A type of health care arrangement by which a health care provider may provide patient care services in circumstances when they do not have a health care contract with an organisation as commissioner.
The circumstances that are likely to apply are:
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a) |
No health care contract in force to cover the service at time of referral or at time the patient presents without referral. i. Eligible overseas visitor ii. Anyone other than an eligible overseas visitor: A) Arrangement agreed with commissioner during or after treatment. (Occurs where there is no time to agree arrangement prior to treatment because of the patient's condition.) B) Arrangement agreed with commissioner prior to treatment C) Having been referred to a consultant by another consultant, arrangement not agreed with Commissioner prior to treatment iii. Referral of pathology specimens by a consultant for a second opinion or extra tests. |
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b) |
Health care contract in force to cover the required service at the time of referral that is no longer applicable in a particular case before treatment. Arrangement then made with commissioner, if possible, prior to treatment. |
Eligible overseas visitors will be treated with the National Assembly as commissioner, under Sections 3(8) and 20, schedule 2 part III of the NHS and Community Care Act 1990 and NHS (Charges to Overseas Visitors) Regulations 1989 (SI 1989 No 306).
In other cases the arrangement will be agreed with the commissioning organisation prior to treatment commencing unless the condition of the patient is such that this is not practicable, in which case the treatment will be arranged and subsequent payment required under the provisions of the National Health Service and Community Care Act 1990, Sections 3(5) and 3(6) and paragraph 19 of schedule 2.