Regulation 13 Payments during suspension

England and Wales

F1(A1)

A Practitioner may apply to F2NHS England before the end of the period of 90 days beginning with the date on which a decision to suspend them was made under regulation 12 (suspension) for payments during the period of suspension.

(1)

During a period of suspension under regulation 12, payments may be made by NHS England toF3... a Practitioner in accordance with a determination by the Secretary of State F4where the Practitioner has made an application in accordance with paragraph (A1).

(2)

If such a payment is made but the Practitioner was not entitled to receive all or any part of it, the amount to which the Practitioner was not entitled (“the overpayment”) may be recovered by NHS England as a civil debt.

(3)

Where requested by a Practitioner to do so, NHS England is to reconsider any decision—

(a)

to refuse to make a payment to, or in respect of, the Practitioner under paragraph (1);

(b)

as to the amount of a payment to, or in respect of, the Practitioner under paragraph (1); or

(c)

in respect of recovery of what NHS England considers to be an overpayment under paragraph (2).

F5(3A)

A request by the Practitioner under paragraph (3) must be made before the end of the period of 28 days beginning with the day on which the decision was notified to the Practitioner.

(4)

Following the reconsideration of such a decision NHS England is to notify the Practitioner in writing of the outcome of its reconsideration (“the reconsidered decision”) together with the reasons for it.

(5)

Following notification of the reconsidered decision, the Practitioner may, within a period of 28 days beginning on the day on which the Practitioner is notified of that reconsidered decision, give the Secretary of State a notice of appeal.

(6)

A notice of appeal under paragraph (5) must include—

(a)

the name and address of the Practitioner;

(b)

a contact name and address to be used by NHS England for the purposes of the appeal;

(c)

a copy of the reconsidered decision; and

(d)

a brief statement of the grounds for appeal.

(7)

The Secretary of State must thereafter send a written request to the Practitioner and NHS England (“the parties”) to make, in writing and within a specified period, any representations they may wish to make about the matter: the request to NHS England is to include a copy of the Practitioner's brief statement of the grounds for appeal.

(8)

Once the period specified pursuant to paragraph (7) has elapsed, the Secretary of State is to—

(a)

give a copy of any representations received from each party to the other party; and

(b)

request that each party make any written observations which that party wishes to make on the representations of the other party.

(9)

The Secretary of State is to, as soon as is reasonably practicable, having taken into account any such representations or observations as referred to in paragraphs (7) and (8) and such other evidence as the Secretary of State sees fit—

(a)

decide the appeal, and notify the parties of its decision and the reasons for it; and

(b)

give NHS England such directions in writing, if any, on the matter as the Secretary of State thinks fit.

Annotations

Textual amendments

F1: Reg. 13(A1) inserted (18.9.2023) by The National Health Service (Performers Lists) (England) (Amendment) (No. 2) Regulations 2023 (S.I. 2023/828), regs. 1(1), 11(a)
F2: Words in Instrument substituted (6.11.2023) by The Health and Care Act 2022 (Further Consequential Amendments) (No. 2) Regulations 2023 (S.I. 2023/1071), reg. 1(1), Sch. para. 1
F3: Words in reg. 13(1) omitted (18.9.2023) by virtue of The National Health Service (Performers Lists) (England) (Amendment) (No. 2) Regulations 2023 (S.I. 2023/828), regs. 1(1), 11(b)(i)
F4: Words in reg. 13(1) inserted (18.9.2023) by The National Health Service (Performers Lists) (England) (Amendment) (No. 2) Regulations 2023 (S.I. 2023/828), regs. 1(1), 11(b)(ii)
F5: Reg. 13(3A) inserted (18.9.2023) by The National Health Service (Performers Lists) (England) (Amendment) (No. 2) Regulations 2023 (S.I. 2023/828), regs. 1(1), 11(c)