OpenLegislation

Regulation 15 Criteria for a decision on removal

England and Wales

(1)

Where F1NHS England is considering whether to remove a Practitioner from a performers list under regulation 14(3)(d) (an unsuitability case), it is to consider—

(a)

any information relating to that Practitioner which it has received pursuant to regulation 9;

(b)

any information held by the NHSLA about past or current investigations or proceedings involving or relating to that Practitioner, which information the NHSLA must supply if NHS England so requests; and

(c)

the matters set out in paragraph (2).

(2)

Those matters are—

(a)

the nature of any event which gives rise to a question as to the suitability of the Practitioner to be included in the performers list;

(b)

the length of time since the event and the facts which gave rise to it occurred;

(c)

any action taken or penalty imposed by any regulatory or other body (including the police or the courts) as a result of the event;

(d)

the relevance of the event to the Practitioner's performance of the services which those included in the relevant performers list perform, and any likely risk to any patients or to public finances;

(e)

whether any offence was a sexual offence for the purposes of Part 2 of the Sexual Offences Act 2003 (notification and orders) M1, or if it had been committed in England and Wales, would have been such an offence;

(f)

whether, in respect of any list, the Practitioner—

(i)

was refused inclusion in it,

(ii)

was included in it subject to conditions,

(iii)

was removed from it, or

(iv)

is currently suspended from it,

and, if so, the facts relating to the event which led to such action and the reasons given for such action by the holder of the list; and

(g)

whether, in respect of any list, the Practitioner was, at the time of the originating event or in the six months preceding that event, a director of a body corporate which—

(i)

was refused inclusion in it,

(ii)

was included in it subject to conditions,

(iii)

was removed from it, or

(iv)

is currently suspended from it,

and, if so, the facts relating to that event and the reasons given for such action by the holder of the list.

(3)

Where NHS England is considering whether to remove a Practitioner from a performers list under regulation 14(3)(c) (a fraud case) it is to consider—

(a)

any information relating to that Practitioner which it has received under regulation 9;

(b)

any information held by the NHSLA about past or current investigations or proceedings involving or relating to that Practitioner, which information the NHSLA must supply if NHS England so requests;

(c)

any information held by the F2NHS Counter Fraud Authority about past or current investigations or proceedings involving or relating to that Practitioner, which information that Authority must supply if NHS England so requests; and

(d)

the matters set out in paragraph (4).

(4)

Those matters are—

(a)

the nature of any incident of fraud;

(b)

the length of time since the last incident of fraud occurred, and since any investigation into it was concluded;

(c)

any action taken by any regulatory or other body (including the police or the courts) as a result of the incident;

(d)

the relevance of any investigation into any incident of fraud to the Practitioner's performance of the services which those included in the relevant performers list perform, and the likely risk to patients or to public finances;

(e)

whether, in respect of any list, the Practitioner—

(i)

was refused inclusion in it,

(ii)

was included in it subject to conditions,

(iii)

was removed from it, or

(iv)

is currently suspended from it,

and, if so, the facts relating to the incident which led to such action and the reasons given for such action by the holder of the list; and

(f)

whether, in respect of any list, the Practitioner was at the time of the originating event or in the six months preceding that event, a director of a body corporate, which—

(i)

was refused inclusion in it,

(ii)

was included in it subject to conditions,

(iii)

was removed from it, or

(iv)

is currently suspended from it,

and, if so, the facts relating to that event and the reasons given for such action by the holder of the list.

(5)

Where NHS England is considering whether to remove a Practitioner from a performers list under regulation 14(3)(b) (an efficiency case), it must consider—

(a)

any information relating to that Practitioner which it has received under regulation 9;

(b)

any information held by the NHSLA about past or current investigations or proceedings involving or relating to that Practitioner, which information the NHSLA must supply if NHS England so requests; and

(c)

the matters referred to in paragraph (6).

(6)

Those matters are—

(a)

the nature of any incident which was prejudicial to the efficiency of the services which the Practitioner performed;

(b)

the length of time since the last incident occurred and since any investigation into it was concluded;

(c)

any action taken by any regulatory or other body (including the police or courts) as a result of any such incident;

(d)

the relevance of the incident to the Practitioner's performance of the services which those included in the relevant performers list perform, and the likely risk to patients or to public finances;

(e)

whether the Practitioner has ever failed to comply with a request to undertake an assessment by the NCAA on or before 31st March 2005, by the NPSA between 1st April 2005 and 31st March 2012 inclusive, by the NICE between 1st April 2012 and 31st March 2013 inclusive, or thereafter by the NHSLA;

(f)

whether the Practitioner has previously failed to supply information, make a declaration or comply with an undertaking required on inclusion in a performers list;

(g)

whether, in respect of any list, the Practitioner—

(i)

was refused inclusion in it,

(ii)

was included in it subject to conditions,

(iii)

was removed from it, or

(iv)

is currently suspended from it,

and, if so, the facts relating to the incident which led to such action and the reasons given for such action by the holder of the list; and

(h)

whether, in respect of any list, the Practitioner was at the time of the originating event or in the six months preceding that event, a director of a body corporate, which —

(i)

was refused inclusion in it,

(ii)

was included in it subject to conditions,

(iii)

was removed from it, or

(iv)

is currently suspended from it,

and, if so, the facts relating to that event and the reasons given for such action by the holder of the list.

Annotations

Textual amendments

F1

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

F2

Words in reg. 15(3)(c) substituted (1.11.2017) by The NHS Counter Fraud Authority (Investigatory Powers and Other Miscellaneous Amendments) Order 2017 (S.I. 2017/960), arts. 1(1), 4(4)(f)

Marginal citations

M1

2003 c. 42.