25B Duty to calculate and take steps to maintain nurse staffing levels
(1) Where a Local Health Board or NHS Trust in Wales provides nursing services in a situation to which this section applies, it must—
(a) designate a person or a description of person to calculate the number of nurses appropriate to provide care to patients that meets all reasonable requirements in that situation (the “nurse staffing level”),
(b) take all reasonable steps to maintain the nurse staffing level, and
(c) make arrangements for the purpose of informing patients of the nurse staffing level.
(2) A person designated by virtue of subsection (1)(a) (“a designated person”) must calculate the nurse staffing level in accordance with section 25C.
(3) This section applies to the following situations—
(a) adult acute medical inpatient wards,
(b) adult acute surgical inpatient wards, and
(c) such other situations as the Welsh Ministers may by regulations specify.
(1) When calculating a nurse staffing level, a designated person must—
(a) exercise professional judgement, and
(b) take into account each of the following—
(i) the average ratio of nurses to patients appropriate to provide care to patients that meets all reasonable requirements, estimated for a specified period using evidence-based workforce planning tools;
(ii) the extent to which patients' well-being is known to be particularly sensitive to the provision of care by a nurse.
(2) A designated person may calculate different nurse staffing levels—
(a) in relation to different periods of time;
(b) depending on the conditions in which care is provided by a nurse.
(1) The Welsh Ministers must issue guidance about the duties under sections 25B and 25C and Local Health Boards and any NHS Trust to which those sections apply must have regard to the guidance.
(2) The guidance may set out, in particular, that when calculating a nurse staffing level a designated person should exercise professional judgement by taking the following into account—
(a) the qualifications, competencies, skills and experience of the nurses providing care to patients;
(b) the conditions in which care by a nurse is provided;
(c) the potential impact on care by a nurse of—
(i) the physical condition and layout of the ward or other situation in which the care is provided;
(ii) the turnover of patients receiving the care;
(d) services or care provided to patients by other health professionals or other staff (for example, health care support workers), and their qualifications, competencies, skills and experience;
(e) the extent to which the nurses providing care are required to undertake supervisory or administrative functions.
(3) The guidance may also make provision about workforce planning that Local Health Boards and NHS Trusts may undertake in order to enable them to comply with their duties under sections 25B and 25C.
(4) Before issuing guidance the Welsh Ministers must consult—
(a) Local Health Boards and any NHS Trust that is under a duty to have regard to the guidance,
(b) such organisations as appear to them to represent the interests of any—
(i) providers of care homes, or
(ii) providers of independent hospitals in Wales,
likely to be affected by the guidance,
(c) such organisations as appear to them to represent the interests of any other persons likely to be affected by the guidance, and
(d) such other persons likely to be affected by the guidance as they consider appropriate.
(5) For the purposes of subsection (4)—
“care home” means premises at which a care home service within the meaning given by paragraph 1 of Schedule 1 to the Regulation and Inspection of Social Care (Wales) Act 2016 (anaw 2) is provided, and
“independent hospital” has the meaning given in section 2 of the Care Standards Act 2000 (c.14).
(1) Each Local Health Board and any NHS Trust to which the duty in section 25B applies must submit a nurse staffing levels report (whether or not as part of a wider report) in accordance with this section.
(2) A nurse staffing levels report must set out, in respect of the period to which the report relates (the “reporting period”)—
(a) the extent to which nurse staffing levels have been maintained;
(b) the impact the Board or Trust considers that not maintaining nurse staffing levels has had on care provided to patients by nurses, for example by reference to complaints about care provided to patients by nurses made in accordance with the Complaints Regulations or by reference to an increase in incidents of harm caused by—
(i) errors in administering medication to patients;
(ii) patients falling;
(iii) patients developing hospital-acquired pressure ulcers;
(c) any actions taken in response to not maintaining nurse staffing levels.
(3) Each nurse staffing levels report must be submitted to the Welsh Ministers no later than 30 days after the last day of the reporting period.
(4) The Welsh Ministers must, after the expiry of each reporting period—
(a) prepare and publish a document summarising the content of the nurse staffing levels reports submitted in respect of that reporting period, and
(b) lay each report submitted to them in that period before the National Assembly for Wales.
(5) For the purposes of this section the reporting period is—
(a) in the case of the initial reporting period, the period of three years beginning with the commencement of this section, and
(b) in the case of all subsequent reporting periods, the period of three years beginning with the day after the last day of the preceding reporting period.
(6) In subsection (2)(b) “Complaints Regulations” means regulations made under—
(a) section 113 of the Health and Social Care (Community Health and Standards) Act 2003 (c.43);
(b) the NHS Redress (Wales) Measure 2008 (nawm 1) .
(1) This section applies to NHS bodies other than NHS England , integrated care boards and NHS foundation trusts.
(2) If the Welsh Ministers—
(a) consider that a body to which this section applies is not performing one or more of its functions adequately or at all, or that there are significant failings in the way the body is being run, and
(b) are satisfied that it is appropriate for them to intervene under this section,
they may make an order under this section in respect of the body (an “intervention order”).
(3) An intervention order may make any provision authorised by section 27 (including any combination of such provisions).
(1) In this section—
(a) “member” means a member of a ... ... Special Health Authority or Local Health Board, or a member of the board of directors of an NHS trust,
(b) “employee member” means a member of a ... ... Special Health Authority or Local Health Board who is an officer of the body, or an executive director of an NHS trust.
(2) An intervention order may provide for the removal from office of—
(a) all the members, or
(b) those specified in the order,
and for their replacement with individuals specified in or determined in accordance with the order (who need not be the same in number as the removed individuals).
(3) An intervention order may provide for the suspension (either wholly, or in respect only of powers and duties specified in or determined in accordance with the order) of—
(a) all the members, or
(b) those specified in the order,
and for the powers of the suspended members to be exercised, and their duties performed, during their suspension by individuals specified in or determined in accordance with the order (who need not be the same in number as the suspended individuals).
(4) The powers and duties referred to in subsection (3) are, in the case of an employee member, only those which he has in his capacity as a member.
(5) An intervention order may contain directions to the body to which it relates to secure that a function of the body specified in the directions—
(a) is performed, to the extent specified in the directions, on behalf of the body and at its expense, by such person as is specified in the directions, and
(b) is so performed in such a way as to achieve such objectives as are so specified,
and the directions may require that any contract or other arrangement made by the body with that person contains such terms and conditions as may be so specified.
(6) If the person referred to in subsection (5)(a) is a body to which section 26 applies, the functions of that body include the performance of the functions specified in the directions under subsection (5).
(7) Subsection (8) applies in relation to any provision in this Act, or in any order or regulations made, or directions given, under this Act, relating to—
(a) the membership of the body to which an intervention order relates (or in the case of an NHS trust to the membership of its board of directors), or
(b) the procedure of the body.
(8) The intervention order may provide in relation to any provision specified in the order—
(a) that it does not apply in relation to the body while the order remains in force, or
(b) that it applies in relation to the body, while the order remains in force, with modifications specified in the order.
(9) An intervention order may contain such supplementary directions to the body to which it relates as the Welsh Ministers consider appropriate for the purpose of giving full effect to the order.
(1) This section applies to NHS bodies other than NHS England , integrated care boards and NHS foundation trusts.
(2) If the Welsh Ministers consider that a body to which this section applies—
(a) has failed to carry out any functions conferred or imposed on it by or under this Act, or
(b) has in carrying out those functions failed to comply with any regulations or directions relating to those functions,
they may after such inquiry as they consider appropriate make an order declaring it to be in default.
(3) The members of the body in default must immediately vacate their office, and the order—
(a) must provide for the appointment, in accordance with the provisions of this Act, of new members of the body, and
(b) may contain such provisions as seem to the Welsh Ministers expedient for authorising any person to act in the place of the body pending the appointment of new members.
(4) An order under this section may contain such supplementary and incidental provisions as appear to the Welsh Ministers to be necessary or expedient, including—
(a) provision for the transfer to the Welsh Ministers of property and liabilities of the body in default, and
(b) where any such order is varied or revoked by a subsequent order, provision in the subsequent order for the transfer to the body in default of any property or liabilities acquired or incurred by the Welsh Ministers in discharging any of the functions transferred to them.
(1) If a Local Health Board, an NHS trust or a Special Health Authority ceases to exist, the Welsh Ministers must exercise their functions so as to secure that all of the body's liabilities (other than any criminal liabilities) are dealt with.
(2) A liability is dealt with by being transferred to an NHS body, the Welsh Ministers or the Secretary of State.
30 Schemes for meeting losses and liabilities etc of certain health service bodies
(1) The Welsh Ministers may by regulations establish a scheme (a “mutual indemnity scheme”) whereby any of the bodies or other persons specified in subsection (2) may make provision to meet—
(a) expenses arising from any loss of or damage to their property, and
(b) liabilities to third parties for loss, damage or injury arising out of the carrying out of the functions of the bodies or other persons concerned.
(2) The bodies and other persons referred to in subsection (1) are—
(a) Local Health Boards,
(b) NHS trusts, ...
(c) Special Health Authorities,...
(d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(f) a person who is providing, or who has provided, primary medical services in accordance with a contract or other arrangement under Part 4, and
(g) a body or other person (other than a body or other person specified under paragraphs (a) to (f)) who is providing or arranging the provision of, or who has provided or arranged the provision of, health services whose provision is the subject of a contract or other arrangements with a Local Health Board, NHS trust or Special Health Authority,
but a mutual indemnity scheme may limit the class or description of bodies which, or other persons who, are eligible to participate in it.
(3) A mutual indemnity scheme may, in particular—
(a) provide for the scheme to be administered by the Welsh Ministers or by an NHS trust or Special Health Authority specified in the scheme,
(b) require any body which, or other person who, participates in the scheme to make payments in accordance with the scheme, and
(c) provide for the making of payments for the purposes of the scheme by the Welsh Ministers.
(4) If the Welsh Ministers so direct, a Local Health Board, NHS trust or Special Health Authority which is eligible to participate in a scheme must do so.
(5) Where a mutual indemnity scheme provides for the scheme to be administered by the Welsh Ministers, a Special Health Authority or NHS trust must carry out such functions in connection with the administration of the scheme as the Welsh Ministers may direct.
(6) Subsections (4) and (5) do not affect any other power of direction of the Welsh Ministers.
(7) A person or body administering a mutual indemnity scheme does not require permission under any provision of the Financial Services and Markets Act 2000 (c. 8) as respects activities carried out under the scheme.
(8) The Welsh Ministers may by regulations establish a scheme (a “direct indemnity scheme”) under which they may indemnify any of the bodies or other persons specified in subsection (2) against—
(a) expenses arising from any loss of or damage to their property, and
(b) liabilities to third parties for loss, damage or injury arising out of the carrying out of the functions of the bodies or other persons concerned.
(9) A direct indemnity scheme may, in particular–
(a) specify the persons or other bodies eligible to be indemnified (including limiting the class or description of bodies or other persons who are eligible);
(b) specify the expenses and liabilities in respect of which a body or other person may be indemnified and the extent to which they may be indemnified;
(c) require any body or other person indemnified under the scheme to make payments in accordance with the scheme.
(10) Nothing in this section limits or affects the powers of the Welsh Ministers under this Act, or any other enactment, to provide an indemnity—
(a) to any person other than the bodies or other persons specified in subsection (2), or
(b) to a body or other person specified in subsection (2) in respect of any expenses or liabilities other than those mentioned in subsections (1) and (8).
(11) In this section—
(a) in subsections (1)(b) and (8)(b) “functions”, in relation to a body or other person specified in subsection (2)(g), means the body or person's functions of providing, or arranging the provision of, health services whose provision is the subject of a contract or other arrangements with a Local Health Board, NHS trust or Special Health Authority;
(b) in subsection (2) and in paragraph (a) of this subsection “health services” means services provided as part of the health service.
(1) This section applies to directions and regulations under any of—
(a) section 12,
(b) section 13,
(c) section 19,
(d) section 23,
(e) section 24,
(f) section 25.
(2) Except in prescribed cases, the directions and regulations must not preclude a person or body by whom the function is exercisable apart from the directions or regulations from exercising the function.
32 Supply of goods and services by local authorities
(1) In the Local Authorities (Goods and Services) Act 1970 (c. 39) the expression “public body” includes—
(a) any Local Health Board, and
(b) so far as relates to their functions under this Act, the Welsh Ministers.
(2) Subsection (1) has effect as if made by an order under section 1(5) of the Local Authorities (Goods and Services) Act 1970 and may be varied or revoked by such an order.
(3) Each local authority must make services available to each NHS body acting in its area, so far as is reasonably necessary and practicable to enable the NHS body to discharge its functions under this Act.
(4) “services” means—
(a) in relation to a local authority in England, the services of persons employed by the authority for the purposes of its functions under the Local Authority Social Services Act 1970 (c. 42);
(b) in relation to a local authority in Wales, the services of persons employed by the authority for the purposes of functions which are social services functions for the purposes of the Social Services and Well-being (Wales) Act 2014 (anaw 4).
33 Arrangements between NHS bodies and local authorities
(1) The Welsh Ministers may by regulations make provision for or in connection with enabling prescribed NHS bodies (on the one hand) and prescribed local authorities (on the other) to enter into prescribed arrangements in relation to the exercise of—
(a) prescribed functions of the NHS bodies, and
(b) prescribed health-related functions of the local authorities,
if the arrangements are likely to lead to an improvement in the way in which those functions are exercised.
(2) The arrangements which may be prescribed include arrangements—
(a) for or in connection with the establishment and maintenance of a fund—
(i) which is made up of contributions by one or more NHS bodies and one or more local authorities, and
(ii) out of which payments may be made towards expenditure incurred in the exercise of both prescribed functions of the NHS body or bodies and prescribed health-related functions of the authority or authorities,
(b) for or in connection with the exercise by an NHS body on behalf of a local authority of prescribed health-related functions of the authority in conjunction with the exercise by the NHS body of prescribed functions of the NHS body,
(c) for or in connection with the exercise by a local authority on behalf of an NHS body of prescribed functions of the NHS body in conjunction with the exercise by the local authority of prescribed health-related functions of the local authority,
(d) as to the provision of staff, goods or services in connection with any arrangements mentioned in paragraph (a), (b) or (c),
(e) as to the making of payments by a local authority to an NHS body in connection with any arrangements mentioned in paragraph (b),
(f) as to the making of payments by an NHS body to a local authority in connection with any arrangements mentioned in paragraph (c).
(3) Regulations under this section may make provision—
(a) as to the cases in which NHS bodies and local authorities may enter into prescribed arrangements,
(b) as to the conditions which must be satisfied in relation to prescribed arrangements (including conditions in relation to consultation),
(c) for or in connection with requiring the consent of the Welsh Ministers to the operation of prescribed arrangements (including provision in relation to applications for consent, the approval or refusal of such applications and the variation or withdrawal of approval),
(d) in relation to the duration of prescribed arrangements,
(e) for or in connection with the variation or termination of prescribed arrangements,
(f) as to the responsibility for, and the operation and management of, prescribed arrangements,
(g) as to the sharing of information between NHS bodies and local authorities.
(4) The provision which may be made by virtue of subsection (3)(f) includes provision in relation to—
(a) the formation and operation of joint committees of NHS bodies and local authorities,
(b) the exercise of functions which are the subject of prescribed arrangements (including provision in relation to the exercise of such functions by joint committees or employees of NHS bodies and local authorities),
(c) the drawing up and implementation of plans in respect of prescribed arrangements,
(d) the monitoring of prescribed arrangements,
(e) the provision of reports on, and information about, prescribed arrangements,
(f) complaints and disputes about prescribed arrangements,
(g) accounts and audit in respect of prescribed arrangements.
(5) Arrangements made by virtue of this section do not affect—
(a) the liability of NHS bodies for the exercise of any of their functions,
(b) the liability of local authorities for the exercise of any of their functions, or
(c) any power or duty to recover charges in respect of services provided in the exercise of any local authority functions.
(6) The Welsh Ministers may issue guidance to NHS bodies and local authorities in relation to consultation or applications for consent in respect of prescribed arrangements.
(7) The reference in subsection (1) to an improvement in the way in which functions are exercised includes an improvement in the provision to any individuals of any services to which those functions relate.
(8) In this section—
“health-related functions”, in relation to a local authority, means functions of the authority which, in the opinion of the Welsh Ministers—
have an effect on the health of any individuals,
have an effect on, or are affected by, any functions of NHS bodies, or
are connected with any functions of NHS bodies,
“NHS body” does not include a Special Health Authority.
(9) Schedule 12 makes provision with respect to the transfer of staff in connection with arrangements made by virtue of this section.
(1) A local authority may make payments to NHS England , an integrated care board ... ... or a Local Health Board towards expenditure incurred or to be incurred by the body in connection with the performance by it of prescribed functions.
(2) A payment under this section may be made in respect of expenditure of a capital or of a revenue nature or in respect of both kinds of expenditure.
(3) The Welsh Ministers may by directions prescribe conditions relating to payments under this section.
(4) The power under subsection (3) may in particular be exercised so as to require, in such circumstances as may be specified—
(a) repayment of the whole or part of a payment under this section, or
(b) in respect of property acquired with payments under this section, payment of an amount representing the whole or part of an increase in the value of the property which has occurred since its acquisition.
(5) No payment may be made under this section in respect of any expenditure unless the conditions relating to it conform with the conditions prescribed for payments of that description under subsection (3).
(1) Where—
(a) an NHS trust is, or will be, a party to any existing or proposed LA delegation arrangements, and
(b) the Welsh Ministers consider that designation of the NHS trust as a Care Trust would be likely to promote the effective exercise by the NHS trust of prescribed health-related functions of a local authority (in accordance with the arrangements) in conjunction with prescribed NHS functions of the NHS trust,
the Welsh Ministers may designate the NHS trust as a Care Trust.
(2) An NHS trust may, however, be designated only in pursuance of an application made to the Welsh Ministers jointly by each prescribed body.
(3) If the application under subsection (2) requests the Welsh Ministers to do so, they may when designating an NHS trust as a Care Trust make a direction under subsection (4).
(4) The direction is that, while it is designated, the NHS trust may (in addition to exercising health-related functions of the local authority as mentioned in subsection (1)(b)) exercise such prescribed health-related functions of the local authority as are specified in the direction in relation to persons in any area so specified, even though it does not exercise any NHS functions in relation to persons in that area.
(5) Where an NHS trust is designated as a Care Trust under this section—
(a) its designation may be revoked by the Welsh Ministers at any time—
(i) of their own motion, and
(ii) after such consultation as they consider appropriate,
(b) if an application for the revocation of its designation is made to the Welsh Ministers by one or more of the parties to the LA delegation arrangements, its designation must be revoked by the Welsh Ministers at the earliest time at which they consider it practicable to do so, having regard, in particular, to any steps that need to be taken in relation to those arrangements in connection with the revocation.
(6) The designation of an NHS trust as a Care Trust under this section must be effected by an order under section 18 which—
(a) (in the case of an existing NHS trust) amends the order establishing the NHS trust so as to change its name to one that includes the words “Care Trust”, or
(b) (in the case of a new NHS trust) establishes the NHS trust with a name that includes those words,
and any revocation of its designation must be effected by a further order under section 18 which makes such provision for changing the name of the NHS trust as the Welsh Ministers consider expedient.
(7) The power of the Welsh Ministers to dissolve an NHS trust includes power to dissolve an NHS trust where they consider that it is appropriate to do so in connection with the designation of any other NHS trust (whether existing or otherwise) as a Care Trust.
(8) Regulations may make such incidental, supplementary or consequential provision (including provision amending, repealing or revoking enactments) as the Welsh Ministers consider expedient in connection with the preceding provisions of this section.
(9) Regulations under subsection (8) may, in particular, make provision—
(a) prescribing—
(i) the manner and circumstances in which, and
(ii) any conditions which must be satisfied before,
an application may be made for an NHS trust to be designated as a Care Trust under this section, or to cease to be so designated, and the information to be supplied with such an application,
(b) enabling the Welsh Ministers to terminate appointments of persons as members of the board of directors of an NHS trust (or of a committee of such a trust) where they consider that it is appropriate to do so in connection with the designation of the NHS trust as a Care Trust,
(c) requiring the consent of the Welsh Ministers to be obtained before any prescribed change is made with respect to the governance of an NHS trust so designated,
(d) for supplementing or modifying, in connection with the operation of subsection (3), any provision made by regulations under section 33.
(10) The designation of an NHS trust as a Care Trust under this section does not affect any of the functions, rights or liabilities of that NHS trust in its capacity as an NHS trust.
(11) In connection with the exercise by an NHS trust so designated of any relevant social services functions of a local authority in England under LA delegation arrangements—
(a) section 7 of the Local Authority Social Services Act 1970 (c. 42) (authorities to exercise social services functions under guidance), and
(b) section 7A of that Act (directions as to exercise of such functions),
apply to the NHS trust as if it were a local authority within the meaning of that Act.
(11A) In connection with the exercise by a body so designated of any relevant social services functions of a local authority in Wales under LA arrangements, sections 145 to 149 of the Social Services and Well-being (Wales) Act 2014 (codes on the exercise of social services functions) apply to the body as if it were a local authority within the meaning of that Act.
(12) In this section—
“health-related functions” has the meaning given by section 33(8),
“LA delegation arrangements” means arrangements falling within section 33(2)(b), whether or not made in conjunction with any pooled fund arrangements,
“NHS functions” means functions exercisable by an NHS trust in its capacity as such,
“pooled fund arrangements” means arrangements falling within section 33(2)(a),
“relevant social services functions” means—
in relation to a local authority in England, health-related functions which are social services functions within the meaning of the Local Authority Social Services Act 1970;
in relation to a local authority in Wales, health-related functions which are social services functions for the purposes of the Social Services and Well-being (Wales) Act 2014 (anaw 4).
(1) If the Welsh Ministers are of the opinion—
(a) that a body to which this section applies (“the failing body”) is not exercising any of its functions adequately, and
(b) that it would be likely to lead to an improvement in the way in which that function is exercised if it were to be exercised—
(i) by another body to which this section applies under delegation arrangements, or
(ii) in accordance with pooled fund arrangements made with another such body,
the Welsh Ministers may direct those bodies to enter into such delegation arrangements or pooled fund arrangements in relation to the exercise of the appropriate function or functions as are specified in the direction.
(2) In subsection (1) “the appropriate function or functions” means—
(a) the function of the failing body mentioned in that subsection, and
(b) such other function of that body (if any) as the Welsh Ministers consider would, if exercised under or in accordance with the arrangements in question, be likely to contribute to an improvement in the exercise of the function referred to in paragraph (a).
(3) The bodies to which this section applies are—
(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(c) NHS trusts,
(d) Local Health Boards, and
(e) local authorities,
but in subsections (1) and (2) any reference to functions is, in relation to a local authority, a reference only to relevant social services functions of the authority.
(4) In this section any reference to an improvement in the way in which any function is exercised includes an improvement in the provision to any individuals of any services to which that function relates.
(5) In this section—
“delegation arrangements” means arrangements falling within section 33(2)(b) or (2)(c), whether or not made in conjunction with any pooled fund arrangements,
“health-related functions” has the meaning given by section 33(8),
“pooled fund arrangements” means arrangements falling within section 33(2)(a),
“relevant social services functions” means health-related functions of local authorities in England within the meaning of the Local Authority Social Services Act 1970 (c. 42) or of local authorities in Wales for the purposes of the Social Services and Well-being (Wales) Act 2014 (anaw 4).
37 Further provisions about directions and directed partnership arrangements
(1) A direction under section 36(1) (a “principal direction”) may make provision with respect to—
(a) any of the matters with respect to which provision is required to be made by the specified arrangements by virtue of regulations under section 33, and
(b) such other matters as the Welsh Ministers consider appropriate.
(2) The Welsh Ministers may in particular (either in a principal direction or in any subsequent direction) make provision—
(a) for the determination, whether—
(i) by agreement, or
(ii) (in default of agreement) by the Welsh Ministers or an arbitrator appointed by them,
of the amount of any payments which need to be made by one body to another for the purposes of the effective operation of the specified arrangements, and for the variation of any such determination,
(b) specifying the manner in which the amount of any such payments must be so determined (or varied),
(c) requiring a body specified in the direction to supply to the Welsh Ministers or an arbitrator, for the purpose of enabling any such amount to be so determined (or varied), such information or documents as may be so specified,
(d) requiring any amount so determined (or varied) to be paid by and to such bodies as are specified in the direction,
(e) requiring capital assets specified in the direction to be made available by and to such bodies as are so specified.
(3) The Welsh Ministers may, when giving a principal direction to any bodies to which section 36 applies, give such directions to any other such body as they consider appropriate for or in connection with securing that full effect is given to the principal direction.
(4) Before giving a principal direction to any bodies to which section 36 applies, the Welsh Ministers may—
(a) direct either or both of the bodies in question to take such steps specified in the direction, or
(b) give such other directions,
as the Welsh Ministers consider appropriate with a view to enabling them to determine whether the principal direction should be given.
(5) The revocation of a principal direction does not affect the continued operation of the specified arrangements.
(6) “The specified arrangements”, in relation to a principal direction, means the arrangements specified in the direction in pursuance of section 36(1).
38 Supply of goods and services by the Welsh Ministers
(1) The Welsh Ministers may supply to—
(a) local authorities, and
(b) such public bodies or classes of public bodies as the Welsh Ministers may determine,
any goods or materials of a kind used in the health service.
(2) In subsection (1) “public bodies” includes public bodies in Northern Ireland.
(3) The Welsh Ministers may make available to persons falling within subsection (1)—
(a) any facilities provided by them ... for any service under this Act, and
(b) the services of persons employed by the Welsh Ministers or by a Local Health Board... or a Special Health Authority.
(4) The Welsh Ministers may carry out maintenance work (including minor renewals, minor improvements and minor extensions) in connection with any land or building for the maintenance of which a local authority is responsible.
(5) The Welsh Ministers may supply or make available to persons—
(a) providing general ophthalmic services or pharmaceutical services,
(b) providing services under a general medical services contract or a general dental services contract, or
(c) providing services in accordance with section 50 arrangements or section 64 arrangements,
such goods, materials or other facilities as may be prescribed.
(6) The Welsh Ministers must make available to local authorities—
(a) any services (other than the services of any person) or other facilities provided under this Act,
(b) the services provided as part of the health service by any person employed by the Welsh Ministers..., a Special Health Authority or a Local Health Board, and
(c) the services of any medical practitioner, dental practitioner or nurse employed by the Welsh Ministers..., a Special Health Authority or a Local Health Board otherwise than to provide services which are part of the health service,
so far as is reasonably necessary and practicable to enable local authorities to discharge their functions relating to social services, education and public health.
(7) The Welsh Ministers may arrange to make available to local authorities the services of persons—
(a) providing general ophthalmic services or pharmaceutical services,
(b) performing services under a general medical services contract or a general dental services contract,
(c) providing services in accordance with section 50 arrangements or section 64 arrangements,
(d) providing Local Health Boards... or Special Health Authorities with services of a kind provided as part of the health service,
so far as is reasonably necessary and practicable to enable local authorities to discharge their functions relating to social services, education and public health.
(1) The Welsh Ministers must, before they make available the services of any officer under subsection (3)(b) of section 38, or subsection (6)(b) or (c) of that section—
(a) consult the officer or a body recognised by the Welsh Ministers as representing the officer, or
(b) satisfy themselves that the body who employs the officer has consulted the officer about the matter.
(2) The Welsh Ministers may disregard the provisions of subsection (1) in a case where they—
(a) consider it necessary to make the services of an officer available for the purpose of dealing temporarily with an emergency, and
(b) have previously consulted a body such as is mentioned in subsection (1)(b) about making services available in an emergency.
(3) The Welsh Ministers may, for the purposes of subsection (3)(b) of section 38, or subsection (6)(b) or (c) of that section, give such directions to ... Special Health Authorities and Local Health Boards to make the services of their officers available as the Welsh Ministers consider appropriate.
(4) Powers under this section and section 38 may be exercised on such terms as may be agreed, including terms as to the making of payments to the Welsh Ministers.
(5) The Welsh Ministers may make such charges in respect of services or facilities provided under section 38(6) as may be agreed between the Welsh Ministers and the local authority or, in default of agreement, as may be determined by arbitration.
(6) Any power to supply goods or materials under section 38 includes—
(a) a power to purchase and store them, and
(b) a power to arrange with third parties for the supply of goods or materials by those third parties.
(1) Each Local Health Board must, to the extent that it considers necessary to meet all reasonable requirements, exercise its powers so as to provide primary medical services within its area, or secure their provision within its area.
(2) A Local Health Board may (in addition to any other power conferred on it)—
(a) provide primary medical services itself (whether within or outside its area),
(b) make such arrangements for their provision (whether within or outside its area) as it considers appropriate, and may in particular make contractual arrangements with any person.
(3) Each Local Health Board must publish information about such matters as may be prescribed in relation to the primary medical services provided under this Act.
(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(5) Regulations may provide that services of a prescribed description must, or must not, be regarded as primary medical services for the purposes of this Act.
(6) Regulations under this section may in particular describe services by reference to the manner or circumstances in which they are provided.
42 General medical services contracts: introductory
(1) A Local Health Board may enter into a contract under which primary medical services are provided in accordance with the following provisions of this Part.
(2) A contract under this section is called in this Act a “general medical services contract”.
(3) A general medical services contract may make such provision as may be agreed between the Local Health Board and the contractor or contractors in relation to—
(a) the services to be provided under the contract,
(b) remuneration under the contract, and
(c) any other matters.
(4) The services to be provided under a general medical services contract may include—
(a) services which are not primary medical services,
(b) services to be provided outside the area of the Local Health Board.
(5) In this Part, “contractor”, in relation to a general medical services contract, means any person entering into the contract with the Local Health Board.
43 Requirement to provide certain primary medical services
(1) A general medical services contract must require the contractor or contractors to provide, for his or their patients, primary medical services of such descriptions as may be prescribed.
(2) Regulations under subsection (1) may in particular describe services by reference to the manner or circumstances in which they are provided.
(1) A Local Health Board may, subject to such conditions as may be prescribed, enter into a general medical services contract with—
(a) a medical practitioner,
(b) two or more individuals practising in partnership where the conditions in subsection (2) are satisfied, or
(c) a company limited by shares where the conditions in subsection (3) are satisfied.
(2) The conditions referred to in subsection (1)(b) are that—
(a) at least one partner is a medical practitioner, and
(b) any partner who is not a medical practitioner is either—
(i) an NHS employee,
(ii) a section 50 employee, section 64 employee, section 92 employee, section 107 employee, section 17C employee or Article 15B employee,
(iii) a health care professional who is engaged in the provision of services under this Act or the National Health Service Act 2006 (c. 41), or
(iv) an individual falling within section 51(1)(d).
(3) The conditions referred to in subsection (1)(c) are that—
(a) at least one share in the company is legally and beneficially owned by a medical practitioner, and
(b) any share which is not so owned is legally and beneficially owned by a person referred to in subsection (2)(b).
(4) Regulations may make provision as to the effect, in relation to a general medical services contract entered into by individuals practising in partnership, of a change in the membership of the partnership.
(5) In this section—
“health care professional”, “NHS employee”, “section 50 employee”, “section 64 employee”, “section 92 employee”, “section 107 employee”, “section 17C employee” and “Article 15B employee” have the meaning given by section 51.
(1) The Welsh Ministers may give directions as to payments to be made under general medical services contracts.
(2) A general medical services contract must require payments to be made under the contract in accordance with directions under this section.
(3) Directions 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
(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 practitioners,
(d) provide that the whole or any part of a payment is subject to conditions (and may provide that payments are payable by a Local Health Board 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 relates.
(4) Before giving a direction under subsection (1), the Welsh Ministers—
(a) must consult any body appearing to them to be representative of persons to whose remuneration the direction would relate, and
(b) may consult such other persons as they consider appropriate.
(5) “Payments” includes fees, allowances, reimbursements, loans and repayments.
(1) A general medical services contract must contain provision requiring the contractor or contractors to comply with any directions given by the Welsh Ministers for the purposes of this section as to the drugs, medicines or other substances which may or may not be ordered for patients in the provision of medical services under the contract.
(2) A direction under this section must, subject to subsection (3), be given by regulations.
(3) A direction under this section may be given by an instrument in writing where it gives effect to a request made in writing to the Welsh Ministers by a person who is a holder of a UK marketing authorisation in respect of the drug, medicine or other substance to which the request relates.
(4) “UK marketing authorisation” has the meaning given by regulation 8(1) of the Human Medicines Regulations 2012 (S.I. 2012/1916).
(1) A general medical services contract must contain such provision as may be prescribed (in addition to the provision required by the preceding provisions of this Part).
(2) Regulations under subsection (1) may in particular make provision as to—
(a) the manner in which, and standards to which, services must be provided,
(b) the persons who perform services,
(c) the persons to whom services will be provided,
(d) the variation of contract terms (other than terms required by or under this Part),
(e) rights of entry and inspection (including inspection of clinical records and other documents),
(f) the circumstances in which, and the manner in which, the contract may be terminated,
(g) enforcement,
(h) the adjudication of disputes.
(3) Regulations making provision under subsection (2)(c) may make provision as to the circumstances in which a contractor or contractors—
(a) must or may accept a person as a patient to whom services are provided under the contract,
(b) may decline to accept a person as such a patient, or
(c) may terminate his or their responsibility for a patient.
(4) Regulations under subsection (2)(d) may—
(a) make provision as to the circumstances in which a Local Health Board 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.
(5) Regulations making provision of the kind described in subsection (4)(b) may prescribe services by reference to the manner or circumstances in which they are provided.
(6) Regulations under subsection (1) must make provision as to the right of patients to choose the persons from whom they receive services.
(1) Regulations may make provision for the resolution of disputes as to the terms of a proposed general medical services contract.
(2) Regulations under subsection (1) may make provision—
(a) for the referral of the terms of the proposed contract to the Welsh Ministers, and
(b) for the Welsh Ministers, or a person appointed by them, to determine the terms on which the contract may be entered into.
(3) Regulations may make provision for a person or persons entering into a general medical services contract to be regarded as a health service body for any purposes of section 7, in circumstances where he or they so elect.
(4) Regulations under subsection (3) may include provision as to the application of section 7 in cases where—
(a) persons practising in partnership elect to become a health service body, and
(b) there is a change in the membership of the partnership.
(5) Where—
(a) by virtue of regulations under subsection (3), section 7(11) applies in relation to a general medical services contract, and
(b) a direction as to payments is made under that subsection in relation to the contract,
the direction is enforceable in a county court (if the court so orders) as if it were a judgment or order of that court.
(1) Regulations may provide that a health care professional of a prescribed description may not perform any primary medical service for which a Local Health Board is responsible unless he is included in a list maintained under the regulations by a Local Health Board.
(2) For the purposes of this section—
(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 (c. 17),
(b) a Local Health Board is responsible for a medical service if it provides the service, or secures its provision, by or under any enactment.
(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 Local Health Board to which an application must be made, and for the procedure for applications and the documents to be supplied on application),
(d) the grounds on which an application for inclusion may or must be granted or refused,
(e) requirements with which a person included in a list must comply (including the declaration of financial interests and gifts and other benefits),
(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 from it,
(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 Welsh Ministers or a person appointed by them),
(i) the criteria to be applied in making decisions under the regulations,
(j) appeals against decisions made by a Local Health Board under the regulations, and
(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 107 to 115.
(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 a Local Health Board,
(b) a Local Health Board to vary the conditions or impose different ones,
(c) the consequences of failing to comply with a condition (including removal from a list),
(d) the review by a Local Health Board of decisions made by it by virtue of the regulations.
(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 relates, or
(b) preventing fraud.
(6) Regulations making provision as to the matters referred to in subsection (3)(k) may in particular authorise the disclosure of information—
(a) by a Local Health Board to the Welsh Ministers, and
(b) by the Welsh Ministers to a Local Health Board.
50 Arrangements by Local Health Boards for the provision of primary medical services
(1) A Local Health Board may make one or more agreements with respect to its area under which primary medical services are provided (otherwise than by the Local Health Board).
(2) An agreement must be in accordance with regulations under section 52.
(3) An agreement may not combine arrangements for the provision of primary medical services with arrangements for the provision of primary dental services.
(4) An agreement may not combine arrangements for the provision of primary medical services with arrangements for the provision of local pharmaceutical services.
(5) But an agreement may include arrangements for the provision of services which are not primary medical services but which may be provided under this Act, other than under Part 6 (general ophthalmic services) or Chapter 1 or 2 of Part 7 (pharmaceutical services and local pharmaceutical services under pilot schemes).
(6) Regulations may provide—
(a) for functions which are exercisable by a Local Health Board in relation to an agreement to be exercisable on behalf of the Local Health Board by a Health Board, and
(b) for functions which are exercisable by a Health Board in relation to an agreement made under section 17C of the National Health Service (Scotland) Act 1978 (c. 29) to be exercisable on behalf of the Board by the Local Health Board.
(7) In this Act, arrangements for the provision of services made under this section are called “section 50 arrangements”.
51 Persons with whom agreements may be made under section 50
(1) A Local Health Board may make an agreement under section 50 only with one or more of the following—
(a) an NHS trust or an NHS foundation trust,
(b) a medical practitioner who meets the prescribed conditions,
(c) a health care professional who meets the prescribed conditions,
(d) an individual who is providing services—
(i) under a general medical services contract or a general dental services contract or an English general medical services contract or an English general dental services contract,
(ii) in accordance with section 50 arrangements, section 64 arrangements, section 92 arrangements, section 107 arrangements, section 17C arrangements or Article 15B arrangements, or
(iii) under section 17J or 25 of the 1978 Act or Article 57 or 61 of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)),
or has so provided them within such period as may be prescribed,
(e) an NHS employee, a section 50 employee, a section 64 employee, a section 92 employee, a section 107 employee, a section 17C employee or an Article 15B employee,
(f) a qualifying body,
(g) a ... Local Health Board.
(2) The power under subsection (1) to make an agreement with a person falling within paragraph (d) or (e) of that subsection is subject to such conditions as may be prescribed.
(3) In this section—
“the 1978 Act” means the National Health Service (Scotland) Act 1978 (c. 29),
“Article 15B arrangements” means arrangements for the provision of services made under Article 15B of the Health and Personal Social Services (Northern Ireland) Order 1972,
“Article 15B employee” means an individual who, in connection with the provision of services in accordance with Article 15B arrangements, is employed by a person providing or performing those services,
“English general dental services contract” means a contract under section 100(2) of the National Health Service Act 2006 (c. 41),
“English general medical services contract” means a contract under section 84(2) of that Act,
“health care professional” means a person who is a member of a profession regulated by a body mentioned (at the time the agreement in question is made) in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002 (c. 17),
“NHS employee” means an individual who, in connection with the provision of services in the health service, the Scottish health service or the Northern Ireland health service, is employed by—
an NHS trust, an NHS foundation trust or (in Northern Ireland) a Health and Social Services Trust,
a ... Local Health Board,
a person who is providing services under a general medical services contract or a general dental services contract or an English general medical services contract or an English general dental services contract,
an individual who is providing services as specified in subsection (1)(d)(iii),
“the Northern Ireland health service” means the health service within the meaning of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)),
“qualifying body” means a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraph (a), (b), (c), (d), (e) or (g) of subsection (1),
“the Scottish health service” means the health service within the meaning of the National Health Service (Scotland) Act 1978 (c. 29),
“section 17C arrangements” means arrangements for the provision of services made under section 17C of the 1978 Act,
“section 17C employee” means an individual who, in connection with the provision of services in accordance with section 17C arrangements, is employed by a person providing or performing those services,
“section 92 arrangements” means arrangements for the provision of services made under section 92 of the National Health Service Act 2006 (c. 41),
“section 107 arrangements” means arrangements for the provision of services made under section 107 of that Act,
“section 92 employee” means an individual who, in connection with the provision of services in accordance with section 92 arrangements, is employed by a person providing or performing those services,
“section 107 employee” means an individual who, in connection with the provision of services in accordance with section 107 arrangements, is employed by a person providing or performing those services,
“section 50 employee” means an individual who, in connection with the provision of services in accordance with section 50 arrangements, is employed by a person providing or performing those services,
“section 64 employee” means an individual who, in connection with the provision of services in accordance with section 64 arrangements, is employed by a person providing or performing those services.
(1) The Welsh Ministers may make regulations about the provision of services in accordance with section 50 arrangements.
(2) The regulations must include provision for participants other than Local Health Boards to withdraw from section 50 arrangements if they wish to do so.
(3) The regulations may, in particular—
(a) provide that section 50 arrangements may be made only in prescribed circumstances,
(b) provide that section 50 arrangements may be made only in prescribed areas,
(c) provide that only prescribed services, or prescribed categories of service, may be provided in accordance with section 50 arrangements,
(d) impose conditions (including conditions as to qualifications and experience) to be satisfied by persons performing services in accordance with section 50 arrangements,
(e) require details of section 50 arrangements to be published,
(f) make provision with respect to the variation and termination of section 50 arrangements,
(g) provide for parties to section 50 arrangements to be treated, in such circumstances and to such extent as may be prescribed, as health service bodies for the purposes of section 7,
(h) provide for directions, as to payments, made under section 7(11) (as it has effect as a result of regulations made by virtue of paragraph (g)) to be enforceable in the county court (if the court so orders) as if they were judgments or orders of that court.
(4) The regulations may also require payments to be made under the arrangements in accordance with directions given for the purpose by the Welsh Ministers.
(5) A direction may 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 relates.
(6) The regulations may also include provision requiring a Local Health Board, in prescribed circumstances and subject to prescribed conditions, to enter into a general medical services contract on prescribed terms with any person who is providing services under section 50 arrangements and who so requests.
(7) The regulations may also include provision for the resolution of disputes as to to the terms of any proposed section 50 arrangements, and in particular may make provision—
(a) for the referral of the terms of the proposed arrangements to the Welsh Ministers, and
(b) for the Welsh Ministers or a person appointed by them to determine the terms on which the arrangements may be entered into.
(8) The regulations must provide for the circumstances in which a person providing primary medical services under section 50 arrangements—
(a) must or may accept a person as a patient to whom such services are so provided,
(b) may decline to accept a person as such a patient,
(c) may terminate his responsibility for a patient.
(9) The regulations must make provision as to the right of patients to choose the persons from whom they receive services under section 50 arrangements.
53 Assistance and support: primary medical services
(1) A Local Health Board may provide assistance or support to any person providing or proposing to provide—
(a) primary medical services under a general medical services contract, or
(b) primary medical services in accordance with section 50 arrangements.
(2) Assistance or support provided by a Local Health Board under subsection (1) is provided on such terms, including terms as to payment, as the Local Health Board considers appropriate.
(3) “Assistance” includes financial assistance.
(1) A Local Health Board may recognise a committee formed for its area, or for its area and that of one or more other Local Health Boards, which it is satisfied is representative of—
(a) the persons to whom subsection (2) applies, and
(b) the persons to whom subsection (3) applies.
(2) This subsection applies to—
(a) each medical practitioner who, under a general medical services contract entered into by him, is providing primary medical services in the area for which the committee is formed, and
(b) each medical practitioner who is providing general ophthalmic services in that area.
(3) This subsection applies to each other medical practitioner—
(a) who is performing primary medical services in the area for which the committee is formed—
(i) pursuant to section 41(2)(a),
(ii) in accordance with section 50 arrangements, or
(iii) under a general medical services contract, and
(b) who has notified the Local Health Board that he wishes to be represented by the committee (and has not notified it that he wishes to cease to be so represented).
(4) A committee recognised under this section is called the Local Medical 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 committee.
(6) Regulations may require a Local Health Board, in the exercise of its functions relating to primary medical services, to consult any committee recognised by it under this section on such occasions and to such extent as may be prescribed.
(7) A committee recognised under this section has such other functions as may be prescribed.
(8) A committee recognised under this section must in respect of each year determine—
(a) the amount of its administrative expenses for that year attributable to persons of whom it is representative under subsection (1)(a), and
(b) the amount of its administrative expenses for that year attributable to persons of whom it is representative under subsection (1)(b).
(9) A Local Health Board may—
(a) on the request of a committee recognised by it, allot to that committee such sums for defraying the expenses referred to in subsection (8)(a) as the Local Health Board may determine, and
(b) deduct the amount of such sums from the remuneration of persons of whom the committee is representative under subsection (1)(a) under the general medical services contracts, or arrangements under section 71, entered into by those persons with the Local Health Board.
(10) A committee recognised under this section must apportion the amount determined by it under subsection (8)(b) among the persons of whom it is representative under subsection (1)(b); and each such person must pay in accordance with the committee's directions the amount so apportioned to him.
(11) The administrative expenses of a committee include the travelling and subsistence allowances payable to its members.
55 Use of accommodation: provision of primary medical services
If the Welsh Ministers consider that any accommodation provided by them by virtue of this Act is suitable for use in connection with the provision of primary medical services, they may make the accommodation available on such terms as they consider appropriate to persons providing those services.
(1) Each Local Health Board must, to the extent that it considers necessary to meet all reasonable requirements, exercise its powers so as to provide primary dental services within its area, or secure their provision within its area.
(2) A Local Health Board may (in addition to any other power conferred on it) provide primary dental services itself (whether within or outside its area).
(3) Each Local Health Board must publish information about such matters as may be prescribed in relation to the primary dental services for which it makes provision under this Act.
(4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(5) Regulations may provide that services of a prescribed description must, or must not, be regarded as primary dental services for the purposes of this Act.
(6) Regulations under subsection (5) may in particular describe services by reference to the manner or circumstances in which they are provided.
57 General dental services contracts: introductory
(1) A Local Health Board may enter into a contract under which primary dental services are provided in accordance with the following provisions of this Part.
(2) A contract under this section is called in this Act a “general dental services contract”.
(3) A general dental services contract may make such provision as may be agreed between the Local Health Board and the contractor in relation to—
(a) the services to be provided under the contract (which may include services which are not primary dental services),
(b) remuneration under the contract, and
(c) any other matters.
(4) In this Part, “contractor”, in relation to a general dental services contract, means any person entering into the contract with the Local Health Board.
58 Requirement to provide certain primary dental services
(1) A general dental services contract must require the contractor or contractors to provide, for his or their patients, primary dental services of such descriptions as may be prescribed.
(2) Regulations under subsection (1) may in particular describe services by reference to the manner or circumstances in which they are provided.
(1) A Local Health Board may, subject to such conditions as may be prescribed, enter into a general dental services contract with—
(a) a dental practitioner,
(b) a dental corporation,
(c) two or more individuals practising in partnership where the conditions in subsection (2) are satisfied.
(2) The conditions referred to in subsection (1)(c) are that—
(a) at least one partner is a dental practitioner, and
(b) any partner who is not a dental practitioner is either—
(i) an NHS employee,
(ii) a section 50 employee, section 64 employee, section 92 employee, section 107 employee, section 17C employee or Article 15B employee,
(iii) a health care professional who is engaged in the provision of services under this Act or the National Health Service Act 2006 (c. 41), or
(iv) an individual falling within section 51(1)(d).
(3) Regulations may make provision as to the effect, in relation to a general dental services contract entered into by individuals practising in partnership, of a change in the membership of the partnership.
(4) In this section—
“dental corporation” means a body corporate which is carrying on the business of dentistry in accordance with the Dentists Act 1984 (c. 24),
“health care professional”, “NHS employee”, “section 50 employee”, “section 64 employee”, “section 92 employee”, “section 107 employee”, “section 17C employee” and “Article 15B employee” have the meaning given by section 65.
(1) The Welsh Ministers may give directions as to payments to be made under general dental services contracts.
(2) A general dental services contract must require payments to be made 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
(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 practitioners,
(d) provide that the whole or any part of a payment is subject to conditions (and may provide that payments are payable by a Local Health Board 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 relates.
(4) Before giving a direction under subsection (1), the Welsh Ministers—
(a) must consult any body appearing to them to be representative of persons to whose remuneration the direction would relate, and
(b) may consult such other persons as they consider appropriate.
(5) “Payments” includes fees, allowances, reimbursements, loans and repayments.
(1) A general dental services contract must contain such provision as may be prescribed (in addition to the provision required by the preceding provisions of this Part).
(2) Regulations under subsection (1) may in particular make provision as to—
(a) the manner in which, and standards to which, services must be provided,
(b) the persons who perform services,
(c) the persons to whom services will be provided,
(d) the variation of contract terms (other than terms required by or under this Part),
(e) rights of entry and inspection (including inspection of clinical records and other documents),
(f) the circumstances in which, and the manner in which, the contract may be terminated,
(g) enforcement,
(h) the adjudication of disputes.
(3) Regulations under subsection (2)(d) may make provision as to the circumstances in which a Local Health Board may impose a variation of contract terms.
(4) Regulations under subsection (1) must make provision as to the right of patients to choose the persons from whom they receive services.