The National Health Service (Direct Payments) (Amendment) Regulations 2013

• Citation: S.I. 2013/2354
• Sections: 5

Section 1 Citation, commencement and interpretation

(1) These Regulations may be cited as the National Health Service (Direct Payments) (Amendment) Regulations 2013 and come into force on 14th October 2013.

(2) In these Regulations, “the Direct Payments Regulations ” means the National Health Service (Direct Payments) Regulations 2013 .

Section 2 Amendment of regulation 7 of the Direct Payments Regulations

In regulation 7 (decision to make a direct payment), after paragraph (10), add the following paragraphs—

(11) Where a health body decides under paragraph (10) not to make a direct payment, a patient, representative or nominee may require the health body to re-consider the decision, and may provide evidence or relevant information for the health body to consider as part of that deliberation.

(12) A health body must inform the patient and any representative or nominee in writing of the decision on a re-consideration, and state the reasons for the decision.

(13) A health body may not be required to undertake more than one re-consideration following a decision under paragraph (10) in any six month period.

Section 3 Amendment of regulation 8 of the Direct Payments Regulations

(1) Regulation 8 (care plan and care co-ordinator) is amended as follows.

(2) After paragraph (5), insert the following paragraph—

(5A) A health body may specify in a care plan that a service may be secured in respect of a patient from a person who is an individual living in the same household as the patient, a family member mentioned in regulation 7(8), or a friend involved in the provision of the patient’s care, whether or not a nominee, only if a health body is satisfied that to secure a service from that person is necessary—

(a) to meet satisfactorily the patient’s need for that service; or

(b) to promote the welfare of a patient who is a child.

(3) After paragraph (6), insert the following paragraphs—

(6A) Where a health body decides under paragraph (6) not to include a particular service in the care plan, a patient, representative or nominee may require the health body to re-consider the decision, and may provide evidence or relevant information for the health body to consider as part of that deliberation.

(6B) The health body must inform the patient and any representative or nominee in writing of the decision on a re-consideration, and state the reasons for the decision.

(6C) A health body may not be required to undertake more than one re-consideration following a decision under paragraph (6).

Section 4 Amendment of regulation 11 of the Direct Payments Regulations

In regulation 11 (conditions to be complied with by the patient, representative or nominee), after paragraph (3), insert the following paragraph—

(3A) A patient, representative or nominee may use direct payments to secure a service in respect of the patient from a person mentioned in regulation 8(5A), only if the care plan specifies, pursuant to that regulation, that the service may be secured from that person.

Section 5 Amendment of regulation 13 of the Direct Payments Regulations

In regulation 13 (amount of direct payment), after paragraph (5), add the following paragraphs—

(6) Where a health body decides under paragraph (5) to reduce the amount paid by way of direct payments, a patient, representative or nominee may require the health body to re-consider the decision, and may provide evidence or relevant information for the health body to consider as part of that deliberation.

(7) A health body must inform the patient and any representative or nominee in writing of the decision on a re-consideration, and state the reasons for the decision.

(8) A health body may not be required to undertake more than one re-consideration following a decision under paragraph (5).