalmic medical practitioner or optician’s brief statement of the grounds for appeal).

(23) Once the period specified pursuant to paragraph (22) has elapsed, the Secretary of State shall—

(a) give a copy of the representations received from a party to the other party; and

(b) request in writing a party to whom a copy of representations is given to make within a period specified by him any written observations which he or it wishes to make on those representations.

(24) Once the period specified pursuant to paragraph (23)(b) has elapsed, the Secretary of State shall, as soon as is reasonably practicable, having taken into account any such representations or observations as are referred to in paragraphs (22) and (23) (if submitted within the specified periods) and such other evidence as he sees fit to consider–—

(a) determine the appeal, and shall give notice of the determination (including a record of the reasons for it) to both parties; and

(b) give the Primary Care Trust such directions in writing, if any, on the matter as he thinks fit.

Section 6 Transitional arrangements in relation to telephone services and general ophthalmic services

(1) Where, as a result of the amendment of the Schedule by virtue of regulation 4(3), a contractor is, by virtue of a contract or other arrangement for the provision of telephone services entered into before 1st July 2006, in breach of his terms of service, no action shall be taken against the contractor in respect of that breach, provided that the contractor complies with the conditions specified in paragraph (2).

(2) The conditions referred to in paragraph (1) are that the contractor—

(a) provides, within the time specified in the request, such details of the contract or other arrangement for telephone services as the Primary Care Trust may request; and

(b) varies or terminates that contract or other arrangement when required to do so by the Primary Care Trust in accordance with directions from the Secretary of State under section 17 of the National Health Service Act 1977 .