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Will we continue to be paid for seeing non-registered patients?

Q: Under the old contract we have over the years provided contraceptive services to some patients who are not registered with us and we have been paid by the PCO for doing so.

Some practices have also provided maternity services and child health surveillance on this basis in the past. Clauses 59-61 in the standard contract set out a requirement to continue to offer these services (unless the practice chooses to opt out) for all patients. This is so that patients do not have to change the practitioner who was providing these services just because of the new contract arrangements.

It appears I have an open-ended obligation to non-registered patients and will not be paid for providing the service.

Is this correct?

A: Paragraph 24 of The General Medical Services Transitional and Consequential Provisions Order 2004 – Statutory Instrument 2004 No 433 sets out in detail the services to patients not registered with the contractor in default contracts and GMS contracts entered into on or before March 31, 2004.

It specifies that when the default or new GMS contract is signed it must require the contractor to provide those additional services to non-registered patients who had been receiving them.

This does not apply if the practice has already opted out of providing these additional services for registered patients, and the practice may subsequently choose to opt out of providing those additional services for all patients under regulation 17.

The contractor may also terminate this responsibility for a non-registered patient under paragraph 28 of schedule 6 to the 2004 regulations (or the equivalent term of a default contract).

Our understanding is that if the practice chooses to continue providing this service to non-registered patients, the GP would have to make a separate claim for payment.

However, at present there are technical difficulties in doing so and some considerable uncertainty about exactly how the system will work.

The GPC has, however, confirmed that GPs should be paid for additional services to non-registered patients under the new contract.

Dr Christine Dewbury, Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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