1. This letter advises NHS Boards and Practitioner Services of:

Transcription

1 NHS Circular: 2006 PCA(O)5 abcdefghijklm = eé~äíü=aéé~êíãéåí= = aáêéåíçê~íé=çñ=mêáã~êó=`~êé=~åç=`çããìåáíó=`~êé= = mêáã~êó=`~êé=aáîáëáçå= = pí=^åçêéïdë=eçìëé= = oéöéåí=oç~ç= = bafk_rode= = ben=pad= Dear Colleague GENERAL OPHTHALMIC SERVICES 1. The NHS (General Ophthalmic Services) (Scotland) Regulations Replacement of Form GOS(S) 6 by Forms GOS(S)6 Part 1 and GOS(S)6 Part 2 3. Amendment of the NHS (Service Committees and Tribunal) Regulations Amendment of the NHS (Tribunal) (Scotland) Regulations March 2006 Addresses For action Chief Executives NHS Boards Director, Practitioner Services For information Chief Executive, NHS National Services Scotland Summary 1. This letter advises NHS Boards and Practitioner Services of: the introduction of the NHS (General Ophthalmic Services) (Scotland) Regulations 2006; the introduction of forms GOS(S) 6 Part 1 and Part 2; the introduction of forms GOS(S)6A Part 1 and Part 2; amendments to the NHS (Service Committees and Tribunal) (Scotland) Regulations 1992; and amendments to the NHS (Tribunal) (Scotland) Regulations 2004 Enquiries to: Senga Robertson Primary Care Division 1 st Floor East Rear St Andrew's House EDINBURGH EH1 3DG Tel: Fax: Éã~áäW= péåö~koçäéêíëçå]ëåçíä~åçköëáköçîkìâ= ÜííéWLLïïïKëÅçíä~åÇKÖçîKìâ which take effect from 1 April 2006.

2 Background NHS (GOS) (Scotland) Regulations 2006 ( The 2006 Regulations ). 2. The 2006 Regulations: consolidate the National Health Service (General Ophthalmic Services) (Scotland) Regulations 1986 and subsequent amending Regulations to these; extend the NHS Board ophthalmic list system to cover those opticians (i.e. optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners who assist with the provision of general ophthalmic services ( GOS ) as well as those who undertake to provide GOS by dividing ophthalmic lists into two parts the first part for ophthalmic contractors and the second for those who assist with GOS provision; extend the requirements with which those who apply to join an ophthalmic list and those whose names appear on these lists must comply in order to demonstrate their fitness to provide or assist with the provision of GOS in a Health Board s area; introduce a power for an NHS Board to suspend an optician or ophthalmic medical practitioner from its ophthalmic list in a limited range of circumstances; and make provision for the introduction of a new, tailored primary eye examination, which will include a sight test where necessary, to be delivered to patients under GOS, in place of the previous sight test. 3. Details of the new primary eye examination are contained in 2006 PCA(O)4. This letter focuses on explaining the expanded ophthalmic list system which aims to increase protection for patients and NHS resources. 4. Background information and guidance for NHS Boards is contained in Annex A to this letter. 5. The forms to be used by applicants to the first (GOS(S)6 Part 1) or second part (GOS(S)6 Part 2) of ophthalmic lists and the forms to be used by Boards to inform Practitioner Services and the Executive of list appointments, terminations or changes of status (GOS(S)6A Parts 1 and 2) are enclosed with this letter. 6. Determinations which provide for payments to ophthalmic contractors and optometrists and ophthalmic medical practitioners subject to suspension are enclosed as Appendix 2 to the Memorandum to this letter. NHS Discipline Committees - The NHS (Service Committee and Tribunal) (Scotland) Amendment Regulations The NHS (Service Committee and Tribunal) (Scotland) Regulations 1992 have been amended to bring those opticians and ophthalmic medical practitioners on the second part of ophthalmic lists within the jurisdiction of NHS Discipline Committees.

3 NHS Tribunal - The NHS (Tribunal) (Scotland) Amendment Regulations The NHS (Tribunal) (Scotland) Regulations 2004 have also been amended to bring those opticians and ophthalmic medical practitioners on the second part of ophthalmic lists within the jurisdiction of the NHS Tribunal. Additionally, these Regulations have been amended in consequence of changes to the NHS Tribunal regime introduced as a result of amendments made by the Smoking, Health and Social Care (Scotland) Act 2005 ( the 2005 Act ) to the NHS (Scotland) Act These include the introduction of an additional ground of unsuitability by reason of professional or personal conduct on which a Board may refer either a list applicant or a listed practitioner to the NHS Tribunal and a provision enabling a Board to refer list applicant to the Tribunal on efficiency grounds. (Currently, only listed practitioners may be referred on this ground.) 9. The sanction of local disqualification will no longer be available to the Tribunal on the principle that, in the interests of patients and of NHS resources, a practitioner who is not considered fit to be on a family health service list in one area should not be free to join the list in another area. The 2005 Act also removes the power of the Tribunal to make declarations of unfitness in respect of a disqualified person since it is the Executive s intention that no practitioner should be able to work in family health services in an area unless his or her name is on the relevant Health Board list. 10. The guidance on the Tribunal contained in Chapter 13 of FHS Disciplinary procedures a Guide for Health Boards and issued under cover of circular PCA(M)(1997)5 etc dated 14 February 1997 has been revised and a copy is enclosed with this letter for internal use by NHS Boards when deciding whether a Tribunal referral would be appropriate. Action 11. NHS Boards are asked to: 11.1 note the provisions in the new NHS (General Ophthalmic Services) (Scotland) Regulations 2006 as described in paragraph 2 above and in Annex A; 11.2 note the new forms GOS(S)6 Part 1 and Part 2 for applicants who wish to join the first or second part of an ophthalmic list and copy/forward these as required from 1 April for completion by applicants to their own ophthalmic list until they receive a printed supply (which has been ordered urgently) and destroy on that date remaining copies of the old GOS(S)6A; 11.3 note the new forms GOS(S)6A Part 1 and Part 2 to be used to inform Practitioner Services and SEHD of list appointments, terminations or changes of status and copy/use these as required from 1 April until they receive a printed supply (which has been ordered urgently) and destroy on that date remaining copies of the old GOS(S)6A; 11.4 note the arrangements set out in paragraph 6 of Annex A for dealing with applications where the applicant wishes to join more than one ophthalmic list;

4 11.5 note that it is for Boards to reimburse the fee for enhanced criminal record certificates required both by applicants and by those who are already listed at 1 April 2006; 11.6 ensure that they have adequate supplies of disclosure application forms to give list applicants and for the one-off exercise described at paragraph 9 of Annex A; 11.7 inform the Executive by 31 March of each financial year of the total amount reimbursed in respect of the above certificates; 11.8 request in writing from those opticians (i.e. optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners on the first part of their ophthalmic lists at 1 April the certificates, declarations and consents required by 30 June 2006 as a one-off exercise as described in paragraph 9 of Annex A; 11.9 note and authorise payments in accordance with the attached Determinations regarding payment to ophthalmic contractors or optometrists or ophthalmic medical practitioners subject to suspension by an NHS Board or the NHS Tribunal; note the amendments to the NHS (Service Committees and Tribunal) (Scotland) Regulations 1992 and to the NHS (Tribunal) (Scotland) Regulations 2004; and note the attached updated guidance on the NHS Tribunal, ensure that the guidance is forwarded to those Board officials dealing with Tribunal/Discipline cases to act in accordance with the guidance; 12. Practitioner Services are asked to note above and make any payments authorised by NHS Boards in accordance with the Determinations at Copies of the NHS (General Ophthalmic Services) (Scotland) Regulations 2006 will be sent to NHS Boards once they are available. NHS Boards are asked to send a copy of these to all opticians (optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners on their ophthalmic list. Copies of both the NHS (Service Committees and Tribunal) (Scotland) Amendment Regulations 2006 and the NHS (Tribunal) (Scotland) Amendment Regulations 2006 will be sent to NHS Boards once they are available. NHS Boards should make these available for inspection by opticians (optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners.

5 14. Copies of the Memorandum and Appendices 1 and 2 to the Memorandum only to this letter are being sent to Board Primary Care Leads for urgent distribution to all opticians (optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners on NHS Board lists. Yours sincerely DR JONATHAN PRYCE Head of Primary Care Division

6 ANNEX A to PCA(O)5 BACKGROUND AND GUIDANCE FOR NHS BOARDS ON THE NATIONAL HEALTH SERVICE (GENERAL OPHTHALMIC SERVCIES) (SCOTLAND) REGULATIONS 2006 ( The 2006 Regulations ) EXTENSION OF OPHTHALMIC LISTS TO OPTOMETRISTS AND OPHTHALMIC MEDICAL PRACTITIONERS WHO ASSIST WITH THE PROVISION OF GENERAL OPHTHALMIC SERVICES ( GOS ) Ophthalmic Lists 1. The ophthalmic list maintained by each NHS Board will be split into two parts from 1 April 2006, the first part listing opticians (i.e. optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners who undertake to provide GOS (i.e. those optometrists, ophthalmic bodies corporate and ophthalmic medical practitioners who provide GOS on a regular basis in a Board area from their own practices or by undertaking domiciliary visits or who are regularly employed or engaged to do so) and the second part listing those who assist with GOS provision (i.e. peripatetic locums). Those whose names feature on current ophthalmic lists at 31 March 2006 will transfer to the first part of these lists from 1 April Those optometrists and ophthalmic medical practitioners who assist with GOS provision and are currently unlisted will have 3 months i.e. until 30 June 2006 to join the second part of the list or lists for areas where they work. Those on the second part of ophthalmic lists will now come within the jurisdiction of NHS Discipline Committees and of the NHS Tribunal, in addition to those on the first part of these lists. 2. There will be terms of service for those on both parts of a Board ophthalmic list, including terms relating to the arrangements for the new eye examination. There will be more terms of service for those on the first part of an ophthalmic list than for those on the second part, including requirements as to accommodation, waiting areas and the provision of the 4 items of required equipment to enable eye examinations to be carried out. There will be terms of service common to those on both parts, such as undergoing the necessary training for providing the new NHS eye examination and maintaining proper, complete, accurate and up to date records in accordance with a dataset specified in Schedule 5 to the 2006 Regulations 2006 PCA(O)4 contains further details of the terms of service. Applications 3. There will be 2 application forms to be completed by applicants GOS(S)6 Part 1 for those wishing to join the first part of the list and GOS(S)6 Part 2 for those wishing to join the second part. The GOS(S)6A for notification to Practitioner Services and the Executive will also be replaced by 2 new forms GOS(S)6A Part1 and GOS(S)6A Part 2. Copies of these 4 forms are enclosed for Boards use from 1 April 2006 until a printed supply can be sent to them. Opticians and ophthalmic medical practitioners wishing to join a Board s ophthalmic list will need to provide more information, documents, declarations, consents and undertakings than was previously the case in support of a formal application for inclusion on either part of a Board s ophthalmic list and these are included in the application forms. One of the documents which must be supplied is an original enhanced criminal record certificate

7 from Disclosure Scotland. In the case of an ophthalmic body corporate, an enhanced criminal record certificate will be required in relation to each director or person controlling that body. It has been agreed that Boards will reimburse the cost of obtaining these certificates. An enhanced criminal record certificate application form should be forwarded to each list applicant, along with a GOS(S)6 Part 1 or Part 2. The applicant should return the completed list and enhanced disclosure application forms to the Board who will complete Part C of the disclosure application form and forward this to Disclosure Scotland. It should be noted that, when completing Part C, the Board must satisfy itself as to the identity of the applicant. A range of documents may be used for this, including a birth certificate or passport. (There is provision in the 2006 Regulations regulation 7(4) under which a Board may seek further information or documents from the applicant in order to determine his or her application.) On receipt of the enhanced criminal record certificate, the Board should reimburse the cost of the enhanced criminal record certificate to the address indicated by the applicant i.e. business or private. The Executive will make available funding to cover these costs. Boards are asked to notify SEHD, General Ophthalmic Services Branch, St Andrews House, Regent Road, Edinburgh EH1 3DG by 31 March of each financial year of the total reimbursement costs. The Executive will then arrange a transfer to each Board s unified budget. 4. A second document which must be supplied by all applicants, except for bodies corporate, is a training certificate in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields. Boards must receive original certificates, not photocopies, which should be returned to the applicant after verification. Deferment/Refusals of Entry/Removals 5. In considering any application, a Board must undertake checks to determine if the applicant meets the criteria to be included on its ophthalmic list. There are grounds specified in the 2006 Regulations for deferment, a power for an NHS Board to require further information from an applicant which he or she must provide and grounds on which a Board must refuse an application. There are similar grounds on which a Board will now be required to remove someone from its list. 6. The circumstances in which a Board must refuse list entry or must remove someone from its list are very limited (regulations 8 and 12 of the 2006 Regulations refer), with one linked directly to the Harold Shipman case i.e. where an applicant or listed optician/ophthalmic medical practitioner has been convicted of murder in the British islands. In such cases, there is a power of re-inclusion where an adverse finding is overturned on appeal. In all other cases where an NHS Board consider that an applicant should not be allowed to join its ophthalmic list or should no longer be named on this list, it may refer the case to the NHS Tribunal. Co-operation regarding applications to more than one Board 7. In order to keep bureaucracy to a minimum, an applicant who wishes to join the ophthalmic list of more than one Board will indicate in the application form the areas where he or she wishes to join the list. He or she will submit the application to one Board (usually for the area in which most of the applicant s general ophthalmic services work will be undertaken) who will obtain all the relevant information on its own behalf and on behalf of other Boards. When the Board which has obtained the information, documents etc has

8 completed checking these, it will forward copies of the application form and the accompanying information and documents to the other Boards for the areas where the applicant wishes to work, together with confirmation of whether or not it has allowed the applicant entry to its list. It will then be for the other Boards to decide on the basis of the application and information/documents that they are satisfied with the applicant s fitness to be listed and, where this is the case, allow the applicant entry onto their lists. Requirements with which those on ophthalmic lists must comply 8. From 1 April, there will be requirements with which those already on a list must comply. Amongst these will be successfully completing the required training to undertake the new eye examination, exercising a reasonable standard of professional and clinical judgement, behaviour, skill, knowledge and care towards their patients, complying with the terms of service, the same undertakings as list applicants, including informing the NHS Board within 7 days if there is any change in circumstance, and all other requirements of the Regulations. One-off Exercise 9. As a one-off exercise, those on the first part of a Board s ophthalmic list at 1 April 2006 will need to provide the declarations in Part C of Schedule 2 to the 2006 Regulations (Schedule 2 is at Appendix 1 to the Memorandum) to the Board by 30 June 2006, together with documents and written consent for the Board to make a request, where relevant, to NHS National Services Scotland, former and current employers or to regulatory/licensing/other bodies for information relating to any current investigations or any investigations where the outcome was adverse. Boards should initiate this from 1 April. There will be a power for Boards to extend the timescale in cases where it considers it is not practicable for the person concerned to provide the material by 30 June. The required documents are (a) a training certificate in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields; and (b) an enhanced criminal record certificate. As for list applicants i) in the case of an ophthalmic body corporate, an enhanced criminal record certificate will be required in relation to each director or person controlling that body; and ii) it has been agreed that Boards will reimburse the costs of these certificates. The Executive will make available funding to cover these costs. Boards are asked to notify SEHD, General Ophthalmic Services Branch, St Andrews House, Regent Road, Edinburgh EH1 3DG by 31 March of the total reimbursement costs. The Executive will then arrange a transfer to each Board s unified budget. Boards must receive original certificates which should be returned to the listed person after verification. Co-operation 10. The same co-operation by Boards will apply as for applications i.e. one Board (usually for the area where the person carries out most of his or her general ophthalmic services work) will request the declarations, certificates and consents and obtain all of the required information etc. That Board will copy the documents, declarations etc to the other relevant Boards and confirm in writing that it has checked the information etc provided and, where relevant, is content for the person to remain listed. It will then be for the remaining Boards to satisfy themselves that they are happy that the person is fit to continue to be listed on their ophthalmic list.

9 Students 11. The Regulations also make provision for students awaiting registration with the GOC and wishing to join ophthalmic lists to provide (no more than 4 and no less than 3 months before the person expects to be registered) the same consents, certificates, information, declarations and undertakings as other applicants, except for the certificate of training required to undertake eye examinations and the applicant s registration number and date of first registration, thus allowing the relevant Health Board to begin the required checks and speeding up the application process for those about to register with the GOC. The students must provide the training certificate and the remaining information as soon as possible after notification of admission to the GOC s register. Consents 12. The consents which will be required of list applicants and those opticians and ophthalmic medical practitioners who are already listed will allow the exchange of information between the NHS Board and specified bodies or persons. This will enable a Board to request, for example, information from a former employer or from a professional regulatory body such as the GOC or the GMC concerning an adverse finding or current proceedings to which the list applicant or listed optician or ophthalmic medical practitioner is subject. It will also enable the Board to notify, for example, a current employer or the GOC or GMC of its decision to refuse entry to a list applicant or to remove an optician or ophthalmic medical practitioner from its list. The full list of bodies to be notified of refusals of entry, removals and suspensions (see paragraph 14 below) are set out in regulation 14 of the 2006 Regulations. Each notification should contain the full name, private address (or registered address for a body corporate) and professional registration number. For the Scottish Ministers, the contact is John W Davidson, Scottish Executive Health Department, 1 East Rear, St Andrew s House. For the other UK Health Departments, notification should be sent to the General Ophthalmic Services Branch at the following addresses: Richmond House, Whitehall, London SW1A 2NS (Department of Health) Castle Buildings, Stormont, Belfast BT4 3SQ (Department of Health, Social Security and Public Safety) Cathays Park, Cardiff CF10 3NQ (Welsh Assembly Government) Power to impose conditions on provision or assistance with provision of GOS 13. NHS Boards will have a new power to impose conditions on the provision, or assistance with provision, of GOS in cases where an optician or ophthalmic medical practitioner wishes to be included on its ophthalmic list and he or she has had conditions relating to his or her inclusion on an ophthalmic list imposed already in England, Wales or Northern Ireland. The Board may modify the conditions as required to suit Scottish circumstances, provided the optician or ophthalmic medical practitioner concerned has been given an opportunity to make representations about these. Suspension by an NHS Board 14. There is also a new power for an NHS Board to suspend from its ophthalmic list an optician or ophthalmic medical practitioner named on either part of it where it is necessary to protect patients or it is otherwise in the public interest. There are a limited number of

10 grounds on which this power may be exercised while the Board awaits the findings of a court anywhere in the world/a professional regulatory or licensing body anywhere in the world/the NHS Tribunal; while it decides whether to refer the person to the NHS Tribunal, while it decides whether to remove the person from its ophthalmic list or where it has decided to remove the person from its list but before that decision take effect. This power does not replace the power of the NHS Tribunal to direct a suspension. It provides Boards with a choice of whether to suspend from its own list or make a Tribunal referral for suspension. 15. When deciding whether to suspend, it is important that NHS Boards are aware that no person should be treated less favourably because of their race, ethnic origin, sex, sexual orientation, religion, age, disability or political views than someone else would be treated in the same or similar circumstances. Boards are reminded that, in making decisions, or exercising statutory obligations or powers, it is good practice to always bear in mind the diverse nature of the practitioner community and patient populations and the consequent variations in practice, aspiration and need. In accordance with good practice, Boards will wish to ensure that they neither discriminate against practitioners nor face allegations that their procedures are discriminatory. It is important that Boards recognise that there is no excuse for imposing preferences, prejudices or to target the performance of individual practitioners purely because they fit a stereotype. 16. Opticians and ophthalmic medical practitioners subject to suspension by an NHS Board or by the Tribunal will be entitled to receive payment to reflect that the neutrality of the suspension. Copies of the relevant Determinations are at Appendix 2 to the Memorandum. SEHD March 2006

11 MEMORANDUM TO NHS: 2006 PCA(O)5 GENERAL OPHTHALMIC SERVICES 1. The NHS (General Ophthalmic Services) (Scotland) Regulations Replacement of Form GOS(S) 6 by Forms GOS(S)6 Part 1 and GOS(S)6 Part 2 3. Amendment of the NHS (Service Committees and Tribunal) Regulations Amendment of the NHS (Tribunal) (Scotland) Regulations This Memorandum advises optometrists, ophthalmic bodies corporate and ophthalmic medical practitioners of: the introduction of the NHS (General Ophthalmic Services) (Scotland) Regulations 2006; the introduction of forms GOS(S) 6 Part 1 and Part 2; amendments to the NHS (Service Committees and Tribunal) (Scotland) Regulations 1992; and amendments to the NHS (Tribunal) (Scotland) Regulations 2004 which take effect from 1 April Background NHS (GOS) (Scotland) Regulations 2006 ( The 2006 Regulations ). 2. The 2006 Regulations: consolidate the National Health Service (General Ophthalmic Services) (Scotland) Regulations 1986 and subsequent amending Regulations to these; extend the NHS Board ophthalmic list system to cover those opticians (i.e. optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners who assist with the provision of general ophthalmic services ( GOS ) as well as those who undertake to provide GOS by dividing ophthalmic lists into two parts the first part for ophthalmic contractors and the second for those who assist with GOS provision; extend the requirements with which those who apply to join an ophthalmic list and those whose names appear on these lists must comply in order to demonstrate their fitness to provide or assist with the provision of GOS in a Health Board s area; introduce a power for an NHS Board to suspend an optician or ophthalmic medical practitioner from its ophthalmic list in a limited range of circumstances; and

12 make provision for the introduction of a new, tailored primary eye examination, which will include a sight test where necessary, to be delivered to patients under GOS, in place of the previous sight test. 3. Details of the new primary eye examination are contained in 2006 PCA(O)4. This circular focuses on explaining the expanded ophthalmic list system which aims to increase protection for patients and NHS resources. Ophthalmic Lists 4. The ophthalmic list maintained by each NHS Board will be split into two parts from 1 April 2006, the first part listing opticians (i.e. optometrists and ophthalmic bodies corporate) and ophthalmic medical practitioners who undertake to provide GOS (i.e. those optometrists, ophthalmic bodies corporate and ophthalmic medical practitioners who provide GOS on a regular basis in a Board area from their own practices or by undertaking domiciliary visits or who are regularly employed or engaged to do so) and the second part listing those who assist with GOS provision (i.e. peripatetic locums). Those whose names feature on current ophthalmic lists at 31 March 2006 will transfer to the first part of these lists from 1 April Those optometrists and ophthalmic medical practitioners who assist with GOS provision and are currently unlisted will have 3 months i.e. until 30 June 2006 to join the second part of the list or lists for areas where they work. Those on the second part of ophthalmic lists will now come within the jurisdiction of NHS Discipline Committees and of the NHS Tribunal, in addition to those on the first part of these lists. 5. There will be terms of service for those on both parts of a Board ophthalmic list, including terms relating to the arrangements for the new eye examination. There will be more terms of service for those on the first part of an ophthalmic list than for those on the second part, including requirements as to accommodation, waiting areas and the provision of the 4 items of required equipment to enable eye examinations to be carried out. There will be terms of service common to those on both parts, such as undergoing the necessary training for providing the new NHS eye examination and maintaining proper, complete, accurate and up to date records in accordance with a dataset specified in Schedule 5 to the 2006 Regulations 2006 PCA(O)4 contains further details of the terms of service. Applications 6. There will be 2 application forms to be completed by applicants GOS(S)6 Part 1 for those wishing to join the first part of the list and GOS(S)6 Part 2 for those wishing to join the second part. Applicants should ask the Board for the appropriate form to be sent to him or her. Opticians and ophthalmic medical practitioners wishing to join a Board s ophthalmic list will need to provide more information, documents, declarations, consents and undertakings than was previously the case in support of a formal application for inclusion on either part of a Board s ophthalmic list and these are included in the application forms. One of the documents which must be supplied is an original enhanced criminal record certificate from Disclosure Scotland. In the case of an ophthalmic body corporate, an enhanced criminal record certificate will be required in relation to each director or person controlling that body. It has been agreed that Boards will reimburse the cost of obtaining these certificates. Each applicant will receive a disclosure application form, along with a GOS(S)6 Part 1 or

13 Part 2. Both forms should be completed (apart from Part C of the disclosure application form which will be completed by the Board) and forwarded to the Board, along with the fee for the enhanced criminal record certificate ( 20 at 1 April) and a document verifying his or her identity such as a birth certificate or passport. The Board will forward the application form to Disclosure Scotland and, on receipt of the certificate, will reimburse the applicant. 7. A second document which must be supplied by all applicants, except for bodies corporate, is a training certificate in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields. Boards must receive original certificates, not photocopies, which will be returned to the applicant in due course. Deferment/Refusals of Entry/Removals 8. In considering any application, a Board must undertake checks to determine if the applicant meets the criteria to be included on its ophthalmic list. There are grounds specified in the 2006 Regulations for deferment, a power for an NHS Board to require further information from an applicant which he or she must provide and grounds on which a Board must refuse an application. There are similar grounds on which a Board will now be required to remove someone from its list. 9. The circumstances in which a Board must refuse list entry or must remove someone from its list are very limited (regulations 8 and 12 of the 2006 Regulations refer), with one linked directly to the Harold Shipman case i.e. where an applicant or listed optician/ophthalmic medical practitioner has been convicted of murder in the British islands. In such cases, there is a power of re-inclusion where an adverse finding is overturned on appeal. In all other cases where an NHS Board consider that an applicant should not be allowed to join its ophthalmic list or should no longer be named on this list, it may refer the case to the NHS Tribunal. Co-operation regarding applications to more than one Board 10. In order to keep bureaucracy to a minimum, an applicant who wishes to join the ophthalmic list of more than one Board should indicate in the application form the areas where he or she wishes to join the list. He or she should submit the application to one Board (usually for the area in which most of the applicant s general ophthalmic services work will be undertaken) who will obtain all the relevant information on its own behalf and on behalf of other Boards. When the Board which has obtained the information, documents etc has completed checking these, it will forward copies of the application form and the accompanying information and documents to the other Boards for the areas where the applicant wishes to work, together with confirmation of whether or not it has allowed the applicant entry to its list. It will then be for the other Boards to decide on the basis of the application and information/documents that they are satisfied with the applicant s fitness to be listed and, where this is the case, allow the applicant entry onto their lists. Requirements with which those on ophthalmic lists must comply 11. From 1 April, there will be requirements with which those already on a list must comply. Amongst these will be successfully completing the required training to

14 undertake the new eye examination, exercising a reasonable standard of professional and clinical judgement, behaviour, skill, knowledge and care towards their patients, complying with the terms of service, the same undertakings as list applicants, including informing the NHS Board within 7 days if there is any change in circumstance, and all other requirements of the Regulations. One-off Exercise 12. As a one-off exercise, those on the first part of a Board s ophthalmic list at 1 April 2006 will need to provide the declarations in Part C of Schedule 2 to the 2006 Regulations (see Appendix 1 to this Memorandum) to the Board by 30 June 2006, together with documents and written consent for the Board to make a request, where relevant, to NHS National Services Scotland, former and current employers or to regulatory/licensing/other bodies for information relating to any current investigations or any investigations where the outcome was adverse. There will be a power for Boards to extend the timescale in cases where it considers it is not practicable for the person concerned to provide the material by 30 June. The required documents are (a) a training certificate in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields; and (b) an enhanced criminal record certificate. As for list applicants i) in the case of an ophthalmic body corporate, an enhanced criminal record certificate will be required in relation to each director or person controlling that body; and ii) it has been agreed that Boards will reimburse the costs of these certificates. Boards must receive original certificates which will be returned to the listed person in due course. Co-operation 13. The same co-operation by Boards will apply as for applications i.e. one Board (usually for the area where the person carries out most of his or her general ophthalmic services work) will request the declarations, certificates and consents and obtain all of the required information etc. That Board will copy the documents, declarations etc to the other relevant Boards and confirm in writing that it has checked the information etc provided and, where relevant, is content for the person to remain listed. It will then be for the remaining Boards to satisfy themselves that they are happy that the person is fit to continue to be listed on their ophthalmic list. Students 14. The Regulations also make provision for students awaiting registration with the GOC and wishing to join ophthalmic lists to provide (no more than 4 and no less than 3 months before the person expects to be registered) the same consents, certificates, information, declarations and undertakings as other applicants, except for the certificate of training required to undertake eye examinations and the applicant s registration number and date of first registration, thus allowing the relevant Health Board to begin the required checks and speeding up the application process for those about to register with the GOC. The students must provide the training certificate and the remaining information as soon as possible after notification of admission to the GOC s register. Consents

15 15. The consents which will be required of list applicants and those opticians and ophthalmic medical practitioners who are already listed will allow the exchange of information between the NHS Board and specified bodies or persons. This will enable a Board to request, for example, information from a former employer or from a professional regulatory body such as the GOC or the GMC concerning an adverse finding or current proceedings to which the list applicant or listed optician or ophthalmic medical practitioner is subject. It will also enable the Board to notify, for example, a current employer or the GOC or GMC of its decision to refuse entry to a list applicant or to remove an optician or ophthalmic medical practitioner from its list. The full list of bodies to be notified of refusals of entry, removals and suspensions are set out in regulation 14 of the 2006 Regulations. Power to impose conditions on provision or assistance with provision of GOS 16. NHS Boards will have a new power to impose conditions on the provision, or assistance with provision, of GOS in cases where an optician or ophthalmic medical practitioner wishes to be included on its ophthalmic list and he or she has had conditions relating to his or her inclusion on an ophthalmic list imposed already in England, Wales or Northern Ireland. The Board may modify the conditions as required to suit Scottish circumstances, provided the optician or ophthalmic medical practitioner concerned has been given an opportunity to make representations about these. Suspension by an NHS Board 17. There is also a new power for an NHS Board to suspend from its ophthalmic list an optician or ophthalmic medical practitioner named on either part of it where it is necessary to protect patients or it is otherwise in the public interest. There are a limited number of grounds on which this power may be exercised while the Board awaits the findings of a court anywhere in the world/a professional regulatory or licensing body anywhere in the world/the NHS Tribunal; while it decides whether to refer the person to the NHS Tribunal, while it decides whether to remove the person from its ophthalmic list or where it has decided to remove the person from its list but before that decision take effect. This power does not replace the power of the NHS Tribunal to direct a suspension. It provides Boards with a choice of whether to suspend from its own list or make a Tribunal referral for suspension. 18. Opticians and ophthalmic medical practitioners subject to suspension by an NHS Board or by the Tribunal will be entitled to receive payment to reflect that the neutrality of the suspension. Copies of the relevant Determinations are at Appendix 2 to this Memorandum. NHS Discipline Committees 19. The NHS (Service Committee and Tribunal) (Scotland) Regulations 1992 have been amended to bring those optometrists and ophthalmic medical practitioners on the second part of ophthalmic lists within the jurisdiction of NHS Discipline Committees. NHS Tribunal

16 20. The NHS (Tribunal) (Scotland) Regulations 2004 have also been amended to bring those optometrists and ophthalmic medical practitioners on the second part of ophthalmic lists within the jurisdiction of the NHS Tribunal. Additionally, they have been amended in consequence of changes to the NHS Tribunal regime introduced as a result of amendments made by the Smoking, Health and Social Care (Scotland) Act 2005 ( the 2005 Act ) to the NHS (Scotland) Act These include the introduction of an additional ground of unsuitability by reason of professional or personal conduct on which a Board may refer either a list applicant or a listed practitioner to the NHS Tribunal and a provision enabling a Board to refer list applicant to the Tribunal on efficiency grounds. (Currently, only listed practitioners may be referred on this ground.) 21. The sanction of local disqualification will no longer be available to the Tribunal on the principle that, in the interests of patients and of NHS resources, a practitioner who is not considered fit to be on a family health service list in one area should not be free to join the list in another area. The 2005 Act also removes the power of the Tribunal to make declarations of unfitness in respect of a disqualified person since it is the Executive s intention that no practitioner should be able to work in family health services in an area unless his or her name is on the relevant Health Board list. 22. A copy of the NHS (General Ophthalmic Services) (Scotland) Regulations will be sent once they are available. 23. Any enquiries arising out of this Memorandum should be taken up with your NHS Board. SCOTTISH EXECUTIVE HEALTH DEPARTMENT March 2006

17 APPENDIX 1 TO MEMORANDUM PCA(O)5 SCHEDULE 2 Regulation 7 and 26(1) PART A INFORMATION, CERTIFICATES, CONSENTS, DECLARATIONS AND UNDERTAKINGS TO BE INCLUDED IN AN APPLICATION FOR INCLUSION IN THE FIRST PART OF THE OPHTHALMIC LIST 1. An application shall contain the following information: (a) the applicant s full name, sex, date of birth and private address and telephone number; (b) a full description of the applicant s qualifications including the institution which awarded them; (c) the applicant s professional registration number and date of first registration; (d) whether the applicant is an ophthalmic medical practitioner, a registered optometrist or a body corporate; (e) address of proposed premises and, in the case of any mobile practice, the address to which correspondence may be sent and the addresses of any day centres and residential centres to be visited more than once; (f) whether the premises may be reached without use of stairs; (g) whether the premises have wheelchair access; (h) proposed days and hours of attendance at these premises and, in the case of any mobile practice, the month in which visits are intended to take place and the planned interval between such visits; (i) the name of each ophthalmic medical practitioner or optician who is regularly engaged as a deputy, director or employee in the provision of general ophthalmic services; (j) chronological details of the applicant s professional experience (including the starting and finishing dates of each appointment together with explanation of any gaps between appointments) with any additional supporting particulars, and an explanation of why the applicant was dismissed from any post; (k) details of any list or equivalent list from which the applicant has ever been disqualified, conditionally disqualified, removed, suspended, contingently removed or suspended or to which admission was refused or conditionally granted together with reasons for such disqualification, conditional disqualification, removal, suspension or refusal; (l) name and addresses of two referees who are willing to provide clinical references relating to two recent posts as an ophthalmic medical practitioner or optometrist each of which lasted at least 3 months without a significant break and which may include a current post, or, where this is not possible a full explanation and name and address of an alternative referee or referees; (m) if the applicant is a national of an EEA state, evidence that the applicant has a knowledge of English which, in the interests of the applicant and of patients who may receive general ophthalmic services from the applicant, is necessary for providing general ophthalmic services;

18 (n) if the applicant is the director or one of the persons with control of a corporate body, the name and registered office of that body; (o) if the applicant is, or has been where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud; (p) whether the applicant has (i) had sequestration of the applicant s estate awarded, or been adjudged bankrupt; (ii) been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986(1); (iii) made a composition or arrangement with, or granted a trust deed for, the applicant s creditors; (q) where the applicant is a body corporate, whether (i) an administrator, administrative receiver or receiver has been appointed in respect of it; or (ii) an administration order has been made in respect of it under Schedule B1 to the Insolvency Act 1986; or (iii) it has been wound up under Part IV of the Insolvency Act 1986; or (r) whether the applicant is subject to a disqualification order under the Company Directors Disqualification Act 1986(2), the Companies (Northern Ireland) Order 1986(3) or to an order made under section 429(2)(b) of the Insolvency Act 1986(4) (failure to pay under county court administration order). 2. An application shall contain the following declarations as to whether or not the applicant: (a) has been convicted of a criminal offence in the British Islands or has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands; (b) is currently the subject of any proceedings anywhere in the world which might lead to a conviction specified in sub-paragraph (a); (c) has in summary proceedings in respect of an offence, been the subject of an order discharging the applicant absolutely (without proceeding to conviction); (d) has accepted and agreed to pay either a procurator fiscal fine under section 302 of the Criminal Procedure (Scotland) Act 1995(5) or a penalty under section 115A of the Social Security Administration Act 1992(6); (e) has accepted a police caution in the British Islands; (f) has been bound over following a criminal conviction in the British Islands; (g) has been subject to any investigation into the applicant s professional conduct by any licensing, regulatory or other body anywhere in the world where the outcome was adverse; (h) is currently subject to any investigation into the applicant s professional conduct by any licensing, regulatory or other body anywhere in the world; (i) is the subject of any investigation or proceedings by another Health Board or equivalent body which might result in the applicant being disqualified, conditionally disqualified, refused entry, granted entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list; (j) is, or has been, where the outcome was adverse, the subject of any investigation into the applicant s professional conduct in respect of any previous or current employment; (1) 1986 c.45. (2) 1986 c.46 as amended by the Insolvency Act 2000 (2000 c.39). (3) S.I. 1986/1032 (N.1.6). (4) 1986 c.45. (5) 1995 c.46. (6) 1992 c.5;. section 115A was inserted by section 15 of the Social Security Administration (Fraud) Act 1997 (c.47).

19 (k) is, or has in the preceding 6 months been, or was at the time of the events that gave rise to conviction, proceedings or investigation, a director or one of the body of persons with control of a body corporate, or a member of a partnership (including a limited liability partnership) which (i) has been convicted of a criminal offence in the British Islands; (ii) has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands; (iii) is currently the subject of any proceeding anywhere in the world which might lead to such a conviction; (iv) has been subject to any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world; or (v) is, to the applicant s knowledge, or has been, where the outcome was adverse, the subject of any investigation by the Agency in relation to fraud; (l) has had sequestration of the applicant s estate awarded or been adjudged bankrupt; (m) has been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986; (n) has made a composition or arrangement with, or granted a trust deed for, the applicant s creditors; (o) if a body corporate (aa) has had an administrator, administrative receiver or receiver appointed in respect of it; or (bb) has had an administration order made in respect of it under Schedule B1 to the Insolvency Act 1986; (cc) has been wound up under Part IV of the Insolvency Act 1986; (p) is subject to a disqualification order under the Company Directors Disqualification Act 1986, the Companies (Northern Ireland) Order 1986 or to an order made under section 429(2)(b) of the Insolvency Act 1986 (failure to pay under county court administration order). 3. An applicant must include: (a) an enhanced criminal record certificate in relation to himself or herself or, where the applicant is a body corporate carrying on business as an optometrist, in relation to each director or person controlling that body corporate, dated not earlier than 28 days before the date of the application, and (b) except in the case of a body corporate carrying on business as an optometrist, a certificate from a provider of training approved by NHS Education for Scotland that the applicant has satisfactorily completed a course of training in the use of slit lamp biomicroscopy, condensing lens biomicroscopy, applanation tonometry and threshold visual fields. 4. An application shall include the following undertakings: (a) the applicant will participate in appropriate and relevant NHS audit procedures; (b) that applicant will be bound by the terms of service; (c) that the applicant will notify the Board in writing within 7 days of its occurrence if the applicant (i) is charged in the British Islands with a criminal offence, the sentence for which could be a term of imprisonment or is charged elsewhere with an offence which, if committed in the British Islands would constitute such a criminal offence; (ii) is convicted of a criminal offence in the British Islands or is convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;