7 (h) evidence that the names of both A and B appear on a lease or, if they live in rental accommodation, rental agreement; and (i) evidence of the length of the relationship. (9) For the purposes of paragraph (6)(b), a relationship is not an exclusive relationship if one or both of the parties is a party to another relati onship which is, or could be considered to be, a substantial and exclusive relati onship having regard to the provisions of this regulation. Infertility treatment: seriously injured serving members and veterans 8. —(1) This regulation applies to a person who is a serving member of the armed forces or a veteran of the armed forces where that person— (a) has been severely injured in service; and (b) as a result of the injury sustained— (i) suffers from infertility, and (ii) is in receipt of compensation for infertility under the Armed Forces Compensation Scheme; and (c) after specialist sperm retrieval, wishes to receive infertility treatment and is eligible for, and has been accepted for, such treatment. (2) The Board must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of infertility treatment to a person to whom this regulation applies and to that person’s partner. (3) The infertility treatment referred to in paragraph (2) must— (a) in any case, include funding the cost of sperm storage facilities; (b) where, and to the extent that, the Board is satisfied that it is clinically appropriate in the circumstances of any particular case, include up to three cycles of in vitro fertilisation treatments or other means of assisted conception; (c) be provided at the same facility at which the specialist sperm retrieval took place and the extracted sperm of that person is stored. (4) For the purposes of this regulation and regula tion 9, “partner” is to be construed in accordance with regulation 7(6) to (9). Infertility treatment: further provision 9. —(1) Where a person referred to in regulation 7(1)(a) or 8(1)— (a) has died or has become mentally incapacitated; and (b) has, before the time of that person’s death or mental incapacity— (i) made provision for sperm storage, and (ii) given written consent to the stored sperm being used by a named partner, the Board must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of infertility treatment to that person’s named partner. (2) The infertility treatment referred to in paragraph (1) must— (a) in any case, include funding the cost of sperm storage facilities from the date on which the person died or, as the case may be, became mentally incapacitated; and (b) where, and to the extent that, the Board is satisfied that it is clinically appropriate in the circumstances of any particular case, include up to three cycles of in vitro fertilisation treatments and other means of assisted conception. (3) Where infertility treatment is provided by the Board under paragraph (1) to the named partner of a person referred to in regulation 8(1), that treatment must be provided at the same 8 facility at which specialist sperm retrieval took place in relation to that person and at which that person’s extracted sperm has been stored. Services for prisoners and other detainees 10. —(1) Where a person is detained in a prison or in other accommodation described in paragraph (2), the Board must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision to that person as part of the health service of— (a) community services; (b) secondary care services; and (c) the services specified in Schedule 4. (2) The other accommodation referred to in paragraph (1) is— (a) a court; (b) a secure children’s home (except those speci fied in Part 1 of Schedule 3); (c) a secure training centre specified in the first co lumn of Table 1 in Schedule 3 from the date specified in the corresponding entry in the second column of that Table; (d) an immigration removal centre specified in th e first column of Table 2 in Schedule 3 from the date specified in the corresponding entry in the second column of that Table; and (e) a young offender institution (except Ashfield Young Offender Institution). (3) In this regulation, “court” means any court in which criminal proceedings against a person are heard. Specified services for rare and very rare conditions 11. The Board must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of the services specified in Schedule 4. Assessment, diagnostic, elective and minor elective care services provided by Independent Sector Treatment Centres 12. —(1) This regulation applies to services provided by an Independent Sector Treatment Centre pursuant to the arrangements specified in paragraph (2). (2) The arrangements referred to in paragraph (1) are— (a) the agreement made on 20th July 2005 and ending on 27th July 2013 between the Secretary of State for Health, Nations Healthcare (Nottingham) Limited, Nottinghamshire County Teaching Primary Care Trust, Nottingham City Primary Care Trust, Derby City Primary Care Trust, Derbyshire County Primary Care Trust, Lincolnshire Teaching Primary Care Trust, Leicestershire County and Rutland Primary Care Trust, Bassetlaw Primary Care Trust and Nottinghamshire University Hospitals NHS Trust for the provision of elective services and diagnos tic services by Nations Healthcare (Nottingham) Limited; (b) the agreement made on 15th December 2006 and ending on 31st March 2014 between the Secretary of State for Health, InHealth Group Limited and InHealth London Limited for the provision of diagnostic services by InHealth London Limited; (c) the agreement made on 30th May 2008 and ending on 2nd February 2016 between the Secretary of State for Health, Care UK Clinical Services Limited and Care UK Limited for the provision of assessment and minor el ective care services and diagnostic services by Care UK Clinical Services Limited; (d) the agreement made on 30th May 2008 and endi ng on 27th October 2015 between the Secretary of State for Health, PHG (Hampshire) Limited and Care UK plc for the provision of elective services and diagnostic services by PHG (Hampshire) Limited; 9 (e) the agreement made on 31st July 2008 and ending on 31st October 2015 between the Secretary of State for Health, UKSH South West Limited and UK Specialist Hospitals Limited for the provision of elective services and diagnostic services by UKSH South West Limited; and (f) the agreement made on 26th September 2011 and ending on 16th October 2016 between the Secretary of State for Health, Clinicenta (H ertfordshire) Limited and Carillion plc for the provision of elective services and assessment and minor elective care services by Clinicenta (Hertfordshire) Limited. (3) The Board must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of the services to which each of the agreements specified in paragraph (2)(a) to (f) relates for the period beginning on 1st April 2013 and, in the case of each respective agreement, ending on the date on which that agreement comes to an end. (4) In this regulation— “assessment and minor elective care services” means services related to the assessment, screening and planned care or treatme nt of minor medical conditions; “diagnostic services” includes imaging services (such as MRI, CT, Ultrasound, Xray, Dexa Scan), physiological measurement , audiology, endoscopies, includi ng direct access diagnostic services from primary care and other ancillary services needed to support the delivery of these services; and “elective services” means clinical care services including Fi nal Finished Consultant Episodes relating to, for example, trauma and ort hopaedic surgery, general surgery, ear nose and throat, oral surgery, urology, gynaecology, plastic surgery, ophthalmology, hepatobiliary and pancreatic surgery, colorectal surgery, vascular surgery, gastroenterology, respiratory medicine, endocrinology, rheum atology, pain manage ment and dermatology. Fixated threat assessment services 13. —(1) The Board must arrange, to such extent as it considers necessary to meet all reasonable requirements, for the provision as part of the health service of specialised clinical risk assessment and management services for people with mental health problems who may present a risk to prominent people or locations. (2) The arrangements to be made by the Board under paragraph (1) must include— (a) the provision of funding for mental health staff to provide the services referred to in paragraph (1); and (b) such provision for partnership working with other persons or health services as is considered necessary to facilitate the effective delivery of those services. PART 4 Mental health after-care services Circumstances in which duty may be imposed on another CCG 14. —(1) The duty imposed by subsection (2) of section 117 of the 1983 Act on a CCG( a ) (CCG A) to arrange for the provision of after-care services for a person (P) to whom section 117 applies is to be imposed instead on another CCG (CCG B) in the circumstances below. (2) These circumstances are where CCG B has responsibility for P by virtue of— (a) section 3(1A) of the 2006 Act( b ); or ( a ) Section 117(2) of the 1983 Act was amended by sections 40(1) and (2)(a) of the 2012 Act. ( b ) Section 3(1A) was inserted by section 13(3) of the 2012 Act. 10 (b) regulation 4 of, and sub-paragraph (c), (g), (h), (i) or (j) of paragraph 2 of Schedule 1 to these Regulations. Circumstances in which duty may be imposed on the Board 15. —(1) The duty imposed by subsection (2) of section 117 of the 1983 Act on a CCG to arrange for the provision of after-care services for a person (P) to whom section 117 of the 1983 Act applies is to be imposed instead on the Board in the circumstances below. (2) These circumstances are where P is receiving an after-care service under section 117 which, if it were being provided under the 2006 Act, would be a service whose provision the Board had a duty to arrange. PART 5 Standing rules: commissioning contract terms Matters to be included in commissioning contracts 16. —(1) A commissioning contract ente red into by a relevant body must contain terms and conditions that prescribe the circumstances in which the health service provider must provide to a relevant person— (a) an appropriate apology; and (b) the relevant information, where there has been a patient safety incident. (2) In this regulation— “appropriate apology” means a sincere expression of sorr ow or regret, given in writing, for the harm that has resulted from a patient safety incident; “patient safety incident” means an unintended or unexpected incident that occurs in respect of a patient, during and as a result of the provisi on of health care services, that could have led to, or did lead to, harm to that patient; “relevant person” means the patient in respect of w hom the patient safety incident occurred, or someone lawfully acting on that patient’s behalf; “relevant information”, in relation to a patie nt safety incident, means written details of— (a) the patient safety incident, (b) any investigation that has been carried out into that incident, and any causes of that incident, or other findings, that have been identified as a result of such an investigation, and (c) any steps that have been taken to prevent the recurrence of such an incident. Terms and conditions to be drafted by the Board 17. —(1) The Board must draft— (a) terms and conditions making provision for th e matters specified in regulation 16; and (b) such other terms and conditions as the Board considers are, or might be, appropriate for inclusion in commissioni ng contracts entered into by a relevant body. (2) The Board may draft model commi ssioning contracts which reflect the terms and conditions it has drafted pursuant to paragraph (1). (3) A relevant body must incorporate the term s and conditions drafted by virtue of paragraph (1)(a) in commissioning contracts entered into by it. (4) The Board may require CCGs to incorporate the terms and conditions it has drafted pursuant to paragraph (1)(b) in commissioning contract s that a CCG enters into. 11 (5) If a CCG is required by the Board to incorporate terms and conditions pursuant to paragraph (4), it must do so. Consultation by the Board 18. —(1) The Board must consult the persons specified in paragraph (2)— (a) before exercising its functions under regulation 17(1) and (2) for the first time; and (b) before revising— (i) terms and conditions it has drafted pursuant to regulation 17(1), or (ii) a model commissioning contract it has drafted pursuant to regulation 17(2), in a way which would, in the opinion of the Board, result in a substantial change to those terms and conditions or that contract (as the case may be). (2) The persons specified for the purposes of paragraph (1) are— (a) the Care Quality Commission( a ); (b) CCGs; (c) Healthwatch England( b ); (d) Monitor( c ); (e) the Secretary of State; and (f) such other persons as the Board considers it is appropriate to consult. Transitional provision 19. —(1) The requirements in regulations 16 and 17 apply in relation to commissioning contracts entered into on or after 1st February 2013. (2) Consultation undertaken before the coming into force of this Part is as effective for the purposes of regulation 18 as consultation undertaken aft er the coming into force of this Part. PART 6 Standing rules: NHS Continuing Healthcare and NHS funded nursing care Interpretation 20. —(1) In this Part— “2008 Act” means the Health and Social Care Act 2008( d ); “Fast Track Pathway Tool” means the Fast Track Pathway Tool for NHS Continuing Healthcare issued by the Secretary of State and dated 28th November 2012( e ); “flat rate payment” means a payment of £108.70 per week; “high band payment” means a payment made at the high band rate of £149.60 per week following a RNCC determination; “low band payment” means a payment made at the low band rate following a RNCC determination; ( a ) The Care Quality Commission is established by section 1 of the Health and Social Care Act 2008 (c. 14) (“the 2008 Act”). ( b ) Healthwatch England is established as a committee of the Care Quality Commission by virtue of paragraph 6(1A) of Schedule 1 to the 2008 Act, as amended by section 181(2) of the 2012 Act. ( c ) Monitor is the new name given to the Independent Regulator of NHS Foundation Trusts: see section 61 of the 2012 Act. ( d ) 2008 c. 14. ( e ) The Fast Track Pathway Tool can be found at dh.gov.uk/health/2012/11/continuing-healthcare-revisions/. 12 “medium band payment” means a payment made at the medium band rate following a RNCC determination; “National Framework” means the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care issued by the Secretary of State and dated 28th November 2012( a ); “NHS Continuing Healthcare” means a package of care arranged and funded solely by the health service in England for a person aged 18 or over to meet physical or mental health needs which have arisen as a result of disability, accident or illness; “nursing care” means nursing care by a regi stered nurse and “nursing care by a registered nurse” has the same meaning as in section 49(2) of the Health and Social Care Act 2001( b ); “old Guidance” means the documents entitled “Guidance on Free Nursing Care in Nursing Homes” dated 25th September 2001( c ) and “NHS Funded Nursing Care Practice Guidance and Workbook (August 2001)” dated 5th September 2001( d ), as supplemented by “NHS Continuing Health Care: Action following the Grogan Judgement” dated 3rd March 2006( e ); “registered manager” means, in respect of relevan t premises, a person registered with the Care Quality Commission under Chapter 2 of Part 1 of the 2008 Act as a manager in respect of the regulated activity carried on at those premises; “registered person” means, in respect of relevant premises, a person who is a service provider or registered manager in respect of those premises; “regulated activity” means the activity of providing residential accommodation, together with personal or nursing care, specified in paragraph 2 of Schedul e 1 to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010( f ); “relevant premises” means premises where regulated activity is carried on and for which there is a registered person; “relevant social services authority” means the social services authority appearing to a relevant body to be the authority in whose area a patient is ordinarily resident; “RNCC determination” means a determination as to the Registered Nursing Contribution to Care taken in respect of a person in accordance with the National Health Service (Nursing Care in Residential Accommodation) (England) Directions 2001( g ); “service provider” means, in respect of relevant premises, a person registered with the Care Quality Commission under Chapter 2 of Part 1 of the 2008 Act as a service provider in respect of the regulated activity carried on at those premises; “social services authority” means a local authority for the purposes of the Local Authority Social Services Act 1970( h ) and the Council of the Isles of Scilly; “social services authority area” means an area for which a local social services authority is responsible. (2) For the purposes of this Part a relevant body has responsibility for a person if the body is responsible— (a) in the case of a CCG, by virtue of— ( a ) The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care can be found at dh.gov.uk/health/2012/11/continuing-healthcare-revisions/. ( b ) 2001 c. 15. ( c ) The guidance can be found at dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Healthservicecirculars/ DH_4003954. ( d ) The guidance and workbook can be found at webarchive.nationalarchives.gov.uk/+/dh.gov.uk/en/ Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009471. ( e ) The guidance can be found at dh. gov.uk/en/Publicationsandstatistics/Publications/ Publicationspolicyandguidance/DH_4131162. ( f ) S.I. 2010/781. Paragraph 2 of Schedule 1 has been amended by article 2 of, and paragraph 27 of the Schedule to, S.I. 2012/979. ( g ) The Directions can be found at dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/ DH_4003016. ( h ) 1970 c.42. See section 1, to which a relevant amendment was made by section 195(3) of the Local Government Act 1972 (c. 70). 13 (i) section 3(1A) of the 2006 Act, except where the person is a person for whom another CCG is responsible by virtue of paragraph 2(b), (d), (e) or (f) of Schedule 1 to these Regulations, or (ii) paragraph 2, other than paragraph 2(a), of Schedule 1 to these Regulations; or (b) in the case of the Board, by virtue of regulation 7 (secondary care services and community services: serving members of the armed forces and their families) or regulation 10 (services for pri soners and other detainees). (3) For the purposes of this Part, an assessment in relation to a person’s need for nursing care means such assessment as the relevant body consid ers appropriate in the circumstances in order to determine whether the person has a need for nursing care. Duty of relevant bodies: assessment and provisi on of NHS Continuing Healthcare 21. —(1) In exercising its functions under or by virtue of sections 3, 3A or 3B of the 2006 Act, insofar as they relate to NHS Continuing Health care, a relevant body must comply with paragraphs (2) to (11). (2) A relevant body must take reasonable steps to ensure that an assessment of eligibility for NHS Continuing Healthcare is carried out in respect of a person for which that body has responsibility in all cases where it appears to that body that— (a) there may be a need for such care; or (b) an individual who is receiving NHS Continuing Healthcare may no longer be eligible for such care. (3) If an assessment for NHS Continuing Healthcare is required under paragraph (2)(a), the relevant body must ensure that it is carried out before any assessment pursuant to regulation 28(1) (persons who enter relevant premises or who develop a need for nursing care) is carried out. (4) If a relevant body wishes to use an initial screeni ng process to decide whether to undertake an assessment of a person’s eligibility for NHS Continuing Healthcare it must— (a) complete and use the NHS Continuing Healthcare Checklist issued by the Secretary of State and dated 28th November 2012( a ) to inform that decision; (b) inform that person (or someone lawfully acti ng on that person’s behalf) in writing of the decision as to whether to carry out an assess ment of that person’s eligibility for NHS Continuing Healthcare; and (c) make a record of that decision. (5) When carrying out an assessment of eligibility for NHS Continuing Healthcare, a relevant body must ensure that— (a) a multi-disciplinary team— (i) undertakes an assessment of needs, or has undertaken an assessment of needs, that is an accurate reflection of that person’s needs at the date of the assessment of eligibility for NHS Continuing Healthcare, and (ii) uses that assessment of needs to complete the Decision Support Tool for NHS Continuing Healthcare issued by the Secretar y of State and dated 28th November 2012( b ); and (b) the relevant body makes a decision as to whet her that person has a primary health need in accordance with paragraph (7), using the completed Decision Support Tool to inform that decision. (6) If a relevant body decides that a person has a primary health need in accordance with paragraph (5)(b), it must also decide that that person is eligible for NHS Continuing Healthcare. ( a ) The NHS Continuing Healthcare Checklist can be found at dh. gov.uk/health/2012/11/continuing-healthcare- revisions/. ( b ) The Decision Support Tool can be found at dh.gov.uk/health/2012/11/continuing-healthcare-revisions/. 14 (7) In deciding whether a person has a primary health need in accordance with paragraph (5)(b), a relevant body must consider whether the nursi ng or other health services required by that person are— (a) where that person is, or is to be, accommodated in relevant premises, more than incidental or ancillary to the provision of accommodation which a social services authority is, or would be but for a person’s means, under a duty to provide; or (b) of a nature beyond which a social services authority whose primary responsibility is to provide social services could be expected to provide, and, if it decides that the nursing or other health services required do, when considered in their totality, fall within sub-paragraph (a) or (b), it must decide that that person has a primary health need. (8) Paragraphs (2) to (6) do not apply where an appropriate clinician decides that— (a) an individual has a primary health need arisi ng from a rapidly deteriorating condition; and (b) the condition may be entering a terminal phase, and that clinician has completed a Fast Track Pathway Tool stating reasons for the decision. (9) A relevant body must, upon receipt of a Fast Track Pathway tool completed in accordance with paragraph (8), decide that a person is eligible for NHS Continuing Healthcare. (10) Where an assessment of eligibility for NHS C ontinuing Healthcare has been carried out, or a relevant body has received a Fast Track Pathway Tool completed in accordance with paragraph (8), the relevant body must— (a) notify the person assessed (or someone lawfully acting on that person’s behalf), in writing, of the decision made about their eligibility for NHS Continuing Healthcare, the reasons for that decision and, where applicable, the matters referred to in paragraph (11); and (b) make a record of that decision. (11) Where a relevant body has decided that a person is not eligible for NHS Continuing Healthcare, it must inform the person (or someone acting on that person’s behalf) of the circumstances and manner in which that person may apply for a review of the decision if they are dissatisfied with— (a) the procedure followed by the relevant body in reaching that decision; or (b) the primary health need decision made in accordance with paragraph (5)(b). (12) In carrying out its duties under this regulation, a relevant body must have regard to the National Framework. (13) In this regulation— “appropriate clinician” means a person who is— (a) responsible for the diagnosis, treatment or care of the person under the 2006 Act in respect of whom a Fast Track Pathwa y Tool is being completed, and (b) a registered nurse( a ) or a registered medical practitioner( b ); “healthcare profession” means a profession which is concerned (wholly or partly) with the physical or mental health of individuals (w hether or not that person is regulated by, or by virtue of, any enactment); “multi-disciplinary team” means a team consisting of at least— (a) two professionals who are from different healthcare professions, or ( a ) See Schedule 1 of the Interpretation Act 1978 (c. 3) for the definition of a registered nurse. ( b ) See Schedule 1 of the Interpretation Act 1978 (c. 3) for the definition of a registered medical practitioner.
Posted on: Sat, 27 Dec 2014 21:59:49 +0000
Trending Topics
Recently Viewed Topics
© 2015