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Annex E
Criteria that must be considered by the HA in discretionary decision making
as extracted from the regulations.
NHS (GMS) Regulations (Reg 7B & Reg 18E(3))
NHS (GMS Supplementary List Regulations (Reg 6(4) & Reg 11)
1. When considering applications for admission the Health Authority must
consider the following criteria before making any discretionary decisions to
refuse to admit or conditionally include a doctor in its lists:-
i. the nature of any offence, investigation or incident;
ii. the length of time since such offence or incident was committed and since
any conviction or investigation;
iii. whether there are other offences, incidents or investigations to be
considered;
iv. any action or penalty imposed by any licensing, regulatory or other body
(which includes any NHS organisation), the police or the courts as a result of
any such offence, incident or investigation;
v. the relevance of any offence, investigation or incident to the provision by
him of general medical services and any likely risk to his patients or to public
finances;
vi. whether any offence was a sexual offence to which Part I of the Sexual
Offences Act 1997 applies (see Annex B);
vii. whether he has been refused admission to or conditionally included in,
removed, contingently removed, or is currently suspended from any of a Health
Authority's lists or from equivalent list (in Wales, Scotland or NI), and if so,
what the facts were in those cases and the reasons given by the Health Authority
or equivalent body involved; and
viii. whether he was at the time, has in the preceding six months been, or was
at the time of the originating events a director of a body corporate which was
refused admittance to, conditionally included, removed or contingently removed
from other Health Authority lists or equivalent lists (in Wales, Scotland or
NI), or is currently suspended from such lists, and if so, what the facts were
in those cases and what were the reasons given by the Health Authority or
equivalent body in the case.
2. When considering the removal or contingent removal of a doctor on
discretionary efficiency grounds the Health Authority must, in respect of the
information it is relying on, consider:-
i. whether it was prejudicial to the efficiency of the general medical
services provided by the doctor;
ii. the length of time since any incident occurred, and since the investigation
was concluded;
iii. any action taken by any licensing, regulatory or other body, the police or
the courts as a result of any such incident;
iv. the nature of the incident and whether there is a likely risk to patients;
v. whether the doctor has ever failed to comply with a request by the Health
Authority to undertake an assessment by the NCAA;
vi. whether the doctor has previously failed to make a declaration or comply
with an undertaking required by these Regulations ;
vii. whether the doctor has been refused admittance to, conditionally included,
removed, contingently removed or is currently suspended from other Health
Authority lists or equivalent lists (in Wales, Scotland and NI), and if so, what
the facts were in those cases and what were the reasons given by the Health
Authority or equivalent body in the case;
viii. whether he was at the time, has in the preceding six months been, or was
at the time of the originating events a director of a body corporate which was
refused admittance to, conditionally included, removed or contingently removed
from other Health Authority lists or equivalent lists (in Wales, Scotland and
NI), or is currently suspended from such lists, and if so, what the facts were
in those cases and what were the reasons given by the Health Authority or
equivalent body in the case.
3. When considering the removal or contingent removal of a doctor on
discretionary fraud grounds the Health Authority must, in respect of the
information it is relying on, consider:-
i. the nature of the incidents of fraud;
ii. the length of time since any incident occurred, and since the investigation
was concluded;
iii. whether there are other incidents of fraud or other criminal offences to be
considered;
iv. any action taken by any licensing, regulatory or other body, the police or
the courts as a result of any such incident;
v. the relevance of the investigation to the provision by him of general medical
services and the likely risk to patients or to public finances;
vi. whether the doctor has been refused admittance to, conditionally included,
removed, contingently removed or is currently suspended from other Health
Authority lists or equivalent lists (in Wales, Scotland and NI), and if so, what
the facts were in those cases and what were the reasons given by the Health
Authority or equivalent body in the case;
vii. whether he was at the time, has in the preceding six months been, or was at
the time of the originating events a director of a body corporate which was
refused admittance to, conditionally included, removed or contingently removed
from other Health Authority lists or equivalent lists (in Wales, Scotland and
NI), or is currently suspended from such lists, and if so, what the facts were
in those cases and what were the reasons given by the Health Authority or
equivalent body in the case.
4. When considering the removal or contingent removal of a doctor on
discretionary unsuitability grounds the Health Authority must, in respect of the
information it is relying on, consider:-
i. the nature of any criminal offence, investigation or incident ;
ii. the length of time since any such offence or incident was committed, and
since any criminal conviction or investigation ;
iii. whether there are other criminal offences to be considered;
iv. the penalty imposed on any criminal conviction or the outcome of any
investigation ;
v. the relevance of any criminal offence, or investigation into professional
conduct, on the provision by the doctor of general medical services and the
likely risk to patients;
vi. whether any criminal offence was a sexual offence to which Part I of the
Sexual Offences Act 1997 (see Annex B) applies;
vii. whether the doctor has been refused admittance to, conditionally included,
removed, contingently removed or is currently suspended from other Health
Authority lists or equivalent lists (in Wales, Scotland and NI), and if so, what
the facts were in those cases and what were the reasons given by the Health
Authority or equivalent body in the case; and
viii. whether he was at the time, has in the preceding six months been, or was
at the time of the originating events a director of a body corporate which was
refused admittance to, conditionally included, removed or contingently removed
from other Health Authority lists or equivalent lists (in Wales, Scotland and
NI), or is currently suspended from such lists, and if so, what the facts were
in those cases and what were the reasons given by the Health Authority or
equivalent body in the case.
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