The National Health Service (General Medical Services Contracts) Regulations 2015

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Premises

• Ensure premises are suitable and sufficient for patient needs

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Patients aged 75 and over

• Offer a consultation to patients aged 75 or over who haven't been seen in a year

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Patients aged 75 and over: accountable GP

• Assign an accountable GP and coordinate care for patients aged 75 and over

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NHS e-Referral Service (e-RS)

• Use NHS e-Referral Service for consultant-led outpatient referrals

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Direct booking by NHS 111 or via a connected service

• Offer minimum daily appointments for direct NHS 111 booking

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Clinical reports

• Provide clinical report to NHS England for non-registered patients

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Storage of vaccines

• Store vaccines correctly and monitor refrigerator temperatures daily

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Infection control

• Have appropriate infection control and decontamination arrangements

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Duty of co-operation

• Co-operate with providers of services you do not offer

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Duty of co-operation: Primary Care Networks

• Co-operate with Primary Care Network services and share information with patients

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Duty to have regard to Armed Forces Covenant principles

• Have due regard to Armed Forces Covenant principles for patients

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Cessation of service provision: information requests

• Comply with information requests when ceasing certain NHS services

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List of patients

• Update patient list data when NHS England asks

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Application for inclusion in a list of patients

• Notify NHS England of new patient registrations as soon as possible

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Inclusion in list of patients: armed forces personnel

• Manage armed forces patients registered with your practice

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Inclusion in list of patients: detained persons

• Accept and process detained persons' patient list applications

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Telephone services

• Do not use 087, 090, 091 or 070 numbers for patient phone lines unless free

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Temporary residents

• Notify NHS England when a temporary resident's period ends

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Refusal of applications for inclusion in list of patients or for acceptance as temporary resident

• Handle patient application refusals fairly and keep records

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Patient preference of a practitioner

• Inform patients of right to choose a GP and try to comply with preference

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Removal from the list at the request of the patient

• Notify NHS England when a patient asks to be removed from your list

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Removal from the list at the request of the contractor

• Remove a patient from your list with proper notice and record-keeping

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Removal from the list of patients who are violent

• Remove violent patients from your list with immediate effect

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Cost of relevant calls

• Keep patient call costs at geographical rates

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Termination of responsibility for patients not registered with the contractor

• Terminate non-registered patient services properly and keep records

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Crown servants and family members returning to the United Kingdom for more than three months: inclusion in list of original or successor practice

• Accept and register qualifying returning Crown servants and family members

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Persons returning to the United Kingdom for three months or less: temporary registration with original or successor practice

• Accept eligible returning persons as temporary patients and notify NHS England

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Crown servants and family members returning to the United Kingdom for more than three months: inclusion in list of patients of a new practice

• Accept returning Crown servants and families onto your patient list

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Crown servants and family members returning to the United Kingdom for three months or less: temporary registration with new practice

• Accept Crown servants returning for ≤3 months as temporary patients

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Refusal of an application under paragraphs 32D to 32G

• Handle application refusals fairly, notify within 14 days, and keep records

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Application for closure of list of patients

• Submit written application to close patient list with required information

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Approval of an application to close a list of patients

• Close your patient list as specified in the closure notice

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Rejection of an application to close a list of patients

• Do not reapply to close patient list within 3 months of rejection unless circumstances change

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Contact with the practice

• Provide multiple contact methods and respond to patients within set times

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Assignment to closed lists: NHS dispute resolution procedure relating to determinations of the assessment panel

Other duties (1) — Crown / regulator

• Secretary of State must hear disputes about assigning new patients to closed GP lists Crown / Minister / Government department

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Sub-contracting of clinical matters

• Do not sub-contract clinical services without NHS England approval and due diligence

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Sub-contracting out of hours services

• Obtain NHS England approval before sub-contracting out-of-hours services

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Marketing campaigns

• Participate in up to 6 NHS marketing campaigns per year

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Advertising private services

• Do not advertise private services alongside NHS primary medical services

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Notices to NHS England

• Notify NHS England of serious incidents, patient changes, and other key events

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Attendance outside practice premises

• Visit patients at home or appropriate alternative when they cannot attend practice

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Notice provisions specific to a contract with a company limited by shares

• Notify NHS England of key company changes and confirm eligibility

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Notice provisions specific to a contract with two or more individuals practising in a partnership

• Notify NHS England of partnership changes (partner leaving or joining)

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Notice of deaths

• Notify NHS England of patient deaths on practice premises by next working day

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Entry and inspection by NHS England

• Allow NHS England to inspect your practice premises

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Entry and inspection by the Care Quality Commission

• Allow Care Quality Commission to enter and inspect your practice premises

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Entry and inspection by Local Healthwatch organisations

• Allow Local Healthwatch organisations to enter and inspect premises

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Variation provisions specific to a contract with an individual medical practitioner

• Notify NHS England before changing to partnership status

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Variation provisions specific to a contract with two or more persons practising in partnership

• Notify NHS England when your GP partnership changes or ends

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Newly registered patients

• Invite newly registered patients for a health check within six months

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Late payment notices

• You can serve a late payment notice and terminate the contract if NHS England fails to pay

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Termination by NHS England for unlawful sub-contracting

Other duties (1) — Crown / regulator

• NHS England must act on unlawful sub-contracting Statutory regulator

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Newly registered patients – alcohol dependency screening

• Screen newly registered patients for alcohol dependency and provide follow-up

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Termination by NHS England: remedial notices and breach notices

• Contractor must remedy contract breaches within notice period or risk termination

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Patients living with frailty

• Identify and manage frailty in patients aged 65 and over

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Accountable GP

• Assign an accountable GP to each registered patient

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Patients not seen within three years

• Offer a catch-up consultation for patients not seen in 3 years

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Right to suspend a general medical services contract

• Notify NHS England of intention to switch to integrated care provider contract

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Suspension of a general medical services contract: general

Other duties (1) — Crown / regulator

• NHS England must pay outstanding payments within 3 months of contract suspension Statutory regulator

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Termination, expiry or variation of an integrated care provider contract

• Resume providing primary medical services after integrated care contract ends

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Conditions relating solely to medical practitioners

• Ensure your practice meets the composition requirements for a GMS contract

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Essential services

• Provide essential GP services to registered patients and certain others

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Out of hours services

• Provide or monitor out-of-hours services depending on your contract

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Patients who should not be tested for, or vaccinated against, coronavirus: confirmation of exemption

• Respond to valid coronavirus exemption requests free of charge via the information hub

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Fees and charges

• Do not charge patients for NHS treatment or prescriptions

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Patient participation

• Establish and maintain a Patient Participation Group to obtain and act on patient feedback

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Publication of earnings information

• Publish GP practice earnings information online each year

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Suspension of contract terms or of enforcement of contract terms while a disease is or in anticipation of a disease being imminently pandemic etc.

Other duties (1) — Crown / regulator

• NHS England must suspend specified contract terms during a pandemic Statutory regulator

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Opt outs: minor surgery

Other duties (1) — Crown / regulator

• NHS England must discuss and support minor surgery opt-outs Crown / Minister / Government department

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Minor surgery: permanent opt outs

Other duties (1) — Crown / regulator

• NHS England must approve or reject minor surgery opt-out notices Statutory regulator

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Out of hours services: opt outs

• Notify NHS England in writing to opt out of out-of-hours services

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Informing patients of opt outs

• Discuss and inform patients about opt-out from services

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Qualifications of performers: health care professionals

• Health care professionals must be registered and not suspended to perform clinical services

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Conditional registration or inclusion in primary care list

• Follow conditions on a health professional's registration or GP list inclusion

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Clinical experience

• Only perform clinical services if you have proper training and experience

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Conditions for employment and engagement: medical practitioners

• Check medical practitioners meet experience and registration requirements

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Conditions for employment or engagement: health care professionals

• Check healthcare professionals' qualifications before employing

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Clinical references

• Obtain and check two clinical references before hiring healthcare professionals

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Verification of qualifications and competence

• Check that staff are suitably qualified and competent before hiring

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Training

• Maintain staff skills and provide training opportunities

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Arrangements for GP Specialty Registrars

• Comply with conditions when employing a GP Specialty Registrar

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Notice requirements in respect of relevant prescribers

• Notify NHS England when prescribers start or stop working for your practice

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Signing of documents

• Include clinical profession and contractor name on signed documents

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Level of skill

• Perform your NHS contract duties with reasonable care and skill

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Appraisal and assessment

• Ensure medical practitioners participate in appraisal and co-operate with patient safety functions

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Prescribing: general

• Ensure prescription forms and oxygen order forms comply with regulatory requirements

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Prescribing software and supply shortages etc. of medicines

• Ensure prescribing software contract includes supply shortage update clause

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Orders for drugs, medicines or appliances

• Order drugs, medicines or appliances for patients using the correct prescription method

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Electronic prescriptions

• Follow rules for electronic prescriptions

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Patient choice: pharmaceutical services

• Honour patient choice of pharmacy and do not steer nominations

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Repeatable prescribing services

• Notify NHS England before offering repeatable prescribing services

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Repeatable prescriptions

• Manage non-electronic repeat prescriptions properly

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Prescribing for electronic repeat dispensing

• Issue electronic repeat dispensing prescriptions in appropriate format when clinically appropriate

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Restrictions on prescribing by medical practitioners

• Follow NHS prescribing restrictions under your GMS contract

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Restrictions on prescribing by supplementary prescribers

• Ensure supplementary prescribers comply with prescribing restrictions

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Bulk prescribing

• Use bulk prescriptions for 10+ patients in large institutions

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Excessive prescribing

• Do not prescribe excessive drugs or medicines for patients

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Provision of drugs, medicines and appliances for immediate treatment or personal administration

• Provide drugs and appliances for immediate patient treatment

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Supply of medicines etc. by contractors providing out of hours services

• Ensure out of hours performers comply with supply rules for medicines and appliances

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Vaccines and immunisations: duty of co-operation

• Co-operate to improve vaccine and immunisation uptake

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Vaccines and immunisations: standards

• Set up a vaccine appointment system and follow data rules

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Vaccines and immunisations: catch-up campaigns

• Take part in one NHS vaccine catch-up campaign each year

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Vaccines and immunisations: additional staff training

• Train staff in anaphylaxis recognition and initial treatment

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Vaccines and immunisations: nominated person

• Appoint a V&I lead and ensure compliance with NHS guidance

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Patient records

• Keep adequate patient records and manage record transfers

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Record of ethnicity information

• Record patient ethnicity when disclosed, or record refusal

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Summary Care Record

• Enable automated upload of patient summary information to Summary Care Record on each record change

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Enabling access to patient records through GP Connect

• Enable GP Connect access and update functionality in clinical systems

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Electronic transfer of patient records between GP practices

• Use GP2GP for electronic patient record transfers

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Transfer of patient records between GP practices: time limits

• Transfer patient records to new GP within 28 days

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Clinical correspondence: requirement for NHS number

• Include NHS number as primary identifier in clinical correspondence

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Use of fax machines

• Stop using fax machines for secure electronic communications

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Patient online services : appointments and prescriptions

• Provide online appointment and prescription services to patients

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Patient access to online services

• Agree a plan with NHS England to increase patient online registration

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Patient access: other availability of directly bookable appointments

• Offer all directly bookable appointments by phone or in person

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Patient online services: provision of online access to coded information in medical record and prospective medical records

• Provide online access to coded health records and prospective records

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Patient online services: provision of online access to full digital medical record

• Provide patients online access to full digital medical record on request

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Patient online services: providing and updating personal or contact information

• Offer and promote online patient information update service

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Patient online services: provision of an online consultation tool

• Offer and promote an online consultation tool to patients

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Secure electronic communications

• Offer and use secure electronic communication with patients

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Video consultations

• Offer and promote video consultations to registered patients

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Confidentiality of personal data: nominated person

• Appoint a person responsible for personal data confidentiality

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Requirement to have and maintain an online presence

• Maintain an online presence and keep information accurate

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Requirement to maintain profile page on NHS website

• Review and update your NHS website profile page annually

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Provision of information

• Provide information requested by NHS England for contract or its functions

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National Diabetes Audit

• Record and submit data for the National Diabetes Audit

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Information relating to indicators no longer in the Quality and Outcomes Framework

• Allow NHS England to extract certain clinical data from your systems

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Information relating to alcohol related risk reduction and dementia diagnosis and treatment

• Allow NHS England to extract alcohol and dementia data from patient records

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NHS England Workforce Collections

• Submit workforce data to NHS England via the National Workforce Reporting Service

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Information relating to overseas visitors

• Record and report overseas visitor information to NHS Digital and NHSBSA

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Medicines and Healthcare products Regulatory Agency Central Alerting System

• Provide and maintain contact details for MHRA Alerting System

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Collection of data relating to appointments in general practice

• Record and upload GP appointments data for NHS collection

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Collection of data relating to use of the online consultation tool and video consultations

• Provide NHS England with data on online consultation and video consultation use

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Recording and reviewing patient safety events

• Register and maintain an administrator account with the LFPSE Service

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Inquiries about prescriptions and referrals

• Answer NHS England inquiries about prescriptions and referrals

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Provision of information to a medical officer etc.

• Supply clinical information and answer inquiries for DWP officers

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Annual return and review

• Submit annual return and digital practice area map to NHS England

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Practice leaflet

• Prepare and keep your practice leaflet up to date

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Complaints procedure

• Set up and operate a formal complaints procedure

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Co-operation with investigations

• Co-operate with complaint investigations by NHS England, Health Service Commissioner or NHS bodies/local authorities

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Local resolution of contract disputes

• Make reasonable efforts to resolve contract disputes locally before escalating

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NHS dispute resolution procedure

Other duties (1) — Crown / regulator

• Secretary of State must process NHS contract dispute referrals under defined procedure Crown / Minister / Government department

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Clinical governance

• Implement a clinical governance system and appoint a responsible person for controlled drugs

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Friends and Family Test

• Offer patients the Friends and Family Test, report and publish results

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Co-operation with NHS England

• Co-operate with NHS England on controlled drugs obligations

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Co-operation with the Secretary of State and NHS England

• Cooperate with Secretary of State and NHS England on education and training

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Insurance

• Maintain insurance cover for clinical services and check sub-contractors' cover

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Public liability insurance

• Hold adequate public liability insurance at all times

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Gifts

• Keep a register of gifts worth over £100

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Compliance with legislation and guidance

• Comply with all relevant legislation and have regard to official guidance